Effect of Anesthesia on Microelectrode Recordings during Deep Brain Stimulation Surgery in Tourette Syndrome Patients
| Autor: | Ana Maria Alzate Sanchez, Anouk Y.J.M. Smeets, Michael J Bos, Anthony Absalom, Mark Roberts, Raffaella Bancone, Wolfgang Buhre, Marcus L.F. Janssen, Linda Ackermans |
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| Přispěvatelé: | MUMC+: MA Anesthesiologie (9), MUMC+: MA AIOS Neurochirurgie (9), RS: MHeNs - R3 - Neuroscience, Neurochirurgie, MUMC+: MA Med Staf Spec Neurochirurgie (9), Anesthesiologie, Perception, RS: FPN CN 3, MUMC+: HZC Med Staf Spec Klinische Neurofys (9), Klinische Neurowetenschappen, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Deep brain stimulation Tics Sedation medicine.medical_treatment Remifentanil Globus Pallidus Tourette syndrome 030218 nuclear medicine & medical imaging Microelectrode recordings 03 medical and health sciences GABA 0302 clinical medicine medicine MANAGEMENT Humans Anesthesia Dexmedetomidine NEURONS Anesthetics DISCHARGE GLOBUS-PALLIDUS SUBTHALAMIC NUCLEUS business.industry Middle Aged medicine.disease Internal globus pallidus Electrodes Implanted RECEPTORS DEXMEDETOMIDINE Anesthetic Clinical Study Midazolam EXPERIENCE Surgery Female Neurology (clinical) IMPLANTATION medicine.symptom business Microelectrodes 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Stereotactic and Functional Neurosurgery, 97(4), 225-231. S. Karger AG Stereotactic and functional neurosurgery, 97(4), 225-231. S. Karger AG |
| ISSN: | 1011-6125 |
| Popis: | Background: Deep brain stimulation (DBS) is an accepted treatment for patients with medication-resistant Tourette syndrome (TS). Sedation is commonly required during electrode implantation to attenuate anxiety, pain, and severe tics. Anesthetic agents potentially impair the quality of microelectrode recordings (MER). Little is known about the effect of these anesthetics on MER in patients with TS. We describe our experience with different sedative regimens on MER and tic severity in patients with TS. Methods: The clinical records of all TS patients who underwent DBS surgery between 2010 and 2018 were reviewed. Demographic data, stimulation targets, anesthetic agents, perioperative complications, and MER from each hemisphere were collected and analyzed. Single-unit activity was identified by filtering spiking activity from broadband MER data and principal component analysis with K-means clustering. Vocal and motor tics which caused artifacts in the MER data were manually selected using visual and auditory inspection. Results: Six patients underwent bilateral DBS electrode implantation. In all patients, the target was the anterior internal globus pallidus. Patient comfort and hemodynamic and respiratory stability were maintained with conscious sedation with one or more of the following anesthetic drugs: propofol, midazolam, remifentanil, clonidine, and dexmedetomidine. Good quality MER and clinical testing were obtained in 9 hemispheres of 6 patients. In 3 patients, MER quality was poor on one side. Conclusion: Cautiously applied sedative drugs can provide patient comfort, hemodynamic and respiratory stability, and suppress severe tics, with minimal interference with MER. |
| Databáze: | OpenAIRE |
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