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- Title
Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson's Disease Patients under Inhalational Anesthesia.
- Authors
Chen, Yu-Chen; Kuo, Chang-Chih; Chen, Shin-Yuan; Chen, Tsung-Ying; Pan, Yan-Hong; Wang, Po-Kai; Tsai, Sheng-Tzung
- Abstract
Deep brain stimulation (DBS) improves Parkinson's disease (PD) symptoms by suppressing neuropathological oscillations. These oscillations are also modulated by inhalational anesthetics used during DBS surgery in some patients, influencing electrode placement accuracy. We sought to evaluate a method that could avoid these effects. We recorded subthalamic nucleus (STN) neuronal firings in 11 PD patients undergoing DBS under inhalational anesthesia. Microelectrode recording (MER) during DBS was collected under median nerve stimulation (MNS) delivered at 5, 20, and 90 Hz frequencies and without MNS. We analyzed the spike firing rate and neuronal activity with power spectral density (PSD), and assessed correlations between the neuronal oscillation parameters and clinical motor outcomes. No patient experienced adverse effects during or after DBS surgery. PSD analysis revealed that peripheral 20 Hz MNS produced significant differences in the dorsal and ventral subthalamic nucleus (STN) between the beta band oscillation (16.9 ± 7.0% versus 13.5 ± 4.8%, respectively) and gamma band oscillation (56.0 ± 13.7% versus 66.3 ± 9.4%, respectively) (p < 0.05). Moreover, 20-Hz MNS entrained neural oscillation over the dorsal STN, which correlated positively with motor disabilities. MNS allowed localization of the sensorimotor STN and identified neural characteristics under inhalational anesthesia. This paradigm may help identify an alternative method to facilitate STN identification and DBS surgery under inhalational anesthesia.
- Subjects
INHALATION anesthesia; NEURAL stimulation; SUBTHALAMIC nucleus; MEDIAN nerve; PARKINSON'S disease; TRANSCRANIAL alternating current stimulation
- Publication
Biomedicines, 2022, Vol 10, Issue 1, p74
- ISSN
2227-9059
- Publication type
Article
- DOI
10.3390/biomedicines10010074