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首页> 外文期刊>Journal of Clinical Medicine >Influence of Anesthesia and Clinical Variables on the Firing Rate, Coefficient of Variation and Multi-Unit Activity of the Subthalamic Nucleus in Patients with Parkinson’s Disease
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Influence of Anesthesia and Clinical Variables on the Firing Rate, Coefficient of Variation and Multi-Unit Activity of the Subthalamic Nucleus in Patients with Parkinson’s Disease

机译：麻醉和临床变量对帕金森病患者次粒子核的烧制率，变异系数和多单位活性

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Background: Microelectrode recordings (MER) are used to optimize lead placement during subthalamic nucleus deep brain stimulation (STN-DBS). To obtain reliable MER, surgery is usually performed while patients are awake. Procedural sedation and analgesia (PSA) is often desirable to improve patient comfort, anxiolysis and pain relief. The effect of these agents on MER are largely unknown. The objective of this study was to determine the effects of commonly used PSA agents, dexmedetomidine, clonidine and remifentanil and patient characteristics on MER during DBS surgery. Methods: Data from 78 patients with Parkinson’s disease (PD) who underwent STN-DBS surgery were retrospectively reviewed. The procedures were performed under local anesthesia or under PSA with dexmedetomidine, clonidine or remifentanil. In total, 4082 sites with multi-unit activity (MUA) and 588 with single units were acquired. Single unit firing rates and coefficient of variation (CV), and MUA total power were compared between patient groups. Results: We observed a significant reduction in MUA, an increase of the CV and a trend for reduced firing rate by dexmedetomidine. The effect of dexmedetomidine was dose-dependent for all measures. Remifentanil had no effect on the firing rate but was associated with a significant increase in CV and a decrease in MUA. Clonidine showed no significant effect on firing rate, CV or MUA. In addition to anesthetic effects, MUA and CV were also influenced by patient-dependent variables. Conclusion: Our results showed that PSA influenced neuronal properties in the STN and the dexmedetomidine (DEX) effect was dose-dependent. In addition, patient-dependent characteristics also influenced MER.
机译：背景：微电极记录（MER）用于优化亚粒细胞核深脑刺激（STN-DBS）期间的铅放置。为了获得可靠的MER，通常进行手术，同时患者醒着。程序镇静和镇痛（PSA）通常是可取的，以改善患者的舒适性，令人焦虑和疼痛缓解。这些药剂对MER的影响主要是未知的。本研究的目的是确定常用的PSA药剂，Dexmedetomidine，Clonidine和Remifentanil和患者特征在DBS手术期间的影响。方法：回顾性审查了78例帕金森病疾病（PD）的78例患者的数据。该程序在局部麻醉下或PSA下进行，用德Xmedetomidine，Clonidine或Remifentanil。获得了4082个具有多单元活动（MUA）和588个具有单位单位的站点。在患者组之间比较单位射击率和变异系数（CV）和MUA总功率。结果：我们观察到MUA的显着降低，CV的增加和Dexmedetomidine降低烧制率降低的趋势。 Dexmedetomidine对所有措施的剂量依赖于剂量。雷芬丹尼对烧制率没有影响，但与CV显着增加和MUA减少有关。 Clonidine对烧制率，CV或MUA显示出没有显着影响。除了麻醉效应外，MUA和CV也受患者依赖变量的影响。结论：我们的研究结果表明，PSA影响STN中的神经元特性和右甲基胺（DEX）效果是依赖性的。此外，患者依赖性特征也影响了MER。

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