Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS
Background: It is currently unknown whether results from intraoperative test stimulation of two types of Deep Brain Stimulation (DBS), either during awake pallidal (GPi) or thalamic (Vim), are comparable to the results generated by chronic stimulation through the definitive lead.Objective: To determ...
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.775784/full |
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| author | Victor J. Geraedts Victor J. Geraedts Rogier A. P. van Ham Jacobus J. van Hilten Arne Mosch Carel F. E. Hoffmann Niels A. van der Gaag Niels A. van der Gaag Maria Fiorella Contarino Maria Fiorella Contarino |
| author_facet | Victor J. Geraedts Victor J. Geraedts Rogier A. P. van Ham Jacobus J. van Hilten Arne Mosch Carel F. E. Hoffmann Niels A. van der Gaag Niels A. van der Gaag Maria Fiorella Contarino Maria Fiorella Contarino |
| author_sort | Victor J. Geraedts |
| collection | DOAJ |
| description | Background: It is currently unknown whether results from intraoperative test stimulation of two types of Deep Brain Stimulation (DBS), either during awake pallidal (GPi) or thalamic (Vim), are comparable to the results generated by chronic stimulation through the definitive lead.Objective: To determine whether side-effects-thresholds from intraoperative test stimulation are indicative of postoperative stimulation findings.Methods: Records of consecutive patients who received GPi or Vim were analyzed. Thresholds for the induction of either capsular or non-capsular side-effects were compared at matched depths and at group-level.Results: Records of fifty-two patients were analyzed (20 GPis, 75 Vims). The induction of side-effects was not significantly different between intraoperative and postoperative assessments at matched depths, although a large variability was observed (capsular: GPi DBS: p = 0.79; Vim DBS: p = 0.68); non-capsular: GPi DBS: p = 0.20; and Vim DBS: p = 0.35). Linear mixed-effect models revealed no differences between intraoperative and postoperative assessments, although the Vim had significantly lower thresholds (capsular side-effects p = 0.01, non-capsular side-effects p < 0.01). Unpaired survival analyses demonstrated lower intraoperative than postoperative thresholds for capsular side-effects in patients under GPi DBS (p = 0.01), while higher intraoperative thresholds for non-capsular side-effects in patients under Vim DBS (p = 0.01).Conclusion: There were no significant differences between intraoperative and postoperative assessments of GPi and Vim DBS, although thresholds cannot be directly extrapolated at an individual level due to high variability. |
| first_indexed | 2024-12-21T23:52:06Z |
| format | Article |
| id | doaj.art-319851723d214798adf2954c99632da9 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-21T23:52:06Z |
| publishDate | 2021-12-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-319851723d214798adf2954c99632da92022-12-21T18:45:55ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-12-011210.3389/fneur.2021.775784775784Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBSVictor J. Geraedts0Victor J. Geraedts1Rogier A. P. van Ham2Jacobus J. van Hilten3Arne Mosch4Carel F. E. Hoffmann5Niels A. van der Gaag6Niels A. van der Gaag7Maria Fiorella Contarino8Maria Fiorella Contarino9Department of Neurology, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Neurology, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Neurology, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Neurology, Haga Teaching Hospital, The Hague, NetherlandsDepartment of Neurosurgery, Haga Teaching Hospital, The Hague, NetherlandsDepartment of Neurosurgery, Haga Teaching Hospital, The Hague, NetherlandsDepartment of Neurosurgery, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Neurology, Leiden University Medical Center (LUMC), Leiden, NetherlandsDepartment of Neurology, Haga Teaching Hospital, The Hague, NetherlandsBackground: It is currently unknown whether results from intraoperative test stimulation of two types of Deep Brain Stimulation (DBS), either during awake pallidal (GPi) or thalamic (Vim), are comparable to the results generated by chronic stimulation through the definitive lead.Objective: To determine whether side-effects-thresholds from intraoperative test stimulation are indicative of postoperative stimulation findings.Methods: Records of consecutive patients who received GPi or Vim were analyzed. Thresholds for the induction of either capsular or non-capsular side-effects were compared at matched depths and at group-level.Results: Records of fifty-two patients were analyzed (20 GPis, 75 Vims). The induction of side-effects was not significantly different between intraoperative and postoperative assessments at matched depths, although a large variability was observed (capsular: GPi DBS: p = 0.79; Vim DBS: p = 0.68); non-capsular: GPi DBS: p = 0.20; and Vim DBS: p = 0.35). Linear mixed-effect models revealed no differences between intraoperative and postoperative assessments, although the Vim had significantly lower thresholds (capsular side-effects p = 0.01, non-capsular side-effects p < 0.01). Unpaired survival analyses demonstrated lower intraoperative than postoperative thresholds for capsular side-effects in patients under GPi DBS (p = 0.01), while higher intraoperative thresholds for non-capsular side-effects in patients under Vim DBS (p = 0.01).Conclusion: There were no significant differences between intraoperative and postoperative assessments of GPi and Vim DBS, although thresholds cannot be directly extrapolated at an individual level due to high variability.https://www.frontiersin.org/articles/10.3389/fneur.2021.775784/fulldeep brain stimulation (DBS)GPiVimmonopolar contact reviewintraoperative test stimulation |
| spellingShingle | Victor J. Geraedts Victor J. Geraedts Rogier A. P. van Ham Jacobus J. van Hilten Arne Mosch Carel F. E. Hoffmann Niels A. van der Gaag Niels A. van der Gaag Maria Fiorella Contarino Maria Fiorella Contarino Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS Frontiers in Neurology deep brain stimulation (DBS) GPi Vim monopolar contact review intraoperative test stimulation |
| title | Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS |
| title_full | Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS |
| title_fullStr | Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS |
| title_full_unstemmed | Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS |
| title_short | Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS |
| title_sort | intraoperative vs postoperative side effects thresholds during pallidal and thalamic dbs |
| topic | deep brain stimulation (DBS) GPi Vim monopolar contact review intraoperative test stimulation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.775784/full |
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