Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia
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...
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MDPI AG
2021-12-01
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| author | Yu-Chen Chen Chang-Chih Kuo Shin-Yuan Chen Tsung-Ying Chen Yan-Hong Pan Po-Kai Wang Sheng-Tzung Tsai |
| author_facet | Yu-Chen Chen Chang-Chih Kuo Shin-Yuan Chen Tsung-Ying Chen Yan-Hong Pan Po-Kai Wang Sheng-Tzung Tsai |
| author_sort | Yu-Chen Chen |
| collection | DOAJ |
| description | 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) (<i>p</i> < 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. |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-10T01:52:16Z |
| publishDate | 2021-12-01 |
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| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-b446ec24a5f74d2d95e0ca5149a782d62023-11-23T13:03:21ZengMDPI AGBiomedicines2227-90592021-12-011017410.3390/biomedicines10010074Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational AnesthesiaYu-Chen Chen0Chang-Chih Kuo1Shin-Yuan Chen2Tsung-Ying Chen3Yan-Hong Pan4Po-Kai Wang5Sheng-Tzung Tsai6Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, TaiwanDepartment of Physiology and Master Program in Medical Physiology, Tzu Chi University, Hualien 970, TaiwanDepartment of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, TaiwanSchool of Medicine, Tzu Chi University, Hualien 970, TaiwanDepartment of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, TaiwanSchool of Medicine, Tzu Chi University, Hualien 970, TaiwanDepartment of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, TaiwanDeep 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) (<i>p</i> < 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.https://www.mdpi.com/2227-9059/10/1/74deep brain stimulationgeneral anesthesiainhalational anesthesiamedian nerve stimulationneural signal analysisParkinson’s disease |
| spellingShingle | Yu-Chen Chen Chang-Chih Kuo Shin-Yuan Chen Tsung-Ying Chen Yan-Hong Pan Po-Kai Wang Sheng-Tzung Tsai Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia Biomedicines deep brain stimulation general anesthesia inhalational anesthesia median nerve stimulation neural signal analysis Parkinson’s disease |
| title | Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia |
| title_full | Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia |
| title_fullStr | Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia |
| title_full_unstemmed | Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia |
| title_short | Median Nerve Stimulation Facilitates the Identification of Somatotopy of the Subthalamic Nucleus in Parkinson’s Disease Patients under Inhalational Anesthesia |
| title_sort | median nerve stimulation facilitates the identification of somatotopy of the subthalamic nucleus in parkinson s disease patients under inhalational anesthesia |
| topic | deep brain stimulation general anesthesia inhalational anesthesia median nerve stimulation neural signal analysis Parkinson’s disease |
| url | https://www.mdpi.com/2227-9059/10/1/74 |
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