2023
Intraoperative electrophysiological monitoring determines the final electrode position for pallidal stimulation in dystonia patients
BALÁŽ, Marek, Jiří BÚŘIL, Tereza JURKOVÁ, Eva KORIŤÁKOVÁ, Dušan HRABOVSKÝ et. al.Základní údaje
Originální název
Intraoperative electrophysiological monitoring determines the final electrode position for pallidal stimulation in dystonia patients
Autoři
BALÁŽ, Marek (703 Slovensko, domácí), Jiří BÚŘIL (203 Česká republika, domácí), Tereza JURKOVÁ (203 Česká republika, domácí), Eva KORIŤÁKOVÁ (203 Česká republika, domácí), Dušan HRABOVSKÝ (703 Slovensko, domácí), Jonáš KUNST (203 Česká republika, domácí), Petra BARTOVA (203 Česká republika) a Jan CHRASTINA (203 Česká republika, garant, domácí)
Vydání
FRONTIERS IN SURGERY, SWITZERLAND, FRONTIERS MEDIA SA, 2023, 2296-875X
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30212 Surgery
Stát vydavatele
Švýcarsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 1.800 v roce 2022
Kód RIV
RIV/00216224:14110/23:00134639
Organizační jednotka
Lékařská fakulta
UT WoS
000998908800001
Klíčová slova anglicky
deep brain stimulation; dystonia; globus pallidus internus; microrecordings; stereotaxy
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 23. 1. 2024 08:46, Mgr. Eva Dubská
Anotace
V originále
BackgroundBilateral deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an effective treatment for refractory dystonia. Neuroradiological target and stimulation electrode trajectory planning with intraoperative microelectrode recordings (MER) and stimulation are used. With improving neuroradiological techniques, the need for MER is in dispute mainly because of the suspected risk of hemorrhage and the impact on clinical post DBS outcome.ObjectiveThe aim of the study is to compare the preplanned GPi electrode trajectories with final trajectories selected for electrode implantation after electrophysiological monitoring and to discuss the factors potentially responsible for differences between preplanned and final trajectories. Finally, the potential association between the final trajectory selected for electrode implantation and clinical outcome will be analyzed.MethodsForty patients underwent bilateral GPi DBS (right-sided implants first) for refractory dystonia. The relationship between preplanned and final trajectories (MicroDrive system) was correlated with patient (gender, age, dystonia type and duration) and surgery characteristics (anesthesia type, postoperative pneumocephalus) and clinical outcome measured using CGI (Clinical Global Impression parameter). The correlation between the preplanned and final trajectories together with CGI was compared between patients 1-20 and 21-40 for the learning curve effect.ResultsThe trajectory selected for definitive electrode implantation matched the preplanned trajectory in 72.5% and 70% on the right and left side respectively; 55% had bilateral definitive electrodes implanted along the preplanned trajectories. Statistical analysis did not confirm any of the studied factors as predictor of the difference between the preplanned and final trajectories. Also no association between CGI and final trajectory selected for electrode implantation in the right/left hemisphere has been proven. The percentages of final electrodes implanted along the preplanned trajectory (the correlation between anatomical planning and intraoperative electrophysiology results) did not differ between patients 1-20 and 21-40. Similarly, there were no statistically significant differences in CGI (clinical outcome) between patients 1-20 and 21-40.ConclusionThe final trajectory selected after electrophysiological study differed from the preplanned trajectory in a significant percentage of patients. No predictor of this difference was identified. The anatomo-electrophysiological difference was not predictive of the clinical outcome (as measured using CGI parameter).
Návaznosti
| NV19-04-00343, projekt VaV |
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