Objective: To evaluate the variation of micro electrode recording(MER) signal acquisitions in the course of conscious and napping sub thalamic nucleus stimulations with deep brain stimulator (S T N – D B S) in Parkinson`s patients then the need of MER throughout “ON-DBS” in universal anesthesia (UA, general or global).

Background: DBS surgery amplified the risk of ‘intracranial-hemorrhage’ because of more electrodes track, restricting some possible DBS candidates. Hence, OF-DBS in universal anesthesia (UA) depend on’ image-position’ is accepted by more DBS clinics. Both ON and OFF DBS study in local and globally anesthetized Parkinson`s analysis done in this study.

Method:

52 successive advanced idiopathic Parkinson`s under-went for the STNDBS surgery at our NIMS tertiary care hospital, south India (Jan 2020 – Jan 2022). Institute ethical clearance obtained following Helsinki principles.

Results: The changes in MER-recording, precision of target, and prediction in distinct anesthesia strategies were investigated in this study. Furthermore, the MER neuronal signals duration was matched with post op microelectrode duration through the microelectrode modernization and also capacity. The MER duration-of-two cohorts was (5.48±1.39mm) within the locally given anesthesia (“LA”) cohort plus 4.38±1.43mm within the UA cohort, through the ‘statistical-significancy’ amongst two cohorts with a chi-square χ²@ 9.3755 with 2 degree of freedom, very significant at 5% with (p<=0.0010) highly significant. The MER duration of the LA cohort was lengthier than its post op length of μ-microelectrode(p<=0.01), though, there was not a major indeed substantial variation amongst the MER-signal duration also post op length of μ-microelectrode in UA cluster (p<=0.61). And also there were not a substantial change in the length of post op μ-electrode, target-precision, plus post op major plus minor score-result amongst two cohorts(p>0.05). Therefore, the findings prove that DBS-OFF under UA is analogous to ON-DBS in L.A.

Conclusion: Universal (global) anesthesia has effects over the MER in the course of surgery, yet usual ‘S T N’ discharges can even now be logged. Thus, the μ-electrode recording is an efficient and important tool for intra op process.

References: 1. Guang-Rui Zhao, Clinical study of intraoperative microelectrode recordings during awake and asleep subthalamic nucleus deep brain stimulation for Parkinson’s disease, Brain sci., Vol.12,No.1469, Pp:1-10,2022

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MDS Abstracts - https://www.mdsabstracts.org/abstract/intra-operative-mer-with-stn-dbs-in-local-and-globally-anesthetized-parkinsons-analysis-a-melancholic-nostalgy-group-study/