Electrocorticography During Deep Brain Stimulation Surgery: Safety Experience From 4 Centers Within the National Institute of Neurological Disorders and Stroke Research Opportunities in Human Consortium.
Electrocorticography During Deep Brain Stimulation Surgery: Safety Experience From 4 Centers Within the National Institute of Neurological Disorders and Stroke Research Opportunities in Human Consortium.
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深部脑刺激手术期间的皮质电图：来自人类联盟国家神经疾病和中风研究机会研究所内 4 个中心的安全经验。
DOI：
10.1093/neuros/nyaa592
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发表时间：
2021
期刊：
影响因子：
4.8
通讯作者：
Richardson,RMark
中科院分区：
文献类型：
--
作者：
Sisterson,NathanielD;Carlson,AprilA;Rutishauser,Ueli;Mamelak,AdamN;Flagg,Mitchell;Pouratian,Nader;Salimpour,Yousef;Anderson,WilliamS;Richardson,RMark
脑深部电刺激（DBS）手术中的术中研究使运动障碍的病理生理和潜在治疗机制的理解取得了重大进展。特别是在过去的十年中，记录皮层表面的皮质电图（ECoG），同时记录皮层下的记录，已经成为评估基底节区-丘脑皮质回路生理学的重要研究工具。目的利用2 BRAIN （BRAIN Research through Advancing Innovative Neurotechnologies）倡议资助的基础人类神经科学项目的相关中心数据，证实在DBS手术期间进行ECoG的安全性。方法4个中心分别收集数据。主要终点是并发症发生率，定义为任何术中事件、感染或术后需要临床随访的磁共振成像异常。解释变量的并发症发生率采用点双列相关和Fisher精确检验进行比较。结果回顾了367例涉及ECoG的DBS手术。未见皮质出血。共发生7例并发症：肺实质内出血4例，感染3例（并发症发生率1.91%，CI= 0.77% ~ 3.89%）。通过单个毛刺孔放置两个独立的ECoG研究电极（84例）与放置单个电极相比，并发症发生率没有显著差异(3.6% vs 1.5%； P=。4)。350例（95.4%）手术成功获得研究资料。结论：结合先前的单一报告，该报告在200例单中心队列中没有描述ECOG相关并发症，这些发现表明，在DBS手术期间研究ECOG并没有显著改变并发症发生率。
BACKGROUNDIntraoperative research during deep brain stimulation (DBS) surgery has enabled major advances in understanding movement disorders pathophysiology and potential mechanisms for therapeutic benefit. In particular, over the last decade, recording electrocorticography (ECoG) from the cortical surface, simultaneously with subcortical recordings, has become an important research tool for assessing basal ganglia-thalamocortical circuit physiology.OBJECTIVETo provide confirmation of the safety of performing ECoG during DBS surgery, using data from centers involved in 2 BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative-funded basic human neuroscience projects.METHODSData were collected separately at 4 centers. The primary endpoint was complication rate, defined as any intraoperative event, infection, or postoperative magnetic resonance imaging abnormality requiring clinical follow-up. Complication rates for explanatory variables were compared using point biserial correlations and Fisher exact tests.RESULTSA total of 367 DBS surgeries involving ECoG were reviewed. No cortical hemorrhages were observed. Seven complications occurred: 4 intraparenchymal hemorrhages and 3 infections (complication rate of 1.91%; CI= 0.77%-3.89%). The placement of 2 separate ECoG research electrodes through a single burr hole (84 cases) did not result in a significantly different rate of complications, compared to placement of a single electrode (3.6% vs 1.5%; P=. 4). Research data were obtained successfully in 350 surgeries (95.4%).CONCLUSIONCombined with the single report previously available, which described no ECoG-related complications in a single-center cohort of 200 cases, these findings suggest that research ECOG during DBS surgery did not significantly alter complication rates.