Influence of Propofol and Fentanyl on Deep Brain Stimulation of the Subthalamic Nucleus
Identifieur interne : 000E68 ( Pmc/Curation ); précédent : 000E67; suivant : 000E69Influence of Propofol and Fentanyl on Deep Brain Stimulation of the Subthalamic Nucleus
Auteurs : Wonki Kim [Corée du Sud] ; In Ho Song [Corée du Sud] ; Yong Hoon Lim [Corée du Sud] ; Mi-Ryoung Kim [Corée du Sud] ; Young Eun Kim [Corée du Sud] ; Jae Ha Hwang [Corée du Sud] ; In Keyoung Kim [Corée du Sud] ; Sang Woo Song [Corée du Sud] ; Jin Wook Kim [Corée du Sud] ; Woong-Woo Lee [Corée du Sud] ; Han-Joon Kim [Corée du Sud] ; Cheolyoung Kim [Corée du Sud] ; Hee Chan Kim [Corée du Sud] ; In Young Kim [Corée du Sud] ; Hee Pyoung Park [Corée du Sud] ; Dong Gyu Kim [Corée du Sud] ; Beom Seok Jeon [Corée du Sud] ; Sun Ha Paek [Corée du Sud]Source :
- Journal of Korean Medical Science [ 1011-8934 ] ; 2014.
Abstract
We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7±16.8 spikes/sec, n=78) and the right side MERs (35.5±17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.
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DOI: 10.3346/jkms.2014.29.9.1278
PubMed: 25246748
PubMed Central: 4168183
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Influence of Propofol and Fentanyl on Deep Brain Stimulation of the Subthalamic Nucleus</title><author><name sortKey="Kim, Wonki" sort="Kim, Wonki" uniqKey="Kim W" first="Wonki" last="Kim">Wonki Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Song, In Ho" sort="Song, In Ho" uniqKey="Song I" first="In Ho" last="Song">In Ho Song</name><affiliation wicri:level="1"><nlm:aff id="A2">Medical Device Development Center, Osong Medical Innovation Foundation, Cheongwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Medical Device Development Center, 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Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Young Eun" sort="Kim, Young Eun" uniqKey="Kim Y" first="Young Eun" last="Kim">Young Eun Kim</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Hwang, Jae Ha" sort="Hwang, Jae Ha" uniqKey="Hwang J" first="Jae Ha" last="Hwang">Jae Ha Hwang</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, In Keyoung" sort="Kim, In Keyoung" uniqKey="Kim I" first="In Keyoung" last="Kim">In Keyoung Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Song, Sang Woo" sort="Song, Sang Woo" uniqKey="Song S" first="Sang Woo" last="Song">Sang Woo Song</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Jin Wook" sort="Kim, Jin Wook" uniqKey="Kim J" first="Jin Wook" last="Kim">Jin Wook Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Woong Woo" sort="Lee, Woong Woo" uniqKey="Lee W" first="Woong-Woo" last="Lee">Woong-Woo Lee</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Han Joon" sort="Kim, Han Joon" uniqKey="Kim H" first="Han-Joon" last="Kim">Han-Joon Kim</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Cheolyoung" sort="Kim, Cheolyoung" uniqKey="Kim C" first="Cheolyoung" last="Kim">Cheolyoung Kim</name><affiliation wicri:level="1"><nlm:aff id="A4">Medical Imaging Laboratory and CyberMed, Inc., Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Medical Imaging Laboratory and CyberMed, Inc., Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Hee Chan" sort="Kim, Hee Chan" uniqKey="Kim H" first="Hee Chan" last="Kim">Hee Chan Kim</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Medical Engineering, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Medical Engineering, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, In Young" sort="Kim, In Young" uniqKey="Kim I" first="In Young" last="Kim">In Young Kim</name><affiliation wicri:level="1"><nlm:aff id="A6">Department of Biomedical Engineering, Hanyang University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Biomedical Engineering, Hanyang University, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Park, Hee Pyoung" sort="Park, Hee Pyoung" uniqKey="Park H" first="Hee Pyoung" last="Park">Hee Pyoung Park</name><affiliation wicri:level="1"><nlm:aff id="A7">Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Dong Gyu" sort="Kim, Dong Gyu" uniqKey="Kim D" first="Dong Gyu" last="Kim">Dong Gyu Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Jeon, Beom Seok" sort="Jeon, Beom Seok" uniqKey="Jeon B" first="Beom Seok" last="Jeon">Beom Seok Jeon</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A8">Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Paek, Sun Ha" sort="Paek, Sun Ha" uniqKey="Paek S" first="Sun Ha" last="Paek">Sun Ha Paek</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A8">Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A9">Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Cancer Research Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A10">Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.</nlm:aff><country xml:lang="fr" 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sort="Kim, Wonki" uniqKey="Kim W" first="Wonki" last="Kim">Wonki Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Song, In Ho" sort="Song, In Ho" uniqKey="Song I" first="In Ho" last="Song">In Ho Song</name><affiliation wicri:level="1"><nlm:aff id="A2">Medical Device Development Center, Osong Medical Innovation Foundation, Cheongwon, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Medical Device Development Center, Osong Medical Innovation Foundation, Cheongwon</wicri:regionArea></affiliation></author><author><name sortKey="Lim, Yong Hoon" sort="Lim, Yong Hoon" uniqKey="Lim Y" first="Yong Hoon" last="Lim">Yong Hoon Lim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Mi Ryoung" sort="Kim, Mi Ryoung" uniqKey="Kim M" first="Mi-Ryoung" last="Kim">Mi-Ryoung Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Young Eun" sort="Kim, Young Eun" uniqKey="Kim Y" first="Young Eun" last="Kim">Young Eun Kim</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Hwang, Jae Ha" sort="Hwang, Jae Ha" uniqKey="Hwang J" first="Jae Ha" last="Hwang">Jae Ha Hwang</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, In Keyoung" sort="Kim, In Keyoung" uniqKey="Kim I" first="In Keyoung" last="Kim">In Keyoung Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Song, Sang Woo" sort="Song, Sang Woo" uniqKey="Song S" first="Sang Woo" last="Song">Sang Woo Song</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Jin Wook" sort="Kim, Jin Wook" uniqKey="Kim J" first="Jin Wook" last="Kim">Jin Wook Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Woong Woo" sort="Lee, Woong Woo" uniqKey="Lee W" first="Woong-Woo" last="Lee">Woong-Woo Lee</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Han Joon" sort="Kim, Han Joon" uniqKey="Kim H" first="Han-Joon" last="Kim">Han-Joon Kim</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Cheolyoung" sort="Kim, Cheolyoung" uniqKey="Kim C" first="Cheolyoung" last="Kim">Cheolyoung Kim</name><affiliation wicri:level="1"><nlm:aff id="A4">Medical Imaging Laboratory and CyberMed, Inc., Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Medical Imaging Laboratory and CyberMed, Inc., Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Hee Chan" sort="Kim, Hee Chan" uniqKey="Kim H" first="Hee Chan" last="Kim">Hee Chan Kim</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Medical Engineering, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Medical Engineering, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, In Young" sort="Kim, In Young" uniqKey="Kim I" first="In Young" last="Kim">In Young Kim</name><affiliation wicri:level="1"><nlm:aff id="A6">Department of Biomedical Engineering, Hanyang University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Biomedical Engineering, Hanyang University, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Park, Hee Pyoung" sort="Park, Hee Pyoung" uniqKey="Park H" first="Hee Pyoung" last="Park">Hee Pyoung Park</name><affiliation wicri:level="1"><nlm:aff id="A7">Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Dong Gyu" sort="Kim, Dong Gyu" uniqKey="Kim D" first="Dong Gyu" last="Kim">Dong Gyu Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Jeon, Beom Seok" sort="Jeon, Beom Seok" uniqKey="Jeon B" first="Beom Seok" last="Jeon">Beom Seok Jeon</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurology, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A8">Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Paek, Sun Ha" sort="Paek, Sun Ha" uniqKey="Paek S" first="Sun Ha" last="Paek">Sun Ha Paek</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Neurosurgery, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A8">Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A9">Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Cancer Research Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A10">Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Clinical Research Institute, Seoul National University Hospital, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Korean Medical Science</title><idno type="ISSN">1011-8934</idno><idno type="eISSN">1598-6357</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7±16.8 spikes/sec, n=78) and the right side MERs (35.5±17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.</p><sec><title>Graphical Abstract</title><p><graphic xlink:href="jkms-29-1278-ab001.jpg" position="float" orientation="portrait"></graphic></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Benabid, Al" uniqKey="Benabid A">AL Benabid</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hutchison, Wd" uniqKey="Hutchison W">WD Hutchison</name></author><author><name sortKey="Allan, Rj" uniqKey="Allan R">RJ Allan</name></author><author><name sortKey="Opitz, H" uniqKey="Opitz H">H Opitz</name></author><author><name sortKey="Levy, R" uniqKey="Levy R">R Levy</name></author><author><name sortKey="Dostrovsky, Jo" uniqKey="Dostrovsky J">JO Dostrovsky</name></author><author><name sortKey="Lang, Ae" uniqKey="Lang A">AE Lang</name></author><author><name sortKey="Lozano, Am" uniqKey="Lozano A">AM Lozano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hertel, F" uniqKey="Hertel F">F Hertel</name></author><author><name sortKey="Zuchner, M" uniqKey="Zuchner M">M Züchner</name></author><author><name sortKey="Weimar, I" uniqKey="Weimar I">I Weimar</name></author><author><name sortKey="Gemmar, P" uniqKey="Gemmar P">P Gemmar</name></author><author><name sortKey="Noll, B" uniqKey="Noll B">B Noll</name></author><author><name sortKey="Bettag, M" uniqKey="Bettag M">M Bettag</name></author><author><name sortKey="Decker, C" uniqKey="Decker C">C Decker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lefaucheur, Jp" uniqKey="Lefaucheur J">JP Lefaucheur</name></author><author><name sortKey="Gurruchaga, Jm" uniqKey="Gurruchaga J">JM Gurruchaga</name></author><author><name sortKey="Pollin, B" uniqKey="Pollin B">B 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Korean Med Sci</journal-id><journal-id journal-id-type="iso-abbrev">J. Korean Med. Sci</journal-id><journal-id journal-id-type="publisher-id">JKMS</journal-id><journal-title-group><journal-title>Journal of Korean Medical Science</journal-title></journal-title-group><issn pub-type="ppub">1011-8934</issn><issn pub-type="epub">1598-6357</issn><publisher><publisher-name>The Korean Academy of Medical Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25246748</article-id><article-id pub-id-type="pmc">4168183</article-id><article-id pub-id-type="doi">10.3346/jkms.2014.29.9.1278</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject><subj-group subj-group-type="heading"><subject>Neuroscience</subject></subj-group></subj-group></article-categories><title-group><article-title>Influence of Propofol and Fentanyl on Deep Brain Stimulation of the Subthalamic Nucleus</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-7197-2366</contrib-id><name><surname>Kim</surname><given-names>Wonki</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-6330-3453</contrib-id><name><surname>Song</surname><given-names>In Ho</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-0346-2345</contrib-id><name><surname>Lim</surname><given-names>Yong Hoon</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-0671-2263</contrib-id><name><surname>Kim</surname><given-names>Mi-Ryoung</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-7182-6569</contrib-id><name><surname>Kim</surname><given-names>Young Eun</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-6455-3590</contrib-id><name><surname>Hwang</surname><given-names>Jae Ha</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-7761-9456</contrib-id><name><surname>Kim</surname><given-names>In Keyoung</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-5523-3798</contrib-id><name><surname>Song</surname><given-names>Sang Woo</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-3773-3940</contrib-id><name><surname>Kim</surname><given-names>Jin Wook</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-8767-7967</contrib-id><name><surname>Lee</surname><given-names>Woong-Woo</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-8219-9663</contrib-id><name><surname>Kim</surname><given-names>Han-Joon</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-5586-9342</contrib-id><name><surname>Kim</surname><given-names>Cheolyoung</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-2112-426X</contrib-id><name><surname>Kim</surname><given-names>Hee Chan</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-9580-7074</contrib-id><name><surname>Kim</surname><given-names>In Young</given-names></name><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-4772-0780</contrib-id><name><surname>Park</surname><given-names>Hee Pyoung</given-names></name><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-5740-6189</contrib-id><name><surname>Kim</surname><given-names>Dong Gyu</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-2491-3544</contrib-id><name><surname>Jeon</surname><given-names>Beom Seok</given-names></name><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-3007-8653</contrib-id><name><surname>Paek</surname><given-names>Sun Ha</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A8">8</xref><xref ref-type="aff" rid="A9">9</xref><xref ref-type="aff" rid="A10">10</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A2"><label>2</label>Medical Device Development Center, Osong Medical Innovation Foundation, Cheongwon, Korea.</aff><aff id="A3"><label>3</label>Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A4"><label>4</label>Medical Imaging Laboratory and CyberMed, Inc., Seoul, Korea.</aff><aff id="A5"><label>5</label>Department of Medical Engineering, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A6"><label>6</label>Department of Biomedical Engineering, Hanyang University, Seoul, Korea.</aff><aff id="A7"><label>7</label>Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A8"><label>8</label>Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A9"><label>9</label>Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A10"><label>10</label>Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.</aff><author-notes><corresp>Address for Correspondence: Sun Ha Paek, MD. Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82.2-2072-3993, Fax: +82.2-744-8459, <email>paeksh@snu.ac.kr</email></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>02</day><month>9</month><year>2014</year></pub-date><volume>29</volume><issue>9</issue><fpage>1278</fpage><lpage>1286</lpage><history><date date-type="received"><day>03</day><month>3</month><year>2014</year></date><date date-type="accepted"><day>26</day><month>6</month><year>2014</year></date></history><permissions><copyright-statement>© 2014 The Korean Academy of Medical Sciences.</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7±16.8 spikes/sec, n=78) and the right side MERs (35.5±17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.</p><sec><title>Graphical Abstract</title><p><graphic xlink:href="jkms-29-1278-ab001.jpg" position="float" orientation="portrait"></graphic></p></sec></abstract><kwd-group><kwd>Parkinson Disease</kwd><kwd>Microelectrodes</kwd><kwd>Propofol</kwd><kwd>Fentanyl</kwd><kwd>Subthalamic Nucleus</kwd><kwd>Deep Brain Stimulation</kwd></kwd-group><funding-group><award-group><funding-source country="KR">Korea Institute of Planning & Evaluation for Technology in Food, Agriculture, Forestry, and Fisheries</funding-source><award-id>311011-05-3-SB020</award-id></award-group><award-group><funding-source country="KR">Ministry of Health and Welfare</funding-source><award-id>HI09C13540100</award-id><award-id>HI10C14110400</award-id><award-id>HI12C02050101</award-id></award-group></funding-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label><caption><p>A sorted single unit on microelectrode recording. This figure demonstrates a sorted single unit. The expectation-maximization algorithm was applied to raw signal (white) for getting isolated unit waveforms (green) from noise signal (yellow). Top, raw spiking activity; middle left, unit waveforms (green) and isolated form noise (yellow); middle right, isolated unit and noise on a principle component plot (x-axis, PC1;y-axis, PC2); bottom, raster trace of unit events (green) and noise events (yellow) over a selected time period.</p></caption><graphic xlink:href="jkms-29-1278-g001"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label><caption><p>Burst discharge patterns on microelectrode recording. This figure shows results of burst discharge patterns under the MAC and the LA conditions. Spike discharge in left column and discharge density histogram in right column with/without burst discharge patterns in MAC and LA.</p></caption><graphic xlink:href="jkms-29-1278-g002"></graphic></fig><fig id="F3" orientation="portrait" position="float"><label>Fig. 3</label><caption><p>Typical bursting patterns (see the boxes). The typical bursting patterns are demonstrated according to anesthetic methods. Left column, bursting pattern in LA; Right column, bursting pattern in MAC.</p></caption><graphic xlink:href="jkms-29-1278-g003"></graphic></fig><fig id="F4" orientation="portrait" position="float"><label>Fig. 4</label><caption><p>Location of the electrodes plotted onto the human brain atlas. Based on the CT-MRI fusion images of the preoperative brain MRI and postoperative brain CT scan taken one month after surgery. All the electrode positions are mostly located to the middle one third part of the STNs on both sides in the fused images. (<bold>A</bold>) It shows location of the electrodes plotted onto the human brain atlas of Schaltenbrand and Wahren. (<bold>B</bold>) The microelectrodes positions were plotted in the sagittal and coronal planes aligned along anterior commissure and posterior commissure line (AC-PC line).</p></caption><graphic xlink:href="jkms-29-1278-g004"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Clinical findings of the 8 patients with advanced Parkinson's disease</p></caption><graphic xlink:href="jkms-29-1278-i001"></graphic><table-wrap-foot><fn><p>ADL, Activities of Daily Life; LEDD, Levodopa equivalent daily dose; UPDRS, Unified Parkinson's Disease Rating Scale.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Clinical outcomes of the 8 patients with advanced Parkinson's disease 6 months after bilateral subthalamic nucleus deep brain stimulation</p></caption><graphic xlink:href="jkms-29-1278-i002"></graphic><table-wrap-foot><fn><p>ADL, Activities of Daily Life; BDI, Beck Depression Inventory; FOGQ, Freezing of Gait Questionnaire; LEDD, Levodopa equivalent daily dose; MMSE, Mini-mental state examination; SF 36, Short Form-36; UPDRS, Unified Parkinson's Disease Rating Scale.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T3" orientation="portrait" position="float"><label>Table 3</label><caption><p>UPDRS III subscores of the 8 patients with advanced Parkinson's disease</p></caption><graphic xlink:href="jkms-29-1278-i003"></graphic><table-wrap-foot><fn><p>UPDRS, Unified Parkinson's Disease Rating Scale.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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