Rosa Manuela, Scelzo Emma, Locatelli Marco, Carrabba Giorgio, Levi Vincenzo, Arlotti Mattia, Barbieri Sergio, Rampini Paolo, Priori Alberto
Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Unit of Stereotactic Functional and Neuroendoscopic Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
World Neurosurg. 2017 Jan;97:64-69. doi: 10.1016/j.wneu.2016.09.069. Epub 2016 Sep 28.
Adaptive deep brain stimulation (aDBS) controlled by local field potentials (LFPs) is considered a promising treatment for advanced Parkinson's disease (PD). The clinical research investigating aDBS functioning is performed using external deep brain stimulation (DBS) systems that require LFP recording through the temporary externalization of DBS leads. Although research examining LFP was first undertaken more than 20 years ago, only a few studies concern lead externalization and LFP recording safety. In the present retrospective study, we assessed the risk of infection related to these procedures.
A total of 105 patients with PD who underwent DBS surgery and lead externalization at our hospital from 2002 to 2014 were included in the present study. The medical records were used to collect clinical data and information concerning surgical site infections. We assessed the infection incidence in our cohort and the risk of infection related to the LFP recording procedure.
The incidence of infections in patients who underwent lead externalization was 2.8%, which was consistent with the postoperative infectious risk reported in the literature (Wilcoxon signed rank test; P > 0.05). Moreover, the LFP recording procedure did not significantly increase the infection risk (LFP recordings vs. no LFP recordings: 2.5% vs. 4.2%; Fisher exact test; P > 0.05).
DBS lead externalization and LFP recording are safe and do not increase the postoperative infection risk in patients with PD who undergo DBS surgery. Our retrospective study supported further clinical research in the field of LFP-based aDBS.
由局部场电位(LFP)控制的适应性深部脑刺激(aDBS)被认为是晚期帕金森病(PD)的一种有前景的治疗方法。研究aDBS功能的临床研究使用的是外部深部脑刺激(DBS)系统,该系统需要通过将DBS导线临时外置来记录LFP。尽管对LFP的研究早在20多年前就已开展,但只有少数研究关注导线外置和LFP记录的安全性。在本回顾性研究中,我们评估了与这些操作相关的感染风险。
本研究纳入了2002年至2014年在我院接受DBS手术并进行导线外置的105例PD患者。通过病历收集临床数据和有关手术部位感染的信息。我们评估了队列中的感染发生率以及与LFP记录操作相关的感染风险。
进行导线外置的患者感染发生率为2.8%,这与文献报道的术后感染风险一致(Wilcoxon符号秩检验;P>0.05)。此外,LFP记录操作并未显著增加感染风险(有LFP记录与无LFP记录:2.5%对4.2%;Fisher精确检验;P>0.05)。
DBS导线外置和LFP记录是安全的,不会增加接受DBS手术的PD患者的术后感染风险。我们的回顾性研究支持了基于LFP的aDBS领域的进一步临床研究。