Propofol anesthesia precludes LFP-based functional mapping of pallidum during DBS implantation

Mahsa Malekmohammadi, Hiro Sparks, Nicholas Auyong, Andrew Hudson, Nader Pouratian

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: There are reports that microelectrode recording (MER) can be performed under certain anesthetized conditions for functional confirmation of the optimal deep brain stimulation (DBS) target. However, it is generally accepted that anesthesia affects MER. Due to a potential role of local field potentials (LFPs) in DBS functional mapping, we characterized the effect of propofol on globus pallidus interna (GPi) and externa (GPe) LFPs in Parkinson disease (PD) patients. Methods: We collected LFPs in 12 awake and anesthetized PD patients undergoing DBS implantation. Spectral power of β (13-35 Hz) and high-frequency oscillations (HFOs: 200-300 Hz) was compared across the pallidum. Results: Propofol suppressed GPi power by > 20 Hz while increasing power at lower frequencies. A similar power shift was observed in GPe; however, power in the high β range (20-35 Hz) increased with propofol. Before anesthesia both β and HFO activity were significantly greater at the GPi (χ 2 = 20.63 and χ 2 = 48.81, p < 0.0001). However, during anesthesia, we found no significant difference across the pallidum (χ 2 = 0.47, p = 0.79, and χ 2 = 4.11, p = 0.12). Conclusion: GPi and GPe are distinguishable using LFP spectral profiles in the awake condition. Propofol obliterates this spectral differentiation. Therefore, LFP spectra cannot be relied upon in the propofol-anesthetized state for functional mapping during DBS implantation.

Original languageEnglish (US)
Pages (from-to)249-258
Number of pages10
JournalStereotactic and Functional Neurosurgery
Volume96
Issue number4
DOIs
StatePublished - Oct 1 2018
Externally publishedYes

Keywords

  • Deep brain stimulation
  • Functional mapping
  • General anesthesia
  • Globus pallidus
  • Local field potentials
  • Propofol

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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