The Association of Dexmedetomidine with Firing Properties in Pallidal Neurons

Abstract

Background: Microelectrode recordings (MERs) are used during deep brain stimulation surgery (DBS) to optimize patient outcomes and provide a unique method of collecting data regarding neurological conditions. However, MERs can be affected by anesthetics such as dexmedetomidine. Little is known about the effects of dexmedetomidine (DEX) on the globus pallidus interna (GPi), a common target for DBS. The primary aim of this study is to investigate the hypothesis that DEX is associated with alterations in GPi MERs. Methods: We conducted a retrospective analysis comparing MERs from patients with Parkinson’s disease (PD) and dystonia who underwent insertion of DBS of the GPi under DEX sedation with those who went through the same procedure without DEX (No DEX). Results: Firing rates for GPi neurons in the DEX group were lower (57.44 ± 2.04; mean ± SEM, n = 163 cells) than the No DEX group (69.53 ± 2.06, n = 112 cells, P < 0.0001). Overall, DEX was associated with a greater proportion of GPi cells classified as firing in bursty pattern compared to our No DEX group. (29.41%, n = 153 vs 14.81%, n = 108, P = 0.008). This effect was present for both PD and dystonia patients who underwent the procedure. High doses of DEX were associated with lower firing rates than low doses. Conclusions: Our results suggest that DEX is associated with a decrease in GPi firing rates and are associated with an increase in burstiness. Furthermore, these effects are similar between dystonia and PD patients. Lastly, the effects of DEX may differ between high doses and low doses.

Choice of anaesthesia in microelectrode recording-guided deep-brain stimulation for Parkinson’s disease (CHAMPION): study protocol for a single-centre, open-label, non-inferiority randomised controlled trial

“…These were done despite many previous trials assessing STN spike-related information such as oscillations, firing rates (FR), and burstiness due to the computational difficulty and susceptibility to errors. [11][12][13] The literature generally recommends using the root mean square (RMS) value of the electrode recorded sampling signal (measured in volts) as the main parameter to evaluate the electrode position. 14 RMS values may vary with electrode properties and other operating-related disturbances; therefore, it is important to normalise RMS by calculating the RMS of each time period in the trajectory divided by the average RMS of the first five stable sessions in the same trajectory.…”

“…The need for real-time computation feasibility is a crucial guideline when choosing the parameters to work with. These were done despite many previous trials assessing STN spike-related information such as oscillations, firing rates (FR), and burstiness due to the computational difficulty and susceptibility to errors 11–13. The literature generally recommends using the root mean square (RMS) value of the electrode recorded sampling signal (measured in volts) as the main parameter to evaluate the electrode position 14.…”

Dex modulates the balance of water-electrolyte metabolism by depressing the expression of AVP in PVN

“…Dexmedetomidine (Dex) is a potent and highly selective α2 adrenergic agonist with sedative, analgesic, and anti-anxiety functions that are widely used in clinical anesthesia ( Weerink et al, 2017 ). It can also be used to eliminate delirium, adjust sleep structure, and reduce sympathetic excitement and inflammatory responses ( Bindra et al, 2019 ; Gasim et al, 2021 ; Tasbihgou et al, 2021 ; Xue et al, 2021 ). Dex can inhibit osmotic water permeability in the rat cortical collecting duct, thus increasing body water discharge ( Rouch et al, 1997 ).…”