PDF(Pubmed)
Abstract：
UNASSIGNED: Charge balancing is used in deep brain stimulation (DBS) to avoid net charge accumulation at the tissue-electrode interface that can result in neural damage. Charge balancing paradigms include passive recharge and active recharge. In passive recharge, each cathodic pulse is accompanied by a waiting period before the next stimulation, whereas active recharge uses energy to deliver symmetric anodic and cathodic stimulation pulses sequentially, producing a net zero charge. We sought to determine differences in stimulation induced side effect thresholds between active vs. passive recharge during the intraoperative monopolar review.
UNASSIGNED: Sixty-five consecutive patients undergoing DBS from 2021 to 2022 were retrospectively reviewed. Intraoperative monopolar review was performed with both active recharge and passive recharge for all included patients to determine side effect stimulation thresholds. Sixteen patients with 64 total DBS contacts met inclusion criteria for further analysis. Intraoperative monopolar review results were compared with the monopolar review from the first DBS programming visit.
UNASSIGNED: The mean intraoperative active recharge stimulation threshold was 4.1 mA, while the mean intraoperative passive recharge stimulation threshold was 3.9 mA, though this difference was not statistically significant on t-test (p = 0.442). Mean stimulation threshold at clinic follow-up was 3.2 mA. In Pearson correlation, intraoperative passive recharge thresholds had stronger correlation with follow-up stimulation thresholds (Pearson r = 0.5281, p < 0.001) than intraoperative active recharge (Pearson r = 0.340, p = 0.018), however the difference between these correlations was not statistically significant on Fisher Z correlation test (p = 0.294). The mean difference between intraoperative passive recharge stimulation threshold and follow-up stimulation threshold was 0.8 mA, while the mean difference between intraoperative active recharge threshold and follow-up threshold was 1.2 mA. This difference was not statistically significant on a t-test (p = 0.134).
UNASSIGNED: Both intraoperative active recharge and passive recharge stimulation were well-correlated with the monopolar review at the first programming visit. No statistically significant differences were observed suggesting that either passive or active recharge may be utilized intraoperatively.
UNASSIGNED: Sixty-five consecutive patients undergoing DBS from 2021 to 2022 were retrospectively reviewed. Intraoperative monopolar review was performed with both active recharge and passive recharge for all included patients to determine side effect stimulation thresholds. Sixteen patients with 64 total DBS contacts met inclusion criteria for further analysis. Intraoperative monopolar review results were compared with the monopolar review from the first DBS programming visit.
UNASSIGNED: The mean intraoperative active recharge stimulation threshold was 4.1 mA, while the mean intraoperative passive recharge stimulation threshold was 3.9 mA, though this difference was not statistically significant on t-test (p = 0.442). Mean stimulation threshold at clinic follow-up was 3.2 mA. In Pearson correlation, intraoperative passive recharge thresholds had stronger correlation with follow-up stimulation thresholds (Pearson r = 0.5281, p < 0.001) than intraoperative active recharge (Pearson r = 0.340, p = 0.018), however the difference between these correlations was not statistically significant on Fisher Z correlation test (p = 0.294). The mean difference between intraoperative passive recharge stimulation threshold and follow-up stimulation threshold was 0.8 mA, while the mean difference between intraoperative active recharge threshold and follow-up threshold was 1.2 mA. This difference was not statistically significant on a t-test (p = 0.134).
UNASSIGNED: Both intraoperative active recharge and passive recharge stimulation were well-correlated with the monopolar review at the first programming visit. No statistically significant differences were observed suggesting that either passive or active recharge may be utilized intraoperatively.
摘要：
■电荷平衡用于深部脑刺激（DBS），以避免在组织-电极界面处净电荷积聚，从而导致神经损伤。电荷平衡范例包括被动再充电和主动再充电。在被动充电中，每个阴极脉冲都伴随着下一次刺激之前的等待期，而主动充电使用能量依次传递对称的阳极和阴极刺激脉冲，产生净零电荷。我们试图确定刺激诱导的副作用阈值之间的差异术中单极复查期间的被动充电。
■对2021年至2022年连续65例接受DBS的患者进行回顾性分析。对所有纳入患者进行了术中单极检查，同时进行了主动充电和被动充电，以确定副作用刺激阈值。16例患者（共64例DBS接触者）符合进一步分析的纳入标准。将术中单极审查结果与第一次DBS编程访问的单极审查进行比较。
■术中主动再充电刺激阈值平均值为4.1mA，而平均术中被动再充电刺激阈值为3.9mA，尽管这种差异在t检验中没有统计学意义（p=0.442）。临床随访时的平均刺激阈值为3.2mA。在皮尔逊相关性中，术中被动再充电阈值与随访刺激阈值(Pearsonr=0.5281,p<0.001)的相关性高于术中主动再充电阈值(Pearsonr=0.340,p=0.018),然而,在FisherZ相关检验中,这些相关性之间的差异无统计学意义(p=0.294).术中被动再充电刺激阈值与随访刺激阈值的平均差值为0.8mA,而术中主动充电阈值和随访阈值之间的平均差异为1.2mA。这种差异在t检验中没有统计学意义(p=0.134)。
■术中主动再充电和被动再充电刺激均与首次编程访视时的单极检查密切相关。没有观察到统计学上的显着差异，表明术中可以使用被动或主动充电。
■对2021年至2022年连续65例接受DBS的患者进行回顾性分析。对所有纳入患者进行了术中单极检查，同时进行了主动充电和被动充电，以确定副作用刺激阈值。16例患者（共64例DBS接触者）符合进一步分析的纳入标准。将术中单极审查结果与第一次DBS编程访问的单极审查进行比较。
■术中主动再充电刺激阈值平均值为4.1mA，而平均术中被动再充电刺激阈值为3.9mA，尽管这种差异在t检验中没有统计学意义（p=0.442）。临床随访时的平均刺激阈值为3.2mA。在皮尔逊相关性中，术中被动再充电阈值与随访刺激阈值(Pearsonr=0.5281,p<0.001)的相关性高于术中主动再充电阈值(Pearsonr=0.340,p=0.018),然而,在FisherZ相关检验中,这些相关性之间的差异无统计学意义(p=0.294).术中被动再充电刺激阈值与随访刺激阈值的平均差值为0.8mA,而术中主动充电阈值和随访阈值之间的平均差异为1.2mA。这种差异在t检验中没有统计学意义(p=0.134)。
■术中主动再充电和被动再充电刺激均与首次编程访视时的单极检查密切相关。没有观察到统计学上的显着差异，表明术中可以使用被动或主动充电。
