Effect of Dexmedetomidine and Propofol on Basal Ganglia Activity in Parkinson Disease: A Controlled Clinical Trial
Antonio Martinez-Simon (1) , Manuel Alegre, Cristina Honorato-Cia, Jorge M Nuñez-Cordoba, Elena Cacho-Asenjo, Iñaki F Trocóniz, Mar Carmona-Abellán, Miguel Valencia, Jorge Guridi
(1) From the Department of Anesthesia, Perioperative Medicine and Critical Care (A.M.-S., C.H-C., E.C.-A.), Department of Neurophysiology (M.A.), Research Support Service, Central Clinical Trials Unit (J.M.N.-C), Department of Neurology (M.C.-A.), and Department of Neurosurgery (J.G.), University of Navarra Clinic, Pamplona, Spain; and Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy and Nutrition (I.F.T.) and Neurophysiology Laboratory, Center for Applied Medical Research (M.V.), University of Navarra, Pamplona, Spain.
Background: Deep brain stimulation electrodes can record oscillatory activity from deep brain structures, known as local field potentials. The authors' objective was to evaluate and quantify the effects of dexmedetomidine (0.2 μg·kg·h) on local field potentials in patients with Parkinson disease undergoing deep brain stimulation surgery compared with control recording (primary outcome), as well as the effect of propofol at different estimated peak effect site concentrations (0.5, 1.0, 1.5, 2.0, and 2.5 μg/ml) from control recording.
Methods: A nonrandomized, nonblinded controlled clinical trial was carried out to assess the change in local field potentials activity over time in 10 patients with Parkinson disease who underwent deep brain stimulation placement surgery (18 subthalamic nuclei). The relationship was assessed between the activity in nuclei in the same patient at a given time and repeated measures from the same nucleus over time.
Results: No significant difference was observed between the relative beta power of local field potentials in dexmedetomidine and control recordings (-7.7; 95% CI, -18.9 to 7.6). By contrast, there was a significant decline of 12.7% (95% CI, -21.3 to -4.7) in the relative beta power of the local field potentials for each increment in the estimated peak propofol concentrations at the effect site relative to the control recordings.
Conclusions: Dexmedetomidine (0.2 μg·kg·h) did not show effect on local field potentials compared with control recording. A significant deep brain activity decline from control recording was observed with incremental doses of propofol.
CITA DEL ARTÍCULO Anesthesiology . 2017 Jun;126(6):1033-1042. doi: 10.1097/ALN.0000000000001620