Effects of Dexmedetomidine on Activity in the Subthalamic Nucleus

University of Wisconsin, Madison6 enrolled

Overview

The purpose of this research study is to find out whether dexmedetomidine changes brain cell activity in the subthalamic nucleus (STN).

In order to find whether dexmedetomidine is optimal for sedation during Deep brain stimulation surgery, we will measure the electrical activity in the STN during Deep brain stimulation surgery, and measure how this activity is changed during administration of Dexmedetomidine. We hypothesize that dexmedetomidine does not change the firing rate and pattern in the STN.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Parkinson's Disease Deep Brain Stimulation Surgery

Interventions

DexmedetomidineDRUG

Dexmedetomidine infusion will be started with a loading dose of 1 mcg/Kg over ten to 20 minutes followed by a maintenance infusion of 0.7 mcg/Kg/hr until stable sedation is achieved.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients scheduled to undergo bilateral STN electrode implantation surgery with Micro-electrode recording for the treatment of Parkinson's disease. Exclusion Criteria: * Hypersensitivity to dexmedetomidine * Bradycardia: Sinus rhythm slower than 50 bpm * Known or suspected obstructive sleep apnea * Suspected difficult intubation * Pregnancy * Under 18 years of age or over 85 years of age * Cognitive disability impairing understanding the experiment or signing the informed consent form

Locations (1)

University of Wisconsin - Madison, School of Medicine and Public Health

Madison, Wisconsin, United States

Outcomes

Primary Outcomes

Change in Average Population Spiking Activity

We calculated the root mean square (RMS) of the high frequency electrical activity. This is a common measure for the spiking rate of the population of neurons in the vicinity of the electrode tip. This Measure has been previously described as a useful measure to determine the target location during deep brain stimulation (DBS) procedures. We calculated the change in RMS inside the STN between baseline and peak sedation. For each subject we normalized the RMS to the RMS of the electrical activity outside the nucleus. This is done to eliminate the effects of noise and variability in electrode resistance. Thus, the normalized RMS is a pure number with no units.

Time frame: 20-35 minutes following drug administration

Secondary Outcomes

Change in Average Firing Pattern in the STN

We've used total power in the Beta range (13-30Hz) to evaluate change in firing pattern and oscillation frequency.

Time frame: 20-35 minutes following drug administration

Time to Recovery

The time it takes for the patient to become alert after drug administration is stopped.

Time frame: 20-60 minutes after stopping drug administration

Portion of Participants With Timely Return of the Neuronal Activity to Baseline

The portion of patients in which neuronal activity returned to baseline within 30 after stopping sedation.

Time frame: 30 minutes after stopping drug administration

Data from ClinicalTrials.gov

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