Desflurane and sevoflurane differentially affect activity of the subthalamic nucleus in Parkinson's disease. (February 2021)

• Record Type: Journal Article
• Authors: Chen, Yu-Chen; Chen, Shin-Yuan; Chen, Tsung-Ying; Pan, Jiann-I; Tsai, Sheng-Tzung
• Is Part Of: British journal of anaesthesia. Volume 126:Number 2(2021)
• Page Start: 477
• Page End: 485
• Publication Date: 2021-02
• Subjects: deep brain stimulation -- desflurane -- microelectrode recording -- Parkinson's disease -- sevoflurane -- subthalamic nucleus; Anesthesiology -- Periodicals; Anesthesia -- Periodicals; 617.9605
• DOI: 10.1016/j.bja.2020.09.041
• Languages: English
• ISSNs: 0007-0912

Abstract

Abstract: Background: Desflurane and sevoflurane are commonly used during inhalational anaesthesia, but few studies have investigated their effects on deep cerebral neuronal activity. In addition, the association between subthalamic nucleus (STN) neurophysiology and general anaesthesia induced by volatile anaesthetics are not yet identified. This study aimed to identify differences in neurophysiological characteristics of the STN during comparable minimal alveolar concentration (MAC) desflurane and sevoflurane anaesthesia for deep brain stimulation (DBS) in patients with Parkinson's disease. Methods: Twelve patients with similar Parkinson's disease severity received desflurane ( n =6) or sevoflurane ( n =6) during DBS surgery. We obtained STN spike firing using microelectrode recording at 0.5–0.6 MAC and compared firing rate, power spectral density, and coherence. Results: Neuronal firing rate was lower with desflurane (47.4 [26.7] Hz) than with sevoflurane (63.9 [36.5] Hz) anaesthesia ( P <0.001). Sevoflurane entrained greater gamma oscillation power than desflurane (62.9% [0.9%] vs 57.0% [1.5%], respectively; P =0.002). There was greater coherence in the theta band of the desflurane group compared with the sevoflurane group (13% vs 6%, respectively). Anaesthetic choice did not differentially influence STN mapping accuracy or the clinical outcome of DBS electrode implantation. Conclusions: Desflurane and sevoflurane produced distinct neurophysiological profiles in humans that may be associated with their analgesic and hypnotic actions.