Intracranial approach for sub-second monitoring of neurotransmitters during DBS electrode implantation does not increase infection rate

Abstract

Introduction Currently, sub-second monitoring of neurotransmitter release in humans can only be performed during standard of care invasive procedures like DBS electrode implantation. The procedure requires acute insertion of a research probe and additional time in surgery, which may increase infection risk. We sought to determine the impact of our research procedure, particularly the extended time in surgery, on infection risk. Methods We screened 602 patients who had one or more procedure codes documented for DBS electrode implantation, generator placement, programming, or revision for any reason performed at Wake Forest Baptist Medical Center between January 2011 through October 2020 using International Classification of Diseases (ICD) codes for infection. During this period, 116 patients included an IRB approved 30-minute research protocol, during the Phase 1 DBS electrode implantation surgery, to monitor sub-second neurotransmitter release. We used Fisher’s Exact test (FET) to determine if there was a significant change in the infection rate following DBS electrode implantation procedures that included, versus those that did not include, the neurotransmitter monitoring research protocol. Results Within 30-days following DBS electrode implantation, infection was observed in 1 (0.21%) out of 486 patients that did not participate in the research procedure and 2 (1.72%) of the 116 patients that did participate in the research procedure. Notably, all types of infection observed were typical of those expected for DBS electrode implantation. Conclusion Infection rates are not statistically different across research and non-research groups within 30-days following the research procedure (1.72% vs. 0.21%; p = 0.0966, FET). Our results demonstrate that the research procedures used for sub-second monitoring of neurotransmitter release in humans can be performed without increasing the rate of infection.

Subsecond fluctuations in extracellular dopamine encode reward and punishment prediction errors in humans

“…Following the research procedure, the carbon-fiber microelectrode is removed, and the DBS electrode implantation surgery is completed. No change in the outcome or associated risks have been associated with performing this kind of intracranial research ( 48 ).…”

Intracranial subsecond dopamine measurements during a “sure bet or gamble” decision-making task in patients with alcohol use disorder suggest diminished dopaminergic signals about relief

“…Notably, recent work has demonstrated that this research protocol does not increase the infection rate compared with DBS surgeries without this research protocol. 19 The FSCV protocol and analysis used in this study followed prior work. 10,[13][14][15] Carbon fiber microsensors were conditioned using a 60-Hz application of a triangular voltage protocol for approximately 10 minutes.…”

Sub-second fluctuations in extracellular dopamine encode reward and punishment prediction errors in humans

“…Following the research procedure, the carbon fiber microelectrode is removed and the DBS electrode implantation surgery is completed. Importantly, no change in the outcome or associated risks have been associated with performing this intracranial research ( 46 ).…”

“…Importantly, no change in the outcome or associated risks have been associated with performing this intracranial research (46).…”