Risk of Infection After Local Field Potential Recording from Externalized Deep Brain Stimulation Leads in Parkinson's Disease.
OBJECTIVE
Adaptive deep brain stimulation (aDBS) controlled by local field potentials (LFPs) is considered a promising treatment for advanced Parkinson's disease (PD). The clinical research investigating aDBS functioning is performed using external deep brain stimulation (DBS) systems that require LFP recording through the temporary externalization of DBS leads. Although research examining LFP was first undertaken more than 20 years ago, only a few studies concern lead externalization and LFP recording safety. In the present retrospective study, we assessed the risk of infection related to these procedures.


METHODS
A total of 105 patients with PD who underwent DBS surgery and lead externalization at our hospital from 2002 to 2014 were included in the present study. The medical records were used to collect clinical data and information concerning surgical site infections. We assessed the infection incidence in our cohort and the risk of infection related to the LFP recording procedure.


RESULTS
The incidence of infections in patients who underwent lead externalization was 2.8%, which was consistent with the postoperative infectious risk reported in the literature (Wilcoxon signed rank test; P > 0.05). Moreover, the LFP recording procedure did not significantly increase the infection risk (LFP recordings vs. no LFP recordings: 2.5% vs. 4.2%; Fisher exact test; P > 0.05).


CONCLUSIONS
DBS lead externalization and LFP recording are safe and do not increase the postoperative infection risk in patients with PD who undergo DBS surgery. Our retrospective study supported further clinical research in the field of LFP-based aDBS.
Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Manuela
M
Rosa
Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Emma
E
Scelzo
Unit of Stereotactic Functional and Neuroendoscopic Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Marco
M
Locatelli
Unit of Stereotactic Functional and Neuroendoscopic Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Giorgio
G
Carrabba
Unit of Stereotactic Functional and Neuroendoscopic Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Vincenzo
V
Levi
Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Mattia
M
Arlotti
Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Unit of Clinical Neurophysiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Sergio
S
Barbieri
Unit of Stereotactic Functional and Neuroendoscopic Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Paolo
P
Rampini
Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; III Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, Italy. Electronic address: alberto.priori@unimi.it.
Alberto
A
Priori
D019072:Antibiotic Prophylaxis / Q000379:methods; D015331:Cohort Studies; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000209:etiology*; D007854:Lead / Q000633:toxicity*; D008297:Male; D008875:Middle Aged; D009482:Neurophysiology; D010300:Parkinson Disease / Q000628:therapy*; D012189:Retrospective Studies
D007854:Lead
Adaptive deep brain stimulation; Infections; Lead externalization; Local field potentials; Parkinson's disease