Abstract Details

Title Predicting Post-operative Dysarthria Using Intra-operative Tongue Depression at High Pulse Width Stimulation During Asleep Deep Brain Stimulation

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-009

Objective

To assess the significance of intraoperative tongue depression as a predictor for postoperative dysarthria during asleep deep brain stimulation (DBS).

Background Asleep DBS targeting the subthalamic nucleus (STN) for Parkinson’s disease (PD) is an alternative to awake DBS in efforts to reduce psychological burden on patients. One disadvantage is the inability to intraoperatively monitor side effects of asleep DBS like postoperative dysarthria. Identifying predictors of postoperative dysarthria during asleep DBS can potentially reduce its impact on a patient’s quality of life. We hypothesize that tongue depression during intraoperative stimulation testing could predict postoperative dysarthria.

Design/Methods

We studied 21 PD patients who underwent asleep STN-DBS from January 2023 to January 2024. After DBS lead placement, test stimulation was applied at 90μs and 120μs (higher than therapeutic pulse width) with 1-6mA intensity, and the threshold for tongue depression was recorded. Postoperatively, dysarthria occurrence was evaluated using 60μs stimulation with 1-6mA intensity. Logistic regression analysis assessed the relationship between intraoperative tongue depression and postoperative dysarthria, with the cutoff determined by the Receiver Operating Characteristic (ROC) curve. The threshold for statistical significance was set at a p-value < 0.05.

Results Intraoperative tongue depression threshold at 90μs stimulation was significantly associated with postoperative dysarthria (p = 0.042, Odd's ratio (OR): 2.3, 95% confidence interval (CI): 1.03 – 5.3), with an ROC area under the curve (AUC) of 0.75 and cutoff value of 4.5mA (sensitivity 0.60, specificity 0.83). At 120μs, significant association was also found (p = 0.032, OR 2.4, 95% CI: 1.08 – 5.4), with an ROC AUC of 0.74 and cutoff of 3.75mA (sensitivity 0.82, specificity 0.67).

Conclusions

Intraoperative high pulse width stimulation during asleep DBS may predict postoperative dysarthria.

Authors/Disclosures
Neepa J. Patel, MD, FAAN (Rush University Medical Center) PRESENTER	Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie Pharmaceuticals. Dr. Patel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal Pharmaceuticals. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernius Pharmaceuticals. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific.
Vivekanudeep Karri, Medical Student	Mr. Karri has nothing to disclose.
Kazuki Sakakura, MD, PhD	Dr. Sakakura has nothing to disclose.
John J. Pearce III, MD	Dr. Pearce has nothing to disclose.
Nathan Pertsch, MD	Dr. Pertsch has nothing to disclose.
Qianyi Pu, MS	Ms. Pu has nothing to disclose.
Freya Mehta, Medical student	Ms. Mehta has nothing to disclose.
Sepehr Sani	The institution of Sepehr Sani has received research support from NIH. Sepehr Sani has received intellectual property interests from a discovery or technology relating to health care. Sepehr Sani has received publishing royalties from a publication relating to health care.

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