Postoperative use of steroids for peri-electrode edema after deep brain stimulation surgery: A retrospective cohort study

CNS Neurosci Ther. 2024 Mar;30(3):e14470. doi: 10.1111/cns.14470. Epub 2023 Sep 16.

Abstract

Background: To review the incidence and extent of peri-electrode edema after DBS and to clarify the effect of postoperative use of steroids on the peri-electrode edema.

Methods: This retrospective cohort study included 250 patients who underwent bilateral subthalamic nucleus (STN) DBS surgery with intact MRI within 1 month after DBS surgery. Patients were divided into steroid and non-steroid groups, based on postoperative steroids use. The occurrence and extent of peri-electrode edema were compared between the two groups, and other associated factors were analyzed using univariate and multivariate methods.

Results: Peri-electrode edema >1 cm3 in at least one hemisphere was reported in 215 (86.00%) patients. The mean volume of peri-electrode edema observed in the steroid group was significantly smaller than in the non-steroid group (8.09 ± 8.47 cm3 vs 17.10 ± 16.90 cm3 , p < 0.001). In the steroid group, 104 (32.91%) of the 316 implanted electrodes present with edema less than 1 cm3 , whereas in the non-steroid group, only 27 (14.67%) of the 184 implanted electrodes present with edema less than 1 cm3 (p < 0.001). Multivariate analysis indicated that lesser peri-electrode edema was significantly associated with postoperative steroids use and general anesthesia.

Conclusions: Peri-electrode edema is common after DBS surgery, and postoperative steroids use reduces the occurrence and extent of peri-electrode edema.

Keywords: Parkinson's disease; deep brain stimulation; dexamethasone; peri-electrode edema; steroids.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Deep Brain Stimulation* / adverse effects
  • Deep Brain Stimulation* / methods
  • Edema / etiology
  • Electrodes, Implanted / adverse effects
  • Humans
  • Parkinson Disease* / therapy
  • Retrospective Studies
  • Steroids / therapeutic use

Substances

  • Steroids