Neurophysiological Intraoperative Monitoring in the Elderly.
Journal
Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
ISSN: 1537-1603
Titre abrégé: J Clin Neurophysiol
Pays: United States
ID NLM: 8506708
Informations de publication
Date de publication:
01 May 2021
01 May 2021
Historique:
pubmed:
7
3
2020
medline:
23
6
2021
entrez:
7
3
2020
Statut:
ppublish
Résumé
Intraoperative neurophysiological monitoring (IONM) is widely used to prevent nervous system injury during surgeries in elderly patients. However, there are no studies that describe the characteristics and changes in neurophysiological tests during the IONM of patients aged 60 years and older. The study aims to describe and compare IONM changes during surgeries in adult patients aged 18 to 59 years with those aged 60 years and older. We performed a comparative retrospective study of patients aged 18 to 59 years versus those 60 aged years and older who underwent IONM during 2013 to 2018 in Mexico City. Sociodemographic characteristics were recorded and compared. Intraoperative neurophysiological monitoring techniques, their changes, and surgical procedures for both groups were analyzed and compared using descriptive statistics, Mann-Whitney U, Fisher, and χ2 tests. The sensitivity, specificity, and positive and negative predictive values were calculated. In total, 195 patients were analyzed: 104 patients, 68.63 ± 6.54 years old (elderly group) and 91 patients, 42.3 ± 10.5 years old (younger group). No differences were found in the rates of signal change during IONM between the group of elderly patients and the younger group. The sensitivity, specificity, and positive and negative predictive values were 80%, 99%, 80%, and 99%, respectively. Elderly patients have a similar rate of changes in IONM signals compared with younger patients during heterogeneous surgeries guided by IONM.
Identifiants
pubmed: 32141983
pii: 00004691-202105000-00014
doi: 10.1097/WNP.0000000000000689
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
231-236Informations de copyright
Copyright © 2020 by the American Clinical Neurophysiology Society.
Déclaration de conflit d'intérêts
The authors have no funding or conflicts of interest to disclose.
Références
World Health Organization. World Report on Ageing and Health, 2015. Available at: http://www.who.int/ageing/events/world-report-2015-launch/en/ . Accessed March 19, 2019.
Chatterji S, Byles J, Cutler D, Seeman T, Verdes E. Health, functioning, and disability in older adults—present status and future implications. Lancet 2015;385:563–575.
Babiloni C, Del Percio C, Bujan A. EEG in dementing disorders. In: Schomer DL, Lopes da Silva FH, eds. Niedermeyer's Electroencephalography: Basic Principles, Clinical Applications, and Related Fields. New York: Lippincott Williams & Wilkins, 2011; 413–432.
Dorfman LJ, Bosley TM. Age-related changes in peripheral and central nerve conduction in man. Neurology 1979a;29:38–44.
McNeil CJ, Doherty TJ, Stashuk DW, Rice CL. Motor unit number estimates in the tibialis anterior muscle of young, old, and very old men. Muscle Nerve 2005;31:461–467.
Power GA, Dalton BH, Behm DG, Vandervoort AA, Doherty TJ, Rice CL. Motor unit number estimates in masters runners: use it or lose it? Med Sci Sports Exerc 2010;42:1644–1650.
Mayer RF. Nerve conduction studies in man. Neurology 1963;13:1021–1030.
Alemo S, Sayadipour A. Role of intraoperative neurophysiologic monitoring in lumbosacral spine fusion and instrumentation: a retrospective study. World Neurosurg 2010;73:72–76.
Malhotra NR, Shaffrey CI. Intraoperative electrophysiological monitoring in spine surgery. Spine 2010;35:2167–2179.
Ney JP, van der Goes DN, Watanabe JH. Cost-effectiveness of intraoperative neurophysiological monitoring for spinal surgeries: beginning steps. Clin Neurophysiol 2012;123:1705–1707.
Simon MV, Cole AJ, Chang EC, et al. An intraoperative multimodal neurophysiologic approach to successful resection of precentral gyrus epileptogenic lesions: OR Neurophysiology for Epilepsy Surgery. Epilepsia 2012;53:e75–e79.
Nuwer MR. Evidence-based guideline update: intraoperative spinal monitoring with somatosensory and transcranial electrical motor evoked potentials: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Clinical Neurophysiology Society. Neurology 2012;78:585–589.
Makarov MR, Samchukov ML, Birch JG, Cherkashin AM, Sparagana SP, Delgado MR. Somatosensory evoked potential monitoring of peripheral nerves during external fixation for limb lengthening and correction of deformity in children. J Bone Joint Surg Br 2012;94-B:1421–1426.
Feyissa AM, Tummala S. Intraoperative neurophysiologic monitoring with Hoffmann reflex during thoracic spine surgery. J Clin Neurosci 2015;22:990–994.
Ghadirpour R, Nasi D, Iaccarino C, et al. Intraoperative neurophysiological monitoring for intradural extramedullary tumors: why not? Clin Neurol Neurosurg 2015;130:140–149.
Herrera-Pérez M, Andarcia-Bañuelos C, de Bergua-Domingo J, Paul J, Barg A, Valderrabano V. Propuesta de algoritmo global de tratamiento del hallux rigidus según la medicina basada en la evidencia. Rev Esp Cir Ortopédica Traumatol 2014;58:377–386.
Plata-Bello J, Pérez-Lorensu PJ, Brage L, et al. Electrical stimulation threshold in chronically compressed lumbar nerve roots: observational study. Clin Neurol Neurosurg 2015;139:1–5.
Nuwer MR, Emerson RG, Galloway G, et al. Evidence-based guideline update: intraoperative spinal monitoring with somatosensory and transcranial electrical motor evoked potentials. J Clin Neurophysiol 2012;29:101–108.
Youssef AS, Downes AE. Intraoperative neurophysiological monitoring in vestibular schwannoma surgery: advances and clinical implications. Neurosurg Focus 2009;27:E9.
Ringel F, Sala F. Intraoperative mapping and monitoring in supratentorial tumor surgery. J Neurosurg Sci 2015;59:129–139.
Robert EG, Happel LT, Kline DG. Intraoperative nerve action potential recordings. Neurosurgery 2009;65:A97–A104.
Ebersole JS, Pedley TA. Current Practice of Clinical Electroencephalography. 3rd ed. Philadephia, PA: Lippincott Williams & Wilkins, 2003.
Isaev NK, Genrikhs EE, Oborina MV, Stelmashook EV. Accelerated aging and aging process in the brain. Rev Neurosci 2018;29:233–240.
Yeoman M, Scutt G, Faragher R. Insights into CNS ageing from animal models of senescence. Nat Rev Neurosci 2012;13:435–445.
Painter MW. Aging Schwann cells: mechanisms, implications, future directions. Curr Opin Neurobiol 2017;47:203–208.
Rygiel KA, Picard M, Turnbull DM. The ageing neuromuscular system and sarcopenia: a mitochondrial perspective. J Physiol 2016;594:4499–4512.
Dorfman LJ, Bosley TM. Age-related changes in peripheral and central nerve conduction in man. Neurology 1979b;29:38–44.
Kjaer M. Recognizability of brain stem auditory evoked potential components. Acta Neurol Scand 2009;62:20–33.
Jakobsson F, Borg K, Edström L, Grimby L. Use of motor units in relation to muscle fiber type and size in man. Muscle Nerve 1988;11:1211–1218.
Ciciliot S, Rossi AC, Dyar KA, Blaauw B, Schiaffino S. Muscle type and fiber type specificity in muscle wasting. Int J Biochem Cell Biol 2013;45:2191–2199.
Sloan TB. Muscle relaxant use during intraoperative neurophysiologic monitoring. J Clin Monit Comput 2013;27:35–46.
Macdonald DB, Skinner S, Shils J, Yingling C; American Society of Neurophysiological Monitoring. Intraoperative motor evoked potential monitoring—a position statement by the American Society of Neurophysiological Monitoring. Clin Neurophysiol 2013;124:2291–2316.
Calancie B, Klose KJ, Baier S, Green BA. Isoflurane-induced attenuation of motor evoked potentials caused by electrical motor cortex stimulation during surgery. J Neurosurg 1991;74:897–904.
Zentner J, Kiss I, Ebner A. Influence of anesthetics-nitrous oxide in particular-on electromyographic response evoked by transcranial electrical stimulation of the cortex. Neurosurgery 1989;24:253–256.
Zentner J, Ebner A. Nitrous oxide suppresses the electromyographic response evoked by electrical stimulation of the motor cortex. Neurosurgery 1989;24:60–62.
Jang YC, Van Remmen H. Age-associated alterations of the neuromuscular junction. Exp Gerontol 2011;46:193–198.
Hernández-Palazón J, Izura V, Fuentes-García D, Piqueras-Pérez C, Doménech-Asensi P, Falcón-Araña L. Comparison of the effects of propofol and sevoflurane combined with remifentanil on transcranial electric motor-evoked and somatosensory-evoked potential monitoring during brainstem surgery. J Neurosurg Anesthesiol 2015;27:282–288.
Kerz T, Hennes HJ, Fève A, Decq P, Filipetti P, Duvaldestin P. Effects of propofol on H-reflex in humans. Anesthesiology 2015;94:32–37.
Macdonald DB. Intraoperative motor evoked potential monitoring: overview and update. J Clin Monit Comput 2006;20:347–377.
Macdonald DB, Al Zayed Z, Al Saddigi A. Four-limb muscle motor evoked potential and optimized somatosensory evoked potential monitoring with decussation assessment: results in 206 thoracolumbar spine surgeries. Eur Sect Cerv Spine Res Soc 2007;16:S171–S187.
Patton HD, Amassian VE. Single and multiple-unit analysis of cortical stage of pyramidal tract activation. J Neurophysiol 1954;17:345–363.
Chen X, Sterio D, Ming X, et al. Success rate of motor evoked potentials for intraoperative neurophysiologic monitoring: effects of age, lesion location, and preoperative neurologic deficits. J Clin Neurophysiol 2007;24:281–285.
Chen JH, Shilian P, Cheongsiatmoy J, Gonzalez AA. Factors associated with inadequate intraoperative baseline lower extremity somatosensory evoked potentials. J Clin Neurophysiol 2018;35:426–430.