Deep brain stimulation surgery under general anaesthesia with microelectrode recording: the best of both worlds or a little bit of everything?

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Objectives

Most aged people will experience brain atrophy and decrease of cerebral blood flow. In order to avoid missing brain lesions, we apply brain processing software NeuroGam with SPECT to evaluate and analyze the brain cerebral cortical blood flow dynamic data in elderly patients.

Methods

Siemens Symbia T16 SPECT/CT, patients were injected 99Tcm-ECD 1480Mbq. 10 male patients aged 70 years or older who underwent SPECT/CT in period from May to July 2013. Group A of five cases who were group control without cerebral infarction, cerebral hemorrhage, senile dementia, Parkinson9s disease, or any organic or functional impairments. Group B of 5 cases who had unilateral old cerebral infarction or cerebral hemorrhage.

Results

NeuroGam software offers each corresponding region of interest expressed as a percentage of the mean pixel value in the entire volume, including the anterior cerebral, middle cerebral, and vertebral terrain. The data of Group A, the left and right side of the mean blood flow did not exceed more than 1.8%. The data of Group B, according to the lesion location in different regions, left and right side of the mean blood flow blood vessels were more than 2.5%. Except for the temporal lobe and the cerebellar cortex. The data of Group A, the difference between left and right side of the mean blood flow did not exceed more than 1.2%. The data of Group B, according to the lesion location in different regions , the difference between left and right side of the mean changes in blood flow were more than 2%. Some data of Group A in temporal lobe and cerebellar cortex appears more than 2% difference, but there is no clinical evidence of other test results. Compared with traditional nuclear medicine images, when the mean blood flow changes more than 4%, it can show the difference. When the mean blood flow changes more than 6%, it can show a significant difference in visual form.

Conclusions

NeuroGam software can quickly reflect the changes in the cerebral cortex between left and right side. However, when it analyzes the changes in the temporal lobe and cerebellum regions, it may be false positives.