Chronological Changes of C-Reactive Protein Levels Following Uncomplicated, Two-Staged, Bilateral Deep Brain Stimulation.
10.3340/jkns.2015.58.4.368
- Author:
Jae Hun KIM
1
;
Sang Woo HA
;
Jin Gyu CHOI
;
Byung Chul SON
Author Information
1. Department of Neurosurgery, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. sbc@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
C-reactive protein;
Deep brain stimulation;
Inflammation;
Intracerebral infection
- MeSH:
C-Reactive Protein*;
Deep Brain Stimulation*;
Humans;
Inflammation;
Plasma;
Reference Values;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2015;58(4):368-372
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The occurrence of acute cerebral infection following deep brain stimulation (DBS) is currently being reported with elevation of C-reactive protein (CRP) level. The aim of the present study was to establish normal range of the magnitude and time-course of CRP increases following routine DBS procedures in the absence of clinical and laboratory signs of infection. METHODS: A retrospective evaluation of serial changes of plasma CRP levels in 46 patients undergoing bilateral, two-staged DBS was performed. Because DBS was performed as a two-staged procedure involving; implantation of lead and internal pulse generator (IPG), CRP was measured preoperatively and postoperatively every 2 days until normalization of CRP (post-lead implantation day 2 and 4, post-IPG implantation day 2, 4, and 6). RESULTS: Compared with preoperative CRP levels (0.12+/-0.17 mg/dL, n=46), mean CRP levels were significantly elevated after lead insertion day 2 and 4 (1.68+/-1.83 mg/dL, n=46 and 0.76+/-0.38 mg/dL, n=16, respectively, p<0.001). The mean CRP levels at post-lead implantation day 2 were further elevated at post-IPG implantation day 2 (3.41+/-2.56 mg/dL, n=46, respectively, p<0.01). This elevation in post-IPG day 2 rapidly declined in day 4 (1.24+/-1.29 mg/dL, n=46, p<0.05) and normalized to preoperative value at day 6 (0.42+/-0.33 mg/dL, n=46, p>0.05). Mean CRP levels after IPG implantation were significantly higher in patients whose IPGs were implanted at post-lead day 3 than those at post-lead day 5-6 (3.99+/-2.80 mg/dL, n=30, and 2.31+/-1.56 mg/dL, n=16, respectively, p<0.05). However, there was no difference in post-IPG day 2 and 4 between them (p>0.05). CONCLUSION: The mean postoperative CRP levels were highest on post-IPG insertion day 2 and decreased rapidly, returning to the normal range on post-IPG implantation day 6. The duration of post-lead implantation period influenced the magnitude of CRP elevation at post-IPG insertion day 2. Information about the normal response of CRP following DBS could help to avoid unnecessary diagnostic and therapeutic efforts.
