深部脳刺激術中の前頭前皮質生検は手術リスクを増大させない(Obtaining Prefrontal Cortex Biopsies During Deep Brain Stimulation Adds No Risk to Procedure)

2025-09-04

2025-09-03 マウントサイナイ医療システム (MSHS)

マウントサイナイの研究で、深部脳刺激(DBS)手術と同時に前頭前皮質の生検を行っても安全性に問題がないことが示された。2013～2024年に実施された1,152件のDBS手術を解析し、652件で生検を行い、500件は行わなかった。術後90日までの感染、頭蓋内出血、てんかん発作の発生率に有意差はなく、認知機能にも影響は確認されなかった。生検はDBS手技中に行う標準的な小規模サンプル採取で、再現性が高くリスクも最小限だった。この成果により、生存者からの脳組織サンプルを安全に収集できる可能性が示され、脳の分子研究を進める「Living Brain Project」に大きく貢献することが期待される。研究結果は『Neurosurgery』に掲載された。

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深部脳刺激術中の前頭前皮質生検の安全性 Safety of Prefrontal Cortex Biopsies During Deep Brain Stimulation Procedures

Akkus, Sema MD; Simons, Nicole W. MA; Mahtani, Sansara BA; Epstein, Ethan BA; Zuccaro, Philip BSc; Hashemi, Alice BSc; Naderi, Saum MA; Ng, Klaren BA; Chong, Renata Gonzalez BA; Pierce-Scher, Skyler BA; Rogers, Henry BSc; Ona, Gerard MD; Postolovsky, Bohdana BA; Keller, Kate BA; Liharska, Lora E. PhD; Nadkarni, Girish N. MD, MPH; Charney, Alexander W. MD, PhD; Kopell, Brian H. MD
Neurosurgery Published:September 3, 2025
DOI: 10.1227/neu.0000000000003711

Abstract

BACKGROUND AND OBJECTIVES:

A goal of medical research is to advance knowledge of the molecular biology underlying human brain function. Yet, few studies of human brain biology have been performed using brain tissue from living people. This is due to the lack of safe approaches to sampling the living human brain for rigorous scientific inquiry. The Living Brain Project (LBP) developed a method to biopsy a small volume of prefrontal cortex (PFC) tissue during deep brain stimulation (DBS) lead placement procedures. The objective of this LBP report was to establish the safety of the PFC biopsy approach.

METHODS:

Acute adverse events (ie, infection, intracranial hemorrhage [ICH], and seizures) were tracked after 1152 DBS procedures performed on 590 patients. A PFC biopsy was obtained in 652 procedures (“biopsy group”), and no biopsy was obtained in 500 procedures (“nonbiopsy group”). Cognitive health was assessed at baseline and 1 year after DBS surgery for 144 patients. Rates of acute adverse events and changes in cognitive health were compared between the biopsy and nonbiopsy groups.

RESULTS:

No infections occurred in either group. No statistically significant difference in ICH rate was observed between groups (1.7% biopsy group vs 1.4% nonbiopsy group; χ² test P-value = .88), and this observation held regardless of the anatomical location or the clinical severity of the ICH. No statistically significant difference in seizure rate was observed between groups (0.2% biopsy group vs 0.4% nonbiopsy group; P-value = .82). No statistically significant associations were observed between number of biopsies and changes in cognitive health over time.