Clinical Efficacy of Bilateral Deep Brain Stimulation Does Not Change After Implantable Pulse Generator Replacement but the Impedances Do: A Prospective Study

Niemann, Marcel; Schneider, Gerd‐Helge; Kühn, Andrea A.; Vajkoczy, Peter; Faust, Katharina

doi:10.1111/ner.13022

Cited by 4 publications

(5 citation statements)

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“…Depending on the patient's diagnosis and DBS parameter settings, the fixed-life batteries need to be replaced 3–5 years after implantation. Battery depletion is the most common reason for additional surgery in DBS patients ( 1 , 2 ). Although IPG replacement is a minor surgical procedure compared to primary brain surgery, multiple IPG replacements over the course of the patient's treatment and illness can pose an increased health risk, such as an elevated post-implantation infection risk and wound healing problems ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…The choice between rechargeable and non-rechargeable IPGs was significantly associated with affordability (χ 2 (1) = 19.13, p < 0.001). Interestingly, the feature of remote programming significantly affected patients' choices between domestic and imported brands (χ 2 (1) = 16.81, p < 0.001). 87.7% of the patients were satisfied with the stimulating effects as well as the implanted device itself.…”

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confidence: 99%

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Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: Preference and Satisfaction in Chinese Patients With Parkinson's Disease

et al. 2021

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Introduction: DBS is a widely used therapy for PD. There is now a choice between fixed-life implantable pulse generators (IPGs) and rechargeable IPGs, each having advantages and disadvantages. This study aimed to evaluate the preference and satisfaction of Chinese patients with Parkinson's disease (PD) who were treated with deep brain stimulation (DBS).Materials and Methods: Two hundred and twenty PD patients were treated with DBS and completed a self-reported questionnaire to assess their long-term satisfaction and experience with the type of battery they had chosen and the key factors affecting these choices. The survey was performed online and double-checked for completeness and accuracy.Results: The median value of the postoperative duration was 18 months. The most popular way for patients to learn about DBS surgery was through media (79/220, 35.9%) including the Internet and television programs. In total, 87.3% of the DBS used rechargeable IPGs (r-IPG). The choice between rechargeable and non-rechargeable IPGs was significantly associated with affordability (χ(1)2 = 19.13, p < 0.001). Interestingly, the feature of remote programming significantly affected patients' choices between domestic and imported brands (χ(1)2 = 16.81, p < 0.001). 87.7% of the patients were satisfied with the stimulating effects as well as the implanted device itself. 40.6% of the patients with r-IPGs felt confident handling devices within 1 week after discharge. More than half of the patients checked their batteries every week. The mean interval for battery recharge was 4.3 days. 57.8% of the patients spent around 1 h recharging, and 71.4% of them recharged the battery independently.Conclusions: Most patients were satisfied with their choice of IPGs. The patients' economic status and the remote programming function of the device were the two most critical factors in their decision. The skill of recharging the IPG was easy to master for most patients.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: Preference and Satisfaction in Chinese Patients With Parkinson's Disease

et al. 2021

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“…Battery drain is the most common cause of additional surgery in DBS patients [12,15,16]. Although IPG replacement is a minor surgery compared to primary brain surgery, multiple IPG replacements during treatment and the patient's illness can increase the patient's health risk, such as the increased risk of post-implant infection and wound healing problems [17].…”

Section: Plain Language Summarymentioning

confidence: 99%

Evaluating the Longevity of Implantable Pulse Generator Used in Deep Brain Stimulation: A Systematic Review

Hannani

Beigi-Khoozani²,

Afshar-Zarandi³

2022

Iran J Neurosurg

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Background and Aim: Deep Brain Stimulation (DBS) surgery is increasingly performed to treat movement disorders. In these patients, a rechargeable or non-rechargeable battery is placed under their subcutaneous chest after implantation of an electrode in the basal ganglia of the brain, which has different battery life. Methods and Materials/Patients: In this study, three databases, including PubMed, ScienceDirect, Scopus without time limit, and Google Scholar search engine were examined by two independent researchers. Results: In the initial search, a total of 338 data were found. Then, by reviewing the title and summary of articles, 17 articles were included in the study and then 13 articles were reviewed in full text. The results of the articles were divided into two subgroups of battery life related to the types or subtypes of movement disorders indicated by DBS and battery life related to the types of IPG models. Conclusion: Battery life in Parkinson’s movement disorder and tremor is longer than in dystonia. Also, the battery life of Soletra model is longer than Kinetra and Kinetra model is longer than Activa, and any battery replacement surgery reduces battery life.

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“…The choice of IPG can be based on technical parameters. Converting to another type of IPG may cause a difference in impedances [7], requiring different parameter settings [8], and not all current available IPGs have the same longevity as the previous version [3]. Another important factor in the choice of IPG may be national or center-specific agreements on reimbursement [9].…”

Section: Introductionmentioning

confidence: 99%

Choice of Implantable Pulse Generators for Deep Brain Stimulation: An Overview of Clinical Practice

Willems¹,

Gaag²,

Kho

et al. 2023

Stereotact Funct Neurosurg

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Introduction: The success of deep brain stimulation (DBS) treatment depends on several factors, including proper patient selection, accurate electrode placement, and adequate stimulation settings. Another factor that may impact long-term satisfaction and therapy outcomes is the type of implantable pulse generator (IPG) used: rechargeable or non-rechargeable. However, there are currently no guidelines on the choice of IPG type. The present study investigates the current practices, opinions, and factors DBS clinicians consider when choosing an IPG for their patients. Methods: Between December 2021 and June 2022, we sent a structured questionnaire with 42 questions to DBS experts of two international, functional neurosurgery societies. The questionnaire included a rating scale where participants could rate the factors influencing their choice of IPG type and their satisfaction with certain IPG aspects. Additionally, we presented four clinical case scenarios to assess preference of choice of IPG-type in each case. Results: Eighty-seven participants from 30 different countries completed the questionnaire. The three most relevant factors for IPG choice were “existing social support,” “cognitive status,” and “patient age.” Most participants believed that patients valued avoiding repetitive replacement surgeries more than the burden of regularly recharging the IPG. Participants reported that they implanted the same amount of rechargeable as non-rechargeable IPGs for primary DBS insertions and 20% converted non-rechargeable to rechargeable IPGs during IPG replacements. Most participants estimated that rechargeable was the more cost-effective option. Conclusion: This present study shows that the decision-making of the choice of IPG is very individualized. We identified the key factors influencing the physician’s choice of IPG. Compared to patient-centric studies, clinicians may value different aspects. Therefore, clinicians should rely not only on their opinion but also counsel patients on different types of IPGs and consider the patient’s preferences. Uniform global guidelines on IPG choice may not represent regional or national differences in the healthcare systems.

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Clinical Efficacy of Bilateral Deep Brain Stimulation Does Not Change After Implantable Pulse Generator Replacement but the Impedances Do: A Prospective Study

Cited by 4 publications

References 54 publications

Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: Preference and Satisfaction in Chinese Patients With Parkinson's Disease

Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: Preference and Satisfaction in Chinese Patients With Parkinson's Disease

Evaluating the Longevity of Implantable Pulse Generator Used in Deep Brain Stimulation: A Systematic Review

Choice of Implantable Pulse Generators for Deep Brain Stimulation: An Overview of Clinical Practice

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