Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: A Prospective Long-Term Study of Patient’s Preferences

Furlanetti, Luciano; Raslan, Ahmed M.; Khaleeq, Tahir; Hasegawa, Harutomo; Tambirajoo, Kantharuby; Samuel, Michael; Ashkan, Keyoumars

doi:10.1159/000505700

Cited by 12 publications

(8 citation statements)

References 9 publications

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“…Furlanetti et al reported that the main reasons for choosing the nr-IPG were convenience and concern about forgetting to recharge; however, patients using r-IPG did not report experiencing this problem (18). In our study, the main reason for choosing an nr-IPG was the economic cost (92% of patients with nr-IPGs and 62% of patients with r-IPGs).…”

Section: Discussionmentioning

confidence: 50%

Fixed-Life or Rechargeable Batteries for Deep Brain Stimulation: Preference and Satisfaction Among Patients With Hyperkinetic Movement Disorders

et al. 2021

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Background: Deep brain stimulation (DBS) is an established treatment for hyperkinetic movement disorders. Patients undergoing DBS can choose between the use of a rechargeable or non-rechargeable battery for implanted pulse generators (IPG).Objectives: In this study, we aimed to evaluate patient preferences and satisfaction with rechargeable and non-rechargeable batteries for IPGs after undergoing DBS.Methods: Overall, 100 patients with hyperkinetic movement disorders (dystonia: 79, Tourette syndrome: 21) who had undergone DBS took a self-designed questionnaire to assess their satisfaction and experience with the type of battery they had chosen and the factors influencing their choice.Results: Of the participants, 87% were satisfied with the stimulating effects of the treatment as well as the implanted device; 76% had chosen rechargeable devices (r-IPGs), 71.4% of whom recharged the battery themselves. Economic factors were the main reason for choosing both r-IPG and non-rechargeable IPG (nr-IPG). The questionnaire revealed that 66% of the patients checked their r-IPG battery every week. The mean interval for battery recharge was 4.3 days.Conclusions: The majority of the patients were satisfied with their in-service-IPG, regardless of whether it was a r-IPG or nr-IPG. Affordability was the main factor influencing the choice of IPG. The majority of the patients were confident in recharging the battery of their r-IPG themselves; only 11% of patients experienced difficulties. Understanding the recharge process remains difficult for some patients and increasing the number of training sessions for the device may be helpful.

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Section: Discussionmentioning

confidence: 50%

Fixed-Life or Rechargeable Batteries for Deep Brain Stimulation: Preference and Satisfaction Among Patients With Hyperkinetic Movement Disorders

et al. 2021

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“…Most studies have focused on DBS safety and efficacy, but the patient's perspective on the DBS treatment delivered and the reasons for choosing or accepting a specific DBS system remain an important but under-recognized topic. For example, only a few studies performed in Europe have demonstrated that patients with PD preferred rechargeable IPG batteries over fixed-life batteries (7)(8)(9). This situation is problematic because patient preference and satisfaction are important for treatment acceptance, treatment compliance, and the further development of next generation of DBS systems.…”

Section: Introductionmentioning

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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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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“…The size of the non-rechargeable IPG showed a lower score on satisfaction than the size of the rechargeable IPG. Furlanetti et al [10] concluded that the concern about IPG size in patients that received a non-rechargeable IPG rose from 6.7% preoperatively to 60% on long-term postoperative follow-up. Size could be a determining factor, especially in patients with IPG discomfort, pocket pain, or low BMI.…”

Section: Discussionmentioning

confidence: 99%

“…Another important factor in the choice of IPG may be national or center-specific agreements on reimbursement [9]. Besides financial and technical reasons, motor and cognitive functions, patient capability to monitor and operate the device, the size of the IPG [10], and patient preference may be determining factors. The complexity of IPG choice is increased further by combining implants from different medical device manufacturers to enable new stimulation options with already implanted DBS electrodes by creating so-called hybrid DBS systems [11,12].…”

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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Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: A Prospective Long-Term Study of Patient’s Preferences

Cited by 12 publications

References 9 publications

Fixed-Life or Rechargeable Batteries for Deep Brain Stimulation: Preference and Satisfaction Among Patients With Hyperkinetic Movement Disorders

Fixed-Life or Rechargeable Batteries for Deep Brain Stimulation: Preference and Satisfaction Among Patients With Hyperkinetic Movement Disorders

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

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

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