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01-06-2016 | Neurology and Preclinical Neurological Studies - Original Article

Disease-specific longevity of impulse generators in deep brain stimulation and review of the literature

Authors: Christoph van Riesen, Georg Tsironis, Doreen Gruber, Fabian Klostermann, Patricia Krause, Gerd Helge Schneider, Andreas Kupsch

Published in: Journal of Neural Transmission | Issue 6/2016

Abstract

Deep brain stimulation (DBS) represents an established and internationally approved therapy for movement disorders. In the present retrospective analysis, we evaluated disease-specific longevity of dual channel impulse generators (IPG) used in different movement disorders. We correlated the battery lifetime with electrical stimulation settings, “total electrical energy delivered” (TEED), stimulation modi (monopolar, double monopolar and bipolar) and targets. Specifically, we reviewed the longevity and stimulation settings of 464 IPGs implanted between 1996 until 2011 in a single university center. Disease entities comprised Parkinson’s disease (PD, n = 257), dystonia (n = 130) and essential tremor (ET, n = 50). Further subanalyses aimed at assessing differential longevity in different subtypes of PD and dystonia. The main finding relates to longer IPG longevity in ET (thalamic DBS) and PD (subthalamic DBS) vs. dystonia (pallidal DBS; 71.9 ± 6.7 vs. 51.5 ± 2.3 vs. 37 ± 2 months). In PD the tremor-dominant type was associated with a significant shorter battery survival than in the akinetic-rigid type without tremor or the “balanced” type with tremor, bradykinesia and rigidity (38.8 ± 3.9 vs. 53.6 ± 3.4 vs. 58.8 ± 4.1 months), while there were no significant differences in longevity between the subtypes of dystonia. Frequency, amplitude, pulse widths and TEED correlated inversely with battery lifetime. Pallidal DBS in dystonia is associated with a shorter lifetime of IPGs than subthalamic or thalamic DBS for PD or ET. The present results may contribute to the rapidly evolving refinement of DBS devices. Future studies that assess energy consumption both in patients with and without IPG replacement could help to avoid potential underestimation of longevity of IPGs.

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Title: Disease-specific longevity of impulse generators in deep brain stimulation and review of the literature
Authors: Christoph van Riesen
Georg Tsironis
Doreen Gruber
Fabian Klostermann
Patricia Krause
Gerd Helge Schneider
Andreas Kupsch
Publication date: 01-06-2016
Publisher: Springer Vienna
Published in: Journal of Neural Transmission / Issue 6/2016
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-016-1562-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Disease-specific longevity of impulse generators in deep brain stimulation and review of the literature

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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