Neuromodulation : journal of the International Neuromodulation Society
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Deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and the subthalamic nucleus (STN) are established treatment option in Parkinson's disease (PD). If DBS does not provide the desired effect, re-operation to the alternative target is a treatment option, but data on the effect of re-operation are scarce. ⋯ Re-operation to a different target due to lack of effect appears to have a limited chance of leading to objective improvement if the leads were correctly placed during initial surgery.
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Target localization for deep brain stimulation (DBS) is a challenging step that determines not only the correct placement of stimulation electrodes, but also influences the success of the DBS procedure as reflected in the desired clinical outcome of a patient. ⋯ LL-SSEPs represent a promising approach for DBS target localization in the STN, provided deeper understanding on their anesthesia effect is obtained. This approach is advantageous in that it does not require the patient's participation in an intraoperative setting.
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Deep brain stimulation (DBS) is a well-established therapy for otherwise intractable movement disorders. Thus far, most patients receive nonrechargeable implantable pulse generators (IPG). Eventually, another intervention to replace the IPG is inevitable. ⋯ Our findings imply that IPG longevity is shorter in the Activa PC compared to the Kinetra. Higher TEED and more frequent IPG replacements might reduce IPG longevity.
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Observational Study
DBS Electrodes With Single Disconnected Contacts: Long-Term Observation and Implications for the Management.
To evaluate the long-term course of quadripolar DBS electrodes with disconnected single contacts that cannot be used for DBS. ⋯ Disconnections of single contacts occur with increasing cumulative incidence during long-term DBS. Surgery is the main causative risk factor. In the majority of electrodes, the dysfunction remains restricted to the initial contact(s).
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Rechargeable internal pulse generators (r-IPGs) for deep brain stimulation (DBS) promise a longer battery life and cost effectiveness compared to non-rechargeable IPGs. However, patients need to learn to check the battery capacity and perform the recharging process to ensure continuous therapy. ⋯ Choosing a r-IPG during initial DBS surgery is safe and associated with a low number of adverse events even in older patients. The vast majority of patients consider handling and recharging the IPG as "easy." Most of the patients undergoing DBS for movement disorders will benefit from the advantages of r-IPGs.