Neuromodulation : journal of the International Neuromodulation Society
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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.
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The correct positioning of deep brain stimulation electrodes determines the success of surgery. In this study, we attempt to validate transcranial sonography (TCS) as a method for early postoperative confirmation of electrode location in the subthalamic nucleus (STN). ⋯ Transcranial sonography is a useful technique to reliably identify targeted positioning of deep brain stimulation electrodes in or out of the SN.
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Accurate electrode implantation is a major goal of deep brain stimulation (DBS) surgery. Intraoperative physiology with microelectrode recording (MER) is routinely used to refine stereotactic accuracy during awake electrode implantation. Recently, portable imaging systems such as the O-arm have become widely available and can be used in isolation or in association with MER to guide DBS lead placement. The aim of this study was to evaluate how the routine use of the O-arm affected DBS surgery safety, efficiency, and outcomes. ⋯ The use of the O-arm during DBS lead implantation was associated with significantly fewer brain cannulations for microelectrode recording as well as reduced surgical time.
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Pain is a prevalent and debilitating nonmotor symptom of Parkinson's disease (PD) that is often inadequately managed. Deep brain stimulation (DBS) has been shown to relieve pain in PD but an effective method of identifying which types of PD pain respond to DBS has not been established. We examine the effects of DBS on different types of PD pain using the King's Parkinson's disease pain scale (KPDPS), the only validated scale of PD pain. ⋯ In this pilot study, we are the first group to employ KPDPS to monitor pain relief following DBS in PD patients. We demonstrate that fluctuation-related pain and nocturnal pain significantly improve with DBS. Use of the KPDPS in the future will allow better understanding of how STN and GPi DBS treat PD pain over time.