Neuromodulation : journal of the International Neuromodulation Society
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Nonrechargeable deep brain stimulation (DBS) generators must be replaced when the battery capacity is exhausted. Battery life depends on many factors and differs between generator models. A new nonrechargeable generator model replaced the previous model in 2008. Our clinical impression is that the earlier model had a longer battery life than the new one. We conducted this study to substantiate this. ⋯ The battery life of the new model was significantly shorter than that of the previous model. A lower battery capacity is the most likely reason, since current consumption was similar in both groups.
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In closed-loop on-demand control (ODC) of deep brain stimulation (DBS), stimulation is applied only when symptoms appear. Following stimulation of a fixed duration, DBS is switched off until the symptoms reappear. By repeating these demand-driven cycles, the amount of stimulation delivered can be decreased, thereby reducing DBS side-effects and improving battery-life of the pulse-generator. This article introduces Ro metric for quantification of degree of benefit of ODC and explores candidate selection in tremor-dominant Parkinson's disease (PD). ⋯ Ro values can be used for selection of optimal DS* in ODC. Three of nine patients were found to be tremor-free without stimulation for >50% of total time with even up to 80% in one patient. Patients with low Ro may not benefit from ODC in DBS, where the trade-off between having side-effects and using ODC system will need to be assessed.
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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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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.