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Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease
Author(s) -
Anheim Mathieu,
Fraix Valérie,
Chabardès Stéphan,
Krack Paul,
Benabid AlimLouis,
Pollak Pierre
Publication year - 2007
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21726
Subject(s) - subthalamic nucleus , parkinson's disease , stimulation , deep brain stimulation , neuroscience , pulse (music) , medicine , degenerative disease , central nervous system disease , physical medicine and rehabilitation , psychology , disease , physics , optics , detector
Abstract The efficacy of bilateral subthalamic nucleus (STN) stimulation in Parkinson's disease (PD) is well‐established but little is known about the lifetime of implanted pulse generators (IPG). To investigate the lifetime of the bilaterally implanted Itrel II® (Medtronic, Minneapolis) pulse generator, the first 49 consecutive patients with PD having been operated on at our center for bilateral STN chronic stimulation were reviewed with noting of the stimulation parameters in use prior to IPG replacement. The mean electrical voltage was 3.2 ± 0.3 V, mean pulse width was 65 ± 10 μs, and mean frequency was 145 ± 16 Hz. Replacement of an IPG was anticipated in 25% due to unilateral low‐battery signaling, or end of life. In either case, replacement of the contralateral IPG was undertaken simultaneously. The mean IPG lifetime was 83 ± 14 [40–113] months. The IPG lifetime correlated with the total electrical energy delivered ( P = 0.002, r = −0.496). Unilateral IPG end‐of‐life generally led to subacute worsening of contralateral parkinsonism. In 25% of patients, there was also a worsening of axial symptoms leading to potential medical emergencies such as falls (10%), aspiration pneumonia (10%), or psychosis (5%). A close monitoring of patients and an anticipation of IPG replacement in the case of a low‐battery signal are recommended. © 2007 Movement Disorder Society