Battery for deep brain stimulation depletion in Parkinson’s Disease and dystonia patients — a systematic review

Abstract

Introduction. Deep brain stimulation (DBS) therapy for Parkinson's Disease (PD) and dystonia is associated with the possibility of both minor and major complications. One possible side effect is the depletion of implantable pulse generator (IPG) battery and the associated sudden recurrence of PD or dystonia symptoms, which can be potentially life-threatening. Delayed or postponed outpatient visits due to COVID -19 may be a risk factor of battery end-of-life consequences.Objective. To analyse the clinical outcomes in reported PD and dystonia patients treated with DBS, who, as a result of the sudden depletion of the neurostimulator battery, developed life-threatening symptoms.Materials and methods. The databases of PubMed, Scopus, EMBASE and Google Scholar were searched using pre-established criteria.Results. A total of 244 articles was found, of which 12 met the adopted criteria. Selected papers presented a total of 17 case reports of DBS-treated patients -11 with PD, and six with dystonia -who had depleted IPG batteries and due to rapid worsening of PD/dystonia symptoms required urgent hospital admission. IPG battery replacement was the only effective treatment in the majority of cases.Conclusions. IPG battery depletion can result in fatal outcomes. Sudden recurrence of PD or dystonia symptoms in patients treated by DBS can be potentially life-threatening, so scheduling the replacement of a discharged IPG battery should not be postponed. The COVID-19 pandemic should alert staff at emergency, neurology and movement disorders wards not to postpone the visits of patients with an implanted DBS system.

Is deep brain stimulation effective in Huntington’s Disease? — a systematic literature review

“…One dangerous complication, although not one directly related to the DBS implantation procedure, is battery depletion. Such an event, so far reported in PD and dystonia patients, can be life-threatening due to a sudden recurrence of disease symptoms [34]. In the reviewed publications, apart from minor complications, severe adverse events of DBS were reported, such as postoperative malignant hyperthermia, gait impairment and hyperkinesia after reprograming, and suicide attempts.…”

Incidence and characteristics of post-COVID-19 parkinsonism and dyskinesia related to COVID-19 vaccines

“…By early December 2022, three years after the index case of COVID-19, more than 640 million cases had been confirmed, and almost 13 billion vaccines administered [24]. The literature on COVID-19, its short-and long-term complications, and the safety of COVID-19 vaccines, continues to grow [7]. As most papers reporting neurological complications in detail are case reports, we felt there was a strong need to review and analyse them collectively in order to draw more meaningful conclusions.…”

Does deep brain stimulation stimulate metabolism?

“…Deep brain stimulation (DBS) is used to treat a variety of conditions through modulation of brain networks [3,4]. DBS targeting the globus pallidus interna (GPi) or subthalamic nucleus (STN) improves PD-related motor symptoms and prolongs "ON" time [5,6].…”