Fixed-Life or Rechargeable Batteries for Deep Brain Stimulation: Preference and Satisfaction Among Patients With Hyperkinetic Movement Disorders

Abstract

Background: Deep brain stimulation (DBS) is an established treatment for hyperkinetic movement disorders. Patients undergoing DBS can choose between the use of a rechargeable or non-rechargeable battery for implanted pulse generators (IPG).Objectives: In this study, we aimed to evaluate patient preferences and satisfaction with rechargeable and non-rechargeable batteries for IPGs after undergoing DBS.Methods: Overall, 100 patients with hyperkinetic movement disorders (dystonia: 79, Tourette syndrome: 21) who had undergone DBS took a self-designed questionnaire to assess their satisfaction and experience with the type of battery they had chosen and the factors influencing their choice.Results: Of the participants, 87% were satisfied with the stimulating effects of the treatment as well as the implanted device; 76% had chosen rechargeable devices (r-IPGs), 71.4% of whom recharged the battery themselves. Economic factors were the main reason for choosing both r-IPG and non-rechargeable IPG (nr-IPG). The questionnaire revealed that 66% of the patients checked their r-IPG battery every week. The mean interval for battery recharge was 4.3 days.Conclusions: The majority of the patients were satisfied with their in-service-IPG, regardless of whether it was a r-IPG or nr-IPG. Affordability was the main factor influencing the choice of IPG. The majority of the patients were confident in recharging the battery of their r-IPG themselves; only 11% of patients experienced difficulties. Understanding the recharge process remains difficult for some patients and increasing the number of training sessions for the device may be helpful.

Movement disorder Deep brain stimulation Hybridization: Patient and caregiver outcomes

“…In prior DBS series, most patients have not found rechargeable IPGs difficult to recharge, but some clinicians have expressed concerns with elderly, cognitively impaired patients [1] , [8] . The frequency of recharging varies from daily to once weekly, based on the indication for DBS and the stimulation parameters [1] , [2] , [8] , [16] , [26] . Several DBS series show that patients also favored the rechargeable variants based on durability and cost, but few evaluate the role of the caregiver [2] , [11] , [24] , [26] , [27] .…”

“…The frequency of recharging varies from daily to once weekly, based on the indication for DBS and the stimulation parameters [1] , [2] , [8] , [16] , [26] . Several DBS series show that patients also favored the rechargeable variants based on durability and cost, but few evaluate the role of the caregiver [2] , [11] , [24] , [26] , [27] .…”

Millimeter-sized battery-free epidural cortical stimulators

“…There are also additional challenges in creating a comfortable wearable transmitter. Wearable transcutaneous recharge systems have already been developed, evaluated and are in use for existing IPGs 51 . Wearable ME transmitters have been reported for use with implants in the back 40 , suggesting that the battery requirements and electronics can all be sufficiently miniaturized; however, a headset must be designed and tested to ensure sufficient comfort, power, and reliable pairing for frequent at-home use.…”

Preliminary Experience with a Four-Lead Implantable Pulse Generator for Deep Brain Stimulation

“…Innovations in the 2000s with the next generation of DBS systems added constant current or constant voltage control, interleaved stimulation, and multiple independent current control (MICC). However, adding these capabilities shortened lifespans of non-rechargeable batteries to three to 4 years, spurring the development of rechargeable-battery IPGs [8]. These charge wirelessly through induction and now last up to 25 years [7, 9].…”