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Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.

Identifieur interne : 002485 ( PubMed/Curation ); précédent : 002484; suivant : 002486

Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.

Auteurs : Mathieu Anheim [France] ; Valérie Fraix ; Stéphan Chabardès ; Paul Krack ; Alim-Louis Benabid ; Pierre Pollak

Source :

Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.

RBID : pubmed:17960811

English descriptors

KwdEn :
- Aged, Deep Brain Stimulation (instrumentation), Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Parkinson Disease (therapy), Retrospective Studies, Subthalamic Nucleus (physiology).
MESH :
- instrumentation : Deep Brain Stimulation.
- physiology : Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies.

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(R) (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 mus, 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.

DOI: 10.1002/mds.21726
PubMed: 17960811

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<author><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University Hospital A. Michallon, Grenoble, France. anheim@titus.u-strasbg.fr</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Neurology, University Hospital A. Michallon, Grenoble</wicri:regionArea>
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<author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name>
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<author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stéphan" last="Chabardès">Stéphan Chabardès</name>
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<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
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<author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name>
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<author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name>
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<term>Parkinson Disease (therapy)</term>
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<front><div type="abstract" xml:lang="en">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(R) (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 mus, 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.</div>
</front>
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<Title>Movement disorders : official journal of the Movement Disorder Society</Title>
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<Abstract><AbstractText>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(R) (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 mus, 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.</AbstractText>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D012189">Retrospective Studies</DescriptorName>
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	Movement Disorders (revue)
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Movement Disorders (revue)

Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.

Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.

Source :

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki