Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.
Identifieur interne : 000632 ( Hal/Corpus ); précédent : 000631; suivant : 000633Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.
Auteurs : Mathieu Anheim ; Valérie Fraix ; Stéphan Chabardès ; Paul Krack ; Alim-Louis Benabid ; Pierre PollakSource :
- Movement Disorders [ 0885-3185 ] ; 2007-12.
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.
Url:
DOI: 10.1002/mds.21726
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Hal:inserm-00382268Le document en format XML
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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>
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<note type="popular" n="0">No</note>
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<sourceDesc> <biblStruct> <analytic> <title xml:lang="en">Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease.</title>
<author role="aut"> <persName> <forename type="first">Mathieu</forename>
<surname>Anheim</surname>
</persName>
<idno type="halauthorid">228212</idno>
<affiliation ref="#struct-14242"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Valérie</forename>
<surname>Fraix</surname>
</persName>
<idno type="halauthorid">296411</idno>
<affiliation ref="#struct-14242"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Stéphan</forename>
<surname>Chabardès</surname>
</persName>
<idno type="halauthorid">402664</idno>
<affiliation ref="#struct-92131"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Paul</forename>
<surname>Krack</surname>
</persName>
<idno type="halauthorid">296412</idno>
<affiliation ref="#struct-14242"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Alim-Louis</forename>
<surname>Benabid</surname>
</persName>
<idno type="halauthorid">296407</idno>
<affiliation ref="#struct-92131"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Pierre</forename>
<surname>Pollak</surname>
</persName>
<idno type="halauthorid">233619</idno>
<affiliation ref="#struct-14242"></affiliation>
</author>
</analytic>
<monogr> <idno type="halJournalId" status="VALID">17211</idno>
<idno type="issn">0885-3185</idno>
<idno type="eissn">1531-8257</idno>
<title level="j">Movement Disorders</title>
<imprint> <publisher>Wiley</publisher>
<biblScope unit="volume">22</biblScope>
<biblScope unit="issue">16</biblScope>
<biblScope unit="pp">2436-9</biblScope>
<date type="datePub">2007-12</date>
</imprint>
</monogr>
<idno type="doi">10.1002/mds.21726</idno>
<idno type="pubmed">17960811</idno>
</biblStruct>
</sourceDesc>
<profileDesc> <langUsage> <language ident="en">English</language>
</langUsage>
<textClass> <classCode scheme="mesh">Aged</classCode>
<classCode scheme="mesh">Deep Brain Stimulation</classCode>
<classCode scheme="mesh">Subthalamic Nucleus</classCode>
<classCode scheme="mesh">Electrodes, Implanted</classCode>
<classCode scheme="mesh">Female</classCode>
<classCode scheme="mesh">Follow-Up Studies</classCode>
<classCode scheme="mesh">Humans</classCode>
<classCode scheme="mesh">Male</classCode>
<classCode scheme="mesh">Middle Aged</classCode>
<classCode scheme="mesh">Parkinson Disease</classCode>
<classCode scheme="mesh">Retrospective Studies</classCode>
<classCode scheme="halDomain" n="sdv.neu">Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]</classCode>
<classCode scheme="halTypology" n="ART">Journal articles</classCode>
</textClass>
<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.</abstract>
<particDesc> <org type="consortium">Collaboration</org>
</particDesc>
</profileDesc>
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