Department of Neurology, UMM UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Eur J Neurol. 2011 Jun;18(6):872-5. doi: 10.1111/j.1468-1331.2010.03290.x. Epub 2010 Dec 15.
The aim of the study was to analyse the lifetime of Soletra implantable pulse generators (IPG) in deep brain stimulation (DBS) of the globus pallidus internus (GPi) for dystonia, depending on stimulation parameters and the total electrical energy delivered (TEED) by the IPG.
In a prospective series of 20 patients with GPi DBS for dystonia, we recorded IPG longevity and stimulation parameters over time. An evaluation of the TEED was performed using the previously suggested equation [(voltage(2) × pulse width × frequency)/impedance] × 1 s.
During median follow-up of 57 months (range 23-79 months), 64 IPGs were replaced because of battery depletion or end of life signal. We found a mean IPG longevity of 25.1 ± 10.1 (range 16-60) months, which was inversely correlated with the TEED (r = -0.72; P < 0.001). IPG longevity was not different between bipolar and monopolar stimulation (24.9 ± 10.8 vs. 25.4 ± 9.0 months, P = 0.76). Incongruously, the mean TEED applied throughout the lifetime cycle was significantly higher in patients with bipolar compared with monopolar stimulation (584 ± 213 vs. 387 ± 121 Joule; P < 0.01).
Battery lifetime in GPi DBS for dystonia is substantially shorter compared with that reported in DBS for Parkinson's disease, caused by a considerably higher voltage and greater pulse width and therefore a higher TEED applied during the battery lifetime cycle. The commonly used equation to calculate TEED, however, seems to be correct only for monopolar, but not bipolar stimulation.
本研究旨在分析脑深部刺激（DBS）治疗肌张力障碍时，索莱特拉可植入脉冲发生器（IPG）的寿命与刺激参数以及 IPG 输送的总电能（TEED）之间的关系。
在 20 例接受丘脑底核（GPi）DBS 治疗肌张力障碍的患者前瞻性系列研究中，我们记录了 IPG 的使用寿命和随时间推移的刺激参数。通过先前提出的公式[（电压(2) × 脉冲宽度 × 频率)/阻抗] × 1 s 来评估 TEED。
在中位数为 57 个月（范围 23-79 个月）的随访中，因电池耗尽或寿命结束信号而更换了 64 个 IPG。我们发现 IPG 的平均寿命为 25.1 ± 10.1（范围 16-60）个月，与 TEED 呈负相关（r = -0.72；P < 0.001）。双极和单极刺激的 IPG 寿命无差异（24.9 ± 10.8 与 25.4 ± 9.0 个月，P = 0.76）。然而，令人费解的是，整个寿命周期内应用的平均 TEED 在双极刺激患者中明显高于单极刺激患者（584 ± 213 与 387 ± 121 焦耳；P < 0.01）。
与帕金森病 DBS 相比，GPi DBS 治疗肌张力障碍的电池寿命明显缩短，原因是电压更高、脉冲宽度更大，因此在电池寿命周期内应用的 TEED 更高。然而，常用的计算 TEED 的公式似乎仅适用于单极刺激，而不适用于双极刺激。
