Department of Neurology, University Hospital Cologne, Cologne, Germany.
Eur Neurol. 2013;69(4):193-9. doi: 10.1159/000342236. Epub 2013 Jan 10.
Deep brain stimulation (DBS) is highly successful in treating Parkinson's disease (PD), dystonia, and essential tremor (ET). Until recently implantable neurostimulators were nonrechargeable, battery-driven devices, with a lifetime of about 3-5 years. This relatively short duration causes problems for patients (e.g. programming and device-use limitations, unpredictable expiration, surgeries to replace depleted batteries). Additionally, these batteries (relatively large with considerable weight) may cause discomfort. To overcome these issues, the first rechargeable DBS device was introduced: smaller, lighter and intended to function for 9 years.
Of 35 patients implanted with the rechargeable device, 21 (including 8 PD, 10 dystonia, 2 ET) were followed before and 3 months after surgery and completed a systematic survey of satisfaction with the rechargeable device.
Overall patient satisfaction was high (83.3 ± 18.3). Dystonia patients tended to have lower satisfaction values for fit and comfort of the system than PD patients. Age was significantly negatively correlated with satisfaction regarding process of battery recharging.
Dystonia patients (generally high-energy consumption, severe problems at the DBS device end-of-life) are good, reliable candidates for a rechargeable DBS system. In PD, younger patients, without signs of dementia and good technical understanding, might have highest benefit.
深部脑刺激(DBS)在治疗帕金森病(PD)、肌张力障碍和原发性震颤(ET)方面非常成功。直到最近,可植入的神经刺激器都是不可充电的、电池驱动的设备,其使用寿命约为 3-5 年。这种相对较短的寿命给患者带来了问题(例如编程和设备使用限制、不可预测的到期、更换耗尽电池的手术)。此外,这些电池(相对较大且重量相当大)可能会引起不适。为了克服这些问题,引入了第一款可充电的 DBS 设备:更小、更轻,旨在运行 9 年。
在植入可充电设备的 35 名患者中,有 21 名(包括 8 名 PD、10 名肌张力障碍、2 名 ET)在手术前和手术后 3 个月进行了随访,并完成了对可充电设备满意度的系统调查。
总体患者满意度较高(83.3±18.3)。与 PD 患者相比,肌张力障碍患者对系统的适配性和舒适度的满意度较低。年龄与对电池充电过程的满意度呈显著负相关。
肌张力障碍患者(通常能量消耗高,DBS 设备寿命末期问题严重)是可充电 DBS 系统的良好、可靠候选者。在 PD 中,年轻患者、没有痴呆迹象且技术理解良好的患者可能会受益最大。