Rawal Pawan V, Almeida Leonardo, Smelser Luke B, Huang He, Guthrie Barton L, Walker Harrison C
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Surgery, Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Brain Stimul. 2014 May-Jun;7(3):345-9. doi: 10.1016/j.brs.2014.01.008. Epub 2014 Jan 18.
Deep brain stimulation has become a routine therapy for movement disorders, but it is relatively invasive and costly. Although stimulation intensity relates to battery longevity, less is known about how diagnosis and stimulation target contribute to this clinical outcome. Here we evaluate battery longevity in movement disorders patients who were treated at a tertiary referral center.
To compare single channel pulse generator longevity in patients with movement disorders.
With Institutional Review Board approval, we evaluated 470 consecutive Soletra implants for routine care. Battery longevity was estimated with Kaplan-Meier analyses, and group comparisons were performed with the log rank mean test. The frequency of clinic encounters for ongoing care was evaluated across diagnoses with analysis of variance (ANOVA).
The mean pulse generator longevity was 44.9 ± 1.4 months. Pallidal DBS for dystonia was associated with shorter battery longevity than subthalamic and thalamic DBS for Parkinson's disease and essential tremor (28.1 ± 2.1 versus 47.1 ± 1.8 and 47.8 ± 2.6 months, respectively, mean ± standard error, P < 0.001), and dystonia patients required more frequent clinic visits for routine care (F = 6.0, P = 0.003). Pallidal DBS for Parkinson's disease and thalamic DBS for cerebellar outflow tremor were associated with shorter battery longevity, as well (35.3 ± 4.6 and 26.4 ± 4.3 months, respectively).
Pallidal DBS for dystonia was associated with shorter battery longevity and more frequent stimulator adjustments versus DBS for Parkinson's disease and essential tremor. Characteristics of the stimulation target and disease pathophysiology both likely contribute to battery longevity in patients with movement disorders.
深部脑刺激已成为运动障碍的常规治疗方法，但它具有相对的侵入性且成本高昂。尽管刺激强度与电池寿命相关，但对于诊断和刺激靶点如何影响这一临床结果，人们了解较少。在此，我们评估了在一家三级转诊中心接受治疗的运动障碍患者的电池寿命。
比较运动障碍患者单通道脉冲发生器的寿命。
经机构审查委员会批准，我们对470例连续植入Soletra进行常规护理的患者进行了评估。采用Kaplan-Meier分析估计电池寿命，并使用对数秩均值检验进行组间比较。通过方差分析（ANOVA）评估不同诊断下持续护理的门诊就诊频率。
脉冲发生器的平均寿命为44.9±1.4个月。用于肌张力障碍的苍白球深部脑刺激与用于帕金森病和特发性震颤的丘脑底核及丘脑深部脑刺激相比，电池寿命较短（分别为28.1±2.1个月、47.1±1.8个月和47.8±2.6个月，均值±标准误，P<0.001），且肌张力障碍患者需要更频繁地进行常规护理门诊就诊（F = 6.0，P = 0.003）。用于帕金森病的苍白球深部脑刺激和用于小脑传出性震颤的丘脑深部脑刺激也与较短的电池寿命相关（分别为35.3±4.6个月和26.4±4.3个月）。
与用于帕金森病和特发性震颤的深部脑刺激相比，用于肌张力障碍的苍白球深部脑刺激与较短的电池寿命和更频繁的刺激器调整相关。刺激靶点的特征和疾病病理生理学可能都对运动障碍患者的电池寿命有影响。
