Rusheen AE, Jensen MA, Gregg NM, Kaufmann TJ, VanGompel JJ, Lee KH, Klassen BT, Miller KJ. Preliminary Experience with a Four-Lead Implantable Pulse Generator for Deep Brain Stimulation.
Stereotact Funct Neurosurg 2023;
101:254-264. [PMID:
37454656 DOI:
10.1159/000530782]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND
Implantable pulse generators (IPGs) store energy and deliver electrical impulses for deep brain stimulation (DBS) to treat neurological and psychiatric disorders. IPGs have evolved over time to meet the demands of expanding clinical indications and more nuanced therapeutic approaches.
OBJECTIVES
The aim of this study was to examine the workflow of the first 4-lead IPG for DBS in patients with complex disease.
METHOD
The engineering capabilities, clinical use cases, and surgical technique are described in a cohort of 12 patients with epilepsy, essential tremor, Parkinson's disease, mixed tremor, and Tourette's syndrome with comorbid obsessive-compulsive disorder between July 2021 and July 2022.
RESULTS
This system is a rechargeable 32-channel, 4-port system with independent current control that can be connected to 8 contact linear or directionally segmented leads. The system is ideal for patients with mixed disease or those with multiple severe symptoms amenable to >2 lead implantations. A multidisciplinary team including neurologists, radiologists, and neurosurgeons is necessary to safely plan the procedure. There were no serious intraoperative or postoperative adverse events. One patient required revision surgery for bowstringing.
CONCLUSIONS
This new 4-lead IPG represents an important new tool for DBS surgery with the ability to expand lead implantation paradigms for patients with complex disease.
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