Shorter pulse generator longevity and more frequent stimulator adjustments with pallidal DBS for dystonia versus other movement disorders

Pawan Rawal, Leonardo Almeida, Luke B. Smelser, He Huang, Barton L. Guthrie, Harrison C. Walker

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background 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. Objective To compare single channel pulse generator longevity in patients with movement disorders. Methods 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). Results 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). Conclusions 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.

Original languageEnglish (US)
Pages (from-to)345-349
Number of pages5
JournalBrain Stimulation
Volume7
Issue number3
DOIs
StatePublished - Jan 1 2014

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Dystonia
Movement Disorders
Essential Tremor
Parkinson Disease
Deep Brain Stimulation
Research Ethics Committees
Kaplan-Meier Estimate
Tremor
Ambulatory Care
Tertiary Care Centers
Analysis of Variance

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Biophysics
  • Clinical Neurology

Cite this

Shorter pulse generator longevity and more frequent stimulator adjustments with pallidal DBS for dystonia versus other movement disorders. / Rawal, Pawan; Almeida, Leonardo; Smelser, Luke B.; Huang, He; Guthrie, Barton L.; Walker, Harrison C.

In: Brain Stimulation, Vol. 7, No. 3, 01.01.2014, p. 345-349.

Research output: Contribution to journalArticle

Rawal, Pawan ; Almeida, Leonardo ; Smelser, Luke B. ; Huang, He ; Guthrie, Barton L. ; Walker, Harrison C. / Shorter pulse generator longevity and more frequent stimulator adjustments with pallidal DBS for dystonia versus other movement disorders. In: Brain Stimulation. 2014 ; Vol. 7, No. 3. pp. 345-349.
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