Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease
Lifetime of Itrel II pulse generators for subthalamic nucleus stimulation in Parkinson's disease
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DOI：
10.1002/mds.21726
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发表时间：
2007-12-01
影响因子：
8.6
通讯作者：
Pollak, Pierre
中科院分区：
文献类型：
--
作者：
Anheim, Mathieu;Fraix, Valerie;Pollak, Pierre
双侧丘脑下核（STN）刺激治疗帕金森病（PD）的疗效已得到证实，但对植入脉冲发生器（IPG）的寿命知之甚少。为了研究双侧植入Itrel II (R) （Medtronic, Minneapolis）脉冲发生器的寿命，我们回顾了在我们中心连续接受双侧STN慢性刺激手术的前49例PD患者，并记录了在IPG替代之前使用的刺激参数。平均电压为3.2 +/- 0.3 V，平均脉宽为65 +/- 10 μ s，平均频率为145 +/- 16 Hz。由于单侧电池电量不足或寿命终止，预计有25%的患者需要更换IPG。在任何一种情况下，同时进行对侧IPG的更换。IPG的平均生存期为83.14[40-113]个月。IPG寿命与总输出电能相关（P = 0.002, r = -0.496）。单侧IPG终末期通常会导致对侧帕金森病的亚急性恶化。在25%的患者中，轴心症状也会恶化，导致潜在的医疗紧急情况，如跌倒（10%）、吸入性肺炎（10%）或精神病（5%）。建议密切监测患者，并在低电量信号的情况下预期IPG更换。(c) 2007年运动障碍协会。
The efficacy of bilateral subthalamic nucleus (STN) stimulation in Parkinson's disease (PD) is well-established but little is known about the lifetime of implanted pulse generators (IPG). To investigate the lifetime of the bilaterally implanted Itrel II (R) (Medtronic, Minneapolis) pulse generator, the first 49 consecutive patients with PD having been operated on at our center for bilateral STN chronic stimulation were reviewed with noting of the stimulation parameters in use prior to IPG replacement. The mean electrical voltage was 3.2 +/- 0.3 V, mean pulse width was 65 +/- 10 mu s, and mean frequency was 145 +/- 16 Hz. Replacement of an IPG was anticipated in 25% due to unilateral low-battery signaling, or end of life. In either case, replacement of the contralateral IPG was undertaken simultaneously. The mean IPG lifetime was 83 14 [40-113] months. The IPG lifetime correlated with the total electrical energy delivered (P = 0.002, r = -0.496). Unilateral IPG end-of-life generally led to subacute worsening of contralateral parkinsonism. In 25% of patients, there was also a worsening of axial symptoms leading to potential medical emergencies such as falls (10%), aspiration pneumonia (10%), or psychosis (5%). A close monitoring of patients and an anticipation of IPG replacement in the case of a low-battery signal are recommended. (c) 2007 Movement Disorder Society.