Prediction of Implantable Pulse Generator Longevity in Deep Brain Stimulation: Limitations and Possible Solutions in Clinical Practice

Background: Deep brain stimulation (DBS) is used in the treatment of movement disorders, chronic pain and certain neuropsychiatric conditions. Its effect is achieved through local stimulation of specific targets of the brain. Electrical pulses are delivered at settings that can be tailored to provide optimum symptom control. DBS is powered by an implantable pulse generator (IPG). These IPGs do not have an indefinite lifespan and will eventually become depleted. Therefore, regular checks are carried out to monitor the IPG's power status. Objective: To evaluate the utility of computer-based prediction of IPG longevity in patients with DBS devices by imputing the device's settings. Patients: Eighty-two IPGs in 47 consecutive patients were studied comparing the actual longevity of the IPGs with their predicted longevity using a computer-based calculator. Results: Our study showed that the predicted longevities were too different from actual longevities to have a role in clinical practice. The time difference varied by more than 12 months in some cases, with a correlation coefficient of <0.68. There were mul-tiple reasons for this. Conclusion: The longevities of IPGs could not be predicted accurately enough for the computer-based calculator to have a role in clinical practice or the proactive scheduling of IPG replacement. However, rechargeable IPGs may help avoid premature replacements and battery depletions. Copyright (C) 2011 S. Karger AG, Basel