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Deep Brain Stimulation Battery Longevity: Comparison of Monopolar Versus Bipolar Stimulation Modes
Leonardo Almeida1, Pawan V Rawal2, Benjamin Ditty2
1University of Florida, Center for Movement Disorders and Neurorestoration.
Movement Disorders Clinical Practice
|September 13, 2016
Summary
Bipolar stimulation for deep brain stimulation (DBS) in movement disorders significantly increases pulse generator longevity compared to monopolar settings. This programming strategy offers a feasible alternative for extended battery life.
Area of Science:
- Neurosurgery
- Neurology
- Biomedical Engineering
Background:
- Deep brain stimulation (DBS) is a key treatment for movement disorders.
- Current understanding of how stimulation modes affect pulse generator longevity in clinical practice is limited.
- DBS complexity, invasiveness, and cost necessitate optimizing device longevity.
Purpose of the Study:
- To compare the battery longevity of monopolar versus bipolar stimulation in patients undergoing DBS for movement disorders.
- To evaluate the impact of different stimulation modes on implantable pulse generator (IPG) lifespan.
- To identify optimal programming strategies for maximizing DBS device longevity.
Main Methods:
- Retrospective analysis of 2,902 programming adjustments in 393 batteries from 200 patients with Parkinson's disease and essential tremor.
- Classification of IPGs into stimulation modes: monopolar, bipolar, tripolar, and double monopolar.
- Kaplan-Meier survival analyses with log-rank tests were used to compare battery longevity.
Main Results:
- Mean IPG longevity was 47.6±1.6 months across all modes.
- Bipolar stimulation showed significantly greater longevity (56.1±3.4 months) than monopolar (44.2±2.1 months) (p=0.006).
- Double monopolar configuration resulted in shorter longevity (37.8±5.6 months) compared to conventional modes (49.7±1.9 months) (p=0.014).
Conclusions:
- Programming implantable pulse generators in bipolar mode offers approximately one year of additional battery longevity compared to monopolar mode.
- Bipolar stimulation is a viable alternative programming strategy at the initiation of DBS therapy for movement disorders.
- Optimizing stimulation mode can enhance the cost-effectiveness and practicality of long-term DBS therapy.
