Delayed postoperative impedance issues in patients treated with deep brain stimulation: A single-center retrospective...

In rare circumstances, an implanted deep brain stimulation device will develop impedance issues across its contacts. Even more rare is the resultant inability to program a patient effectively, or that the patients' prior programming settings become unusable.

In this study we investigate this occurrence across the device manufacturers implanted, and whether this could be resolved.

The authors performed a retrospective review of all patients managed with DBS at HMH-Jersey Shore University Medical Center from October 2021 to January 2024.

A total of 155 DBS patients were identified; thirty four patients with the Abbott system and 121 with the Medtronic system. Upon follow-up, 16 independent impedance issues were identified from 12 patients. Two patients (1.7 %) from the Medtronic group and 10 patients (29.4 %) from the Abbott group (p < .01). Falls were the most common significant event noted and occurred prior to 5 impedance issues (31.3 %). When falls were controlled for, 9 patients (11 impedance issues) were identified. All of these patients were from the Abbott group (p < 0.01). Revision surgery occurred in 7 (63.6 %) of these cases after an average of 1.05 years following primary implantation. Surgical replacement of the internal pulse generator (IPG) (n = 3), IPG and extension wires (n = 2), or IPG and lead revision (n = 1) resolved impedance in 6 cases.

Patients with the Abbott St. Jude DBS Systems have significantly higher rates of impedance issues requiring reoperation when compared to those implanted with the Medtronic Systems.