Deep brain stimulation battery longevity: a cohort study comparing impact of anaesthesia modality and anatomic target

Deep brain stimulation (DBS) treats various movement disorders, though routine battery replacement is required. Factors affecting battery life remain unclear; prior studies implicate programming parameters and device model. Advancements in intraoperative guidance enable DBS placement under general anaesthesia (GA) using direct targeting instead of conscious sedation (Monitored anesthesia care or MAC) using indirect targeting. This study examines the effect of DBS anaesthesia type on IPG battery longevity and other influencing factors.

Retrospective chart review of 254 patients who underwent DBS placement between 2013 and 2023 at a tertiary care centre was completed under an IRB-approved protocol, 217 of whom met inclusion criteria. Using an accelerated failure time (AFT) model, battery longevity was assessed as a function of anaesthesia type, electrode location, stimulation parameters, diagnosis, demographics, Movement Disorder Society Unified Parkinson's Disease Rating Scale part III score (MDS-UPDRS-III) and battery type.

DBS implanted with MAC resulted in significantly reduced battery longevity, AFT coefficient=-0.149, 95% CI -0.27 to -0.03 (p<0.05) compared with GA. compared with globus pallidus interna, subthalamic nucleus implantation (AFT coefficient=0.223, 95% CI 0.10 to 0.35, p<0.05) and thalamic ventral intermediate nucleus (VIM) implantation (AFT coefficient=0.134, 95% CI 0.01 to 0.26, p<0.05) were associated with significantly longer battery longevity. High amplitude settings significantly reduced battery longevity, AFT coefficient=-0.167, 95% CI -0.21 to -0.12 (p<0.05). Diagnosis, MDS-UPDRS-III score and battery model effects on IPG battery longevity were not statistically significant.

Battery longevity can be optimised by considering anaesthesia type and electrode location during implantation. Improved battery longevity reduces replacement frequency, associated complications and overall healthcare costs.