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A multicenter, open-label, controlled trial on acceptance, convenience, and complications of rechargeable internal pulse generators for deep brain stimulation: the Multi Recharge Trial.
Jakobs, Martin; Helmers, Ann-Kristin; Synowitz, Michael; Slotty, Philipp J; Anthofer, Judith M; Schlaier, Jürgen R; Kloss, Manja; Unterberg, Andreas W; Kiening, Karl L.
Afiliación
  • Jakobs M; 1Department of Neurosurgery, Division of Stereotactic Neurosurgery, and.
  • Helmers AK; Departments of2Neurosurgery and.
  • Synowitz M; 4Department of Neurosurgery, University Medical Center Schleswig-Holstein, Campus Kiel, Christian-Albrechts-University Kiel, Kiel.
  • Slotty PJ; 4Department of Neurosurgery, University Medical Center Schleswig-Holstein, Campus Kiel, Christian-Albrechts-University Kiel, Kiel.
  • Anthofer JM; 5Department of Stereotactic and Functional Neurosurgery, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf; and.
  • Schlaier JR; 6Department of Neurosurgery, University Hospital Regensburg, Regensburg, Germany.
  • Kloss M; 6Department of Neurosurgery, University Hospital Regensburg, Regensburg, Germany.
  • Unterberg AW; 3Neurology, University Hospital Heidelberg, Heidelberg.
  • Kiening KL; Departments of2Neurosurgery and.
J Neurosurg ; : 1-9, 2019 Aug 16.
Article en En | MEDLINE | ID: mdl-31419794
OBJECTIVE: Rechargeable neurostimulators for deep brain stimulation have been available since 2008, promising longer battery life and fewer replacement surgeries compared to non-rechargeable systems. Long-term data on how recharging affects movement disorder patients are sparse. This is the first multicenter, patient-focused, industry-independent study on rechargeable neurostimulators. METHODS: Four neurosurgical centers sent a questionnaire to all adult movement disorder patients with a rechargeable neurostimulator implanted at the time of the trial. The primary endpoint was the convenience of the recharging process rated on an ordinal scale from "very hard" (1) to "very easy" (5). Secondary endpoints were charge burden (time spent per week on recharging), user confidence, and complication rates. Endpoints were compared for several subgroups. RESULTS: Datasets of 195 movement disorder patients (66.1% of sent questionnaires) with Parkinson's disease (PD), tremor, or dystonia were returned and included in the analysis. Patients had a mean age of 61.3 years and the device was implanted for a mean of 40.3 months. The overall convenience of recharging was rated as "easy" (4). The mean charge burden was 122 min/wk and showed a positive correlation with duration of therapy; 93.8% of users felt confident recharging the device. The rate of surgical revisions was 4.1%, and the infection rate was 2.1%. Failed recharges occurred in 8.7% of patients, and 3.6% of patients experienced an interruption of therapy because of a failed recharge. Convenience ratings by PD patients were significantly worse than ratings by dystonia patients. Caregivers recharged the device for the patient in 12.3% of cases. Patients who switched from a non-rechargeable to a rechargeable neurostimulator found recharging to be significantly less convenient at a higher charge burden than did patients whose primary implant was rechargeable. Age did not have a significant impact on any endpoint. CONCLUSIONS: Overall, patients with movement disorders rated recharging as easy, with low complication rates and acceptable charge burden.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: J Neurosurg Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: J Neurosurg Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos