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Implantable Pulse Generators for Deep Brain Stimulation: Challenges, Complications, and Strategies for Practicality and Longevity.
Sarica, Can; Iorio-Morin, Christian; Aguirre-Padilla, David H; Najjar, Ahmed; Paff, Michelle; Fomenko, Anton; Yamamoto, Kazuaki; Zemmar, Ajmal; Lipsman, Nir; Ibrahim, George M; Hamani, Clement; Hodaie, Mojgan; Lozano, Andres M; Munhoz, Renato P; Fasano, Alfonso; Kalia, Suneil K.
Afiliación
  • Sarica C; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Iorio-Morin C; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Aguirre-Padilla DH; Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada.
  • Najjar A; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Paff M; Department of Neurology & Neurosurgery, Center Campus, Universidad de Chile, Santiago, Chile.
  • Fomenko A; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Yamamoto K; Department of Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia.
  • Zemmar A; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Lipsman N; Department of Neurosurgery, University of California, Irvine, Irvine, CA, United States.
  • Ibrahim GM; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Hamani C; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Hodaie M; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Lozano AM; Department of Neurosurgery, Henan University School of Medicine, Zhengzhou, China.
  • Munhoz RP; Department of Neurosurgery, University of Louisville School of Medicine, Louisville, KY, United States.
  • Fasano A; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Kalia SK; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Front Hum Neurosci ; 15: 708481, 2021.
Article en En | MEDLINE | ID: mdl-34512295
Deep brain stimulation (DBS) represents an important treatment modality for movement disorders and other circuitopathies. Despite their miniaturization and increasing sophistication, DBS systems share a common set of components of which the implantable pulse generator (IPG) is the core power supply and programmable element. Here we provide an overview of key hardware and software specifications of commercially available IPG systems such as rechargeability, MRI compatibility, electrode configuration, pulse delivery, IPG case architecture, and local field potential sensing. We present evidence-based approaches to mitigate hardware complications, of which infection represents the most important factor. Strategies correlating positively with decreased complications include antibiotic impregnation and co-administration and other surgical considerations during IPG implantation such as the use of tack-up sutures and smaller profile devices.Strategies aimed at maximizing battery longevity include patient-related elements such as reliability of IPG recharging or consistency of nightly device shutoff, and device-specific such as parameter delivery, choice of lead configuration, implantation location, and careful selection of electrode materials to minimize impedance mismatch. Finally, experimental DBS systems such as ultrasound, magnetoelectric nanoparticles, and near-infrared that use extracorporeal powered neuromodulation strategies are described as potential future directions for minimally invasive treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Hum Neurosci Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Hum Neurosci Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Suiza