BACKGROUND: Deep brain stimulation (DBS) is an effective treatment in patients with movement disorders. Successful outcomes are correlated with patient selection, accurate placement of the electrodes in their surgical target and optimal programming of patients. The loss of clinical efficacy after successful treatment may be related to hardware complications. OBJECTIVES: We studied the causes of loss of stimulation efficacy in patients with stable antiparkinsonian benefit after DBS. RESULTS: Seven out of 110 (6.3%) patients surgically treated with DBS showed a loss of clinical efficacy, and were included in the study. Five cases had subacute clinical worsening and two sudden deterioration. All of them had an impedance increment (>4000 Ω) with the active contacts. Further reprogramming was attempted in all the cases using the undamaged contacts. However, five patients had incomplete clinical control and were reoperated with an electrode replacement. X-rays provided information in all cases except one showing the disruption or rupture of electrode. CONCLUSIONS: It is important to identify this hardware problem in view of the growing number of patients receiving this therapy. A protocol for patients with loss of stimulation efficacy and electrode impedance increment needs to be created in clinical visits in order to detect the failed stimulation mechanism.
BACKGROUND: Deep brain stimulation (DBS) is an effective treatment in patients with movement disorders. Successful outcomes are correlated with patient selection, accurate placement of the electrodes in their surgical target and optimal programming of patients. The loss of clinical efficacy after successful treatment may be related to hardware complications. OBJECTIVES: We studied the causes of loss of stimulation efficacy in patients with stable antiparkinsonian benefit after DBS. RESULTS: Seven out of 110 (6.3%) patients surgically treated with DBS showed a loss of clinical efficacy, and were included in the study. Five cases had subacute clinical worsening and two sudden deterioration. All of them had an impedance increment (>4000 Ω) with the active contacts. Further reprogramming was attempted in all the cases using the undamaged contacts. However, five patients had incomplete clinical control and were reoperated with an electrode replacement. X-rays provided information in all cases except one showing the disruption or rupture of electrode. CONCLUSIONS: It is important to identify this hardware problem in view of the growing number of patients receiving this therapy. A protocol for patients with loss of stimulation efficacy and electrode impedance increment needs to be created in clinical visits in order to detect the failed stimulation mechanism.
Authors: Hui-Jun Yang; Ji Young Yun; Young Eun Kim; Yong Hoon Lim; Han-Joon Kim; Sun Ha Paek; Beom S Jeon Journal: Neuropsychiatr Dis Treat Date: 2015-07-21 Impact factor: 2.570
Authors: Marie Miquel; Umberto Spampinato; Chrystelle Latxague; Iciar Aviles-Olmos; Benedikt Bader; Kelly Bertram; Kailash Bhatia; Pierre Burbaud; Lothar Burghaus; Jin Whan Cho; Emmanuel Cuny; Adrian Danek; Thomas Foltynie; Pedro J Garcia Ruiz; Santiago Giménez-Roldán; Dominique Guehl; Jorge Guridi; Marwan Hariz; Paul Jarman; Zinovia Maria Kefalopoulou; Patricia Limousin; Nir Lipsman; Andres M Lozano; Elena Moro; Dhita Ngy; Maria Cruz Rodriguez-Oroz; Huifang Shang; Hyeeun Shin; Ruth H Walker; Fusako Yokochi; Ludvic Zrinzo; François Tison Journal: PLoS One Date: 2013-11-05 Impact factor: 3.240
Authors: Katja Engel; Torge Huckhagel; Alessandro Gulberti; Monika Pötter-Nerger; Eik Vettorazzi; Ute Hidding; Chi-Un Choe; Simone Zittel; Hanna Braaß; Peter Ludewig; Miriam Schaper; Kara Krajewski; Christian Oehlwein; Katrin Mittmann; Andreas K Engel; Christian Gerloff; Manfred Westphal; Christian K E Moll; Carsten Buhmann; Johannes A Köppen; Wolfgang Hamel Journal: PLoS One Date: 2018-08-02 Impact factor: 3.240