Roberto Eleopra1, Sara Rinaldo2, Grazia Devigili2, Christian Lettieri3, Massimo Mondani4, Stanislao D'Auria4, Massimo Piacentino5, Manuela Pilleri6. 1. Neurological Unit I, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy. Electronic address: roberto.eleopra@istituto-besta.it. 2. Neurological Unit I, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy. 3. Neurological Unit, S. Maria della Misericordia Universital Hospital, Udine, Italy. 4. Neurosurgical Unit, S. Maria della Misericordia Universital Hospital, Udine, Italy. 5. Neurosurgical Unit, S. Bortolo Hospital, Vicenza, Italy. 6. Neurological Unit, Villa Margherita Hospital, Arcugnano, Vicenza, Italy.
Abstract
OBJECTIVE: Conventional deep brain stimulation (DBS) systems with ring-shaped leads generate spherical electrical fields. In contrast, novel directional leads use segmented electrodes. Aim of this study was to quantify the impedance variations over time in subjects with the directional Cartesia-Boston® system. METHODS: Impedance records, programming settings, and clinical data of 11 consecutive Parkinsonian patients implanted with DBS directional leads in two Italian centers (Udine and Vicenza) were retrospectively evaluated. Data were collected before starting stimulation (in the operating room and at days 5 and 40) and after switching stimulation on at the successive follow-up visits (1, 6 and 12 months). RESULTS: Directional leads have significantly higher impedance than ring leads. Stimulated contacts had always lower impedance compared to non-stimulated contacts. Before DBS-on, all contacts had higher impedance in the operating room, with an initial decrease five days post-surgery and a subsequent increase at day 40, more evident for directional contacts. The impedance of directional leads increased post-implantation at 1 and 6 months with a plateau at 12 months. CONCLUSIONS: There was a significant difference between the directional and ring leads at baseline (before activation of DBS) and during follow-up (chronic DBS). SIGNIFICANCE: Our study reveals new information about the impedance of segmented electrodes that is useful for patient management during the initial test period, as well as during long-term DBS follow-up.
OBJECTIVE: Conventional deep brain stimulation (DBS) systems with ring-shaped leads generate spherical electrical fields. In contrast, novel directional leads use segmented electrodes. Aim of this study was to quantify the impedance variations over time in subjects with the directional Cartesia-Boston® system. METHODS: Impedance records, programming settings, and clinical data of 11 consecutive Parkinsonianpatients implanted with DBS directional leads in two Italian centers (Udine and Vicenza) were retrospectively evaluated. Data were collected before starting stimulation (in the operating room and at days 5 and 40) and after switching stimulation on at the successive follow-up visits (1, 6 and 12 months). RESULTS: Directional leads have significantly higher impedance than ring leads. Stimulated contacts had always lower impedance compared to non-stimulated contacts. Before DBS-on, all contacts had higher impedance in the operating room, with an initial decrease five days post-surgery and a subsequent increase at day 40, more evident for directional contacts. The impedance of directional leads increased post-implantation at 1 and 6 months with a plateau at 12 months. CONCLUSIONS: There was a significant difference between the directional and ring leads at baseline (before activation of DBS) and during follow-up (chronic DBS). SIGNIFICANCE: Our study reveals new information about the impedance of segmented electrodes that is useful for patient management during the initial test period, as well as during long-term DBS follow-up.
Authors: Mattia Arlotti; Matteo Colombo; Andrea Bonfanti; Tomasz Mandat; Michele Maria Lanotte; Elena Pirola; Linda Borellini; Paolo Rampini; Roberto Eleopra; Sara Rinaldo; Luigi Romito; Marcus L F Janssen; Alberto Priori; Sara Marceglia Journal: Front Neurosci Date: 2021-12-07 Impact factor: 4.677