title: Deep brain pulse-generator and lead-extensions: subjective sensations related to measured parameters.
abstract: This study analyzed subjective sensations caused by DBS pulse-generator and lead-extensions in relation with objectively measured parameters. In 50 patients implant-related sensations were evaluated. The pulse-generator mobility was video-analyzed. Insufficient lead-extension/pulse-generator tolerability (72%/84%) was documented. Furthermore, 54% of the patients described movement impairments and 48% cosmetic deformity. High body mass index (BMI) was associated with low lead-extension related pain (P < 0.001). High generator mobility resulted in high lead-extension related pain (P < 0.001). Compared with lead-extension type 7482, type 7495 showed less lead-extension related pain (P = 0.0138), we suppose secondary to surgical tunneling instruments with a larger tip diameter. The lead-extension path with one tissue tunnel for both lead-extensions had 36% lead-extension related pain versus 11% for the path with one single tunnel for each lead-extension. Smaller pulse-generators for better cosmetic results, surgical procedures using larger tunneling instruments and one single tunnel for each lead-extension would provide better results for patients with BMI <30.
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Camillo
authors.initials: C
authors.lastname: Sherif
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Dorfer
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Kalteis
authors.affiliation: Department of Neurology, Wilhelminenspital, Vienna, Austria.
authors.forename: Caroline
authors.initials: C
authors.lastname: Thun
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Iris
authors.initials: I
authors.lastname: Kaiser
authors.affiliation: Section of Neurosurgery, Dartmouth Medical School, Lebanon, New Hampshire, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gibson
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: François
authors.initials: F
authors.lastname: Alesch
mesh_terms: D015992:Body Mass Index; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires