title: Prediction of implantable pulse generator longevity in deep brain stimulation: limitations and possible solutions in clinical practice.
abstract: BACKGROUND
  Deep brain stimulation (DBS) is used in the treatment of movement disorders, chronic pain and certain neuropsychiatric conditions. Its effect is achieved through local stimulation of specific targets of the brain. Electrical pulses are delivered at settings that can be tailored to provide optimum symptom control. DBS is powered by an implantable pulse generator (IPG). These IPGs do not have an indefinite lifespan and will eventually become depleted. Therefore, regular checks are carried out to monitor the IPG's power status.
  
  
  OBJECTIVE
  To evaluate the utility of computer-based prediction of IPG longevity in patients with DBS devices by imputing the device's settings.
  
  
  METHODS
  Eighty-two IPGs in 47 consecutive patients were studied comparing the actual longevity of the IPGs with their predicted longevity using a computer-based calculator.
  
  
  RESULTS
  Our study showed that the predicted longevities were too different from actual longevities to have a role in clinical practice. The time difference varied by more than 12 months in some cases, with a correlation coefficient of <0.68. There were multiple reasons for this.
  
  
  CONCLUSIONS
  The longevities of IPGs could not be predicted accurately enough for the computer-based calculator to have a role in clinical practice or the proactive scheduling of IPG replacement. However, rechargeable IPGs may help avoid premature replacements and battery depletions.
authors: Centre of Neuroscience, Department of Neurosurgery, College of Medicine, Dentistry and Nursing, Ninewells Hospital and Medical School, Dundee, UK.
authors: Colin D M
authors: CD
authors: Stewart
authors: Sam
authors: S
authors: Eljamel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000592:standards*; D004567:Electrodes, Implanted / Q000592:standards*; D004867:Equipment Design / Q000592:standards; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors