title: Rechargeable Stimulators in Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Prospective Interventional Cohort Study.
abstract: BACKGROUND
  From 1999 onwards, deep brain stimulation (DBS) has been proposed as an alternative to capsulotomy in refractory cases of obsessive-compulsive disorder (OCD). Although rechargeable implantable pulse generators (rIPGs) have been used extensively in DBS for movement disorders, there are no reports on rIPGs in patients with a psychiatric DBS indication, and even possible objections to their use.
  
  
  OBJECTIVE
  We aim to evaluate rIPGs in OCD in terms of effectiveness, applicability, safety, and need for IPG replacement.
  
  
  METHODS
  In this prospective before-after study recruiting from 2007 until 2012, OCD patients requiring at least one IPG replacement per 18 months were proposed to have a rIPG implanted at the next IPG depletion. OCD severity was the primary outcome. Ten patients were analyzed.
  
  
  RESULTS
  Psychiatric symptoms and global functioning remained stable in the two years after as compared to the two years before rIPG implantation. Over the same period, the prescribed OCD medication doses did not increase and the DBS stimulation parameters were largely unaltered. Until the end of the follow-up (mean 4¾ years; maximum seven years), the DBS-related surgery frequency decreased and there were no rIPG replacements. During the first few weeks after implantation, two patients obsessively checked the rIPG, but afterwards there were no signs of compulsively checking or recharging the rIPG. Two patients experienced rIPG overdischarges (five occurrences in total).
  
  
  CONCLUSIONS
  This is the first report on rIPGs in DBS for OCD patients. The use of rIPGs in this population appears to be effective, applicable, and safe and diminishes the need for IPG replacements.
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.|Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: De Vloo
authors.affiliation: Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Simon
authors.initials: S
authors.lastname: Raymaekers
authors.affiliation: Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium.
authors.forename: Kris
authors.initials: K
authors.lastname: van Kuyck
authors.affiliation: Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium.|Research Group Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium.
authors.forename: Laura
authors.initials: L
authors.lastname: Luyten
authors.affiliation: Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Lutgardis
authors.initials: L
authors.lastname: Gabriëls
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.|Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Nuttin
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods*; D011211:Electric Power Supplies; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D011569:Psychiatric Status Rating Scales
chemical_list: D000928:Antidepressive Agents
keywords: Deep brain stimulation; deep brain stimulation for psychiatric disorders; obsessive-compulsive disorder; rechargeable implantable pulse generator; rechargeable stimulator