Rechargeable and Nonrechargeable Implantable Pulse Generators for Deep Brain Stimulation in Parkinson’s Disease: Long-Term Experience

Abstract

Objectives: The study’s objective is to assess long-term experience with rechargeable (r-IPG) and nonrechargeable implant pulse generators (nr-IPGs) for deep brain stimulation (DBS) in Parkinson’s disease (PD).

Material and Methods: Qualitative semistructured interviews, clinical outcomes, and care load estimations were retrospectively collected for a PD-DBS population implanted at our center from 2006 to 2022.

Results: Thirty-seven nr-IPG patients (follow-up 85.3 ± 32.0 months) and 43 r-IPG patients (follow-up 73.1 ± 7.7 months) were analyzed. Long-term satisfaction was sustained in both groups (100% of r-IPG carriers and 75.7% of nr-IPGs, p = 0.001). In r-IPGs, 97.7% recharged the battery easily, and recharging time did not impact everyday life. The percentage of malfunctioning problems (32.6%) in the r-IPG group was in line with previous observations on short-term follow-ups. The size of the IPG was considered too big for 16.2% and 4.2% for nr-IPGs and r-IPGs (p = 0.086), and concerns of interventions for IPG replacements were still present in the nr-IPG group (48.6%). The total amount of days of hospitalization (19.6 ± 9.9 vs. 9.3 ± 4.8, p < 0.001) and the number of complications after the first implant (13 vs. 5, p < 0.05) and during subsequent admissions for IPG substitutions (4 vs. 0, p < 0.05) were higher for the nr-IPGs.

Conclusions: The overall level of long-term satisfaction with IPGs is consistent over time regardless of type. R-IPGs reported no discomfort with recharging even in the long-term evaluation. IPG replacement surgeries and sizes are still a concern, especially for the nr-IPG carriers, but did not affect a high level of sustained satisfaction. Resource burden remains higher for nr-IPGs even in the long term.