Stereotactic and Functional Neurosurgery

Willems Y.R.a· van der Gaag N.A.a· Kho K.H.b,c· Tveiten Ø.V.d· Krüger M.T.e,f· Jakobs M.g· ESSFN Young Functional Neurosurgeons taskforce

Author affiliations

aDepartment of Neurosurgery, University Neurosurgical Centrum Holland (UNCH), The Hague, The Netherlands
bDepartment of Neurosurgery, Neurocenter Medisch Spectrum Twente, Enschede, The Netherlands
cClinical Neurophysiology (CNPH), TechMed Centre, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
dDepartment of Neurosurgery, Haukeland University Hospital, Bergen, Norway
eDepartment of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
fDepartment of Neurosurgery, University Medical Centre Freiburg, Freiburg, Germany
gDepartment of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany

Stereotact Funct Neurosurg

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Article / Publication Details

First-Page Preview

Received: December 20, 2022
Accepted: January 27, 2023
Published online: March 08, 2023

Number of Print Pages: 11
Number of Figures: 5
Number of Tables: 5

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Abstract

Introduction: The success of deep brain stimulation (DBS) treatment depends on several factors, including proper patient selection, accurate electrode placement, and adequate stimulation settings. Another factor that may impact long-term satisfaction and therapy outcomes is the type of implantable pulse generator (IPG) used: rechargeable or non-rechargeable. However, there are currently no guidelines on the choice of IPG type. The present study investigates the current practices, opinions, and factors DBS clinicians consider when choosing an IPG for their patients. Methods: Between December 2021 and June 2022, we sent a structured questionnaire with 42 questions to DBS experts of two international, functional neurosurgery societies. The questionnaire included a rating scale where participants could rate the factors influencing their choice of IPG type and their satisfaction with certain IPG aspects. Additionally, we presented four clinical case scenarios to assess preference of choice of IPG-type in each case. Results: Eighty-seven participants from 30 different countries completed the questionnaire. The three most relevant factors for IPG choice were “existing social support,” “cognitive status,” and “patient age.” Most participants believed that patients valued avoiding repetitive replacement surgeries more than the burden of regularly recharging the IPG. Participants reported that they implanted the same amount of rechargeable as non-rechargeable IPGs for primary DBS insertions and 20% converted non-rechargeable to rechargeable IPGs during IPG replacements. Most participants estimated that rechargeable was the more cost-effective option. Conclusion: This present study shows that the decision-making of the choice of IPG is very individualized. We identified the key factors influencing the physician’s choice of IPG. Compared to patient-centric studies, clinicians may value different aspects. Therefore, clinicians should rely not only on their opinion but also counsel patients on different types of IPGs and consider the patient’s preferences. Uniform global guidelines on IPG choice may not represent regional or national differences in the healthcare systems.

© 2023 S. Karger AG, Basel

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First-Page Preview

Received: December 20, 2022
Accepted: January 27, 2023
Published online: March 08, 2023

Number of Print Pages: 11
Number of Figures: 5
Number of Tables: 5

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

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