Objective: This study aimed to determine the feasibility and safety of the replacement of non-rechargeable implanted pulse generator (IPG) by rechargeable ones.

Background: DBS of the STN is the reference second line treatment for PD. Battery depletion leading to iterative replacements increasing the risk of device infection and the capacity for neurosurgical teams to perform a growing number of IPG changes are among the most significant limitations of this procedure. Recently, rechargeable IPGs have been developed to overcome these issues. It has consequently been proposed that patients with predictable long disease duration may benefit from replacement with a rechargeable IPG. However, only few studies assessing this strategy in real life have been reported until now.

Method: We retrospectively collected clinical data from all PD patients stimulated in the STN who underwent the replacement of non-rechargeable IPG by rechargeable one in the movement disorders Unit of Lyon Neurological Hospital, France. Duration of hospitalization and number of consultation performed during the 3 months following the replacement was collected. Patients evaluated the convenience of recharging routine by a specific score ranging from 1 = very cumbersome to 5 = very simple. We also assessed patients and physician satisfaction (based on PD symptoms) using a CGI score.

Results: From January 2017 to December 2018, Medtronic ACTIVA PC was replaced in 30 patients by Boston VERCISE RC or GEVIA devices. Mean patients age was 60.1 years, mean duration of the disease was 18.5 years and mean duration of DBS was 6.7 years. 13.3% of patients had an history of device infection, with material removal in 3 cases. During the follow up, 5 patients required rehospitalization for parameters adjustments or rechargeability issues, with a mean stay of 5.2 nights and 11 patients required one or more consultations for DBS settings adjustments, usually in the first weeks following surgery. At 3 months, mean physician CGI was 4, mean patient CGI was 3.9 and mean patient rechargeability score was 4 meaning the stability of the clinical benefit and a high level of patients’ satisfaction. A single patient presented transient local inflammation of the IPG lodge after replacement.

Conclusion: Our data suggest that non rechargeable IPG replacement by rechargeable ones is a feasible and safe procedure, with preservation of the clinical benefit in the short term.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/changing-for-a-rechargeable-neurostimulator-in-parkinsons-disease-patients-safety-and-feasibility/