Objective: To assess predictors of patient satisfaction with rechargeable implantable pulse generators (IPGs)

Background: Deep brain stimulation (DBS) is an effective therapy for Parkinson Disease (PD), tremor, and dystonia. Traditional IPGs require surgical replacement every few years. Rechargeable IPGs can prevent these frequent surgeries and the inherent risks of complications but typically require daily recharging by the patient. A better understanding of patient experience regarding these rechargeable devices will help guide patient selection, training, and counseling.

Methods: All patients previously implanted with rechargeable IPGs at our center are being contacted in an ongoing study. 24 patients have completed comprehensive surveys evaluating experience with the devices. Surveys are modified versions of previously validated scales from Timmermann et al (2013) as well as open ended qualitative questions. Outcomes of patient satisfaction with fit/comfort, recharging, display, training, programmer, and overall satisfaction were analyzed with respect to age, diagnosis, new DBS versus conversion from non-rechargeable IPG, and body mass index (BMI).

Results: The combined study group had high overall satisfaction (82.2). Patients with dystonia had significantly higher satisfaction than patients with PD in fit/comfort (92.6 vs 70.1, p<0.01), recharging (85.5 vs 57.5, p<0.02), and programmer (90.7 vs 70.3, p<0.05) and a trend towards higher overall satisfaction (88.4 vs 63.7, p=0.06). There was no correlation of advancing age with patient satisfaction in a regression model.  There was no difference in patient satisfaction when comparing patients with first time DBS to those with conversion from standard IPGs or between patients with normal and overweight BMIs. Common open-ended positive responses were “fewer surgeries,” “small” size, and “easy to recharge.” Common negative responses were difficulty “finding the right position to recharge,” and need to “recharge every day.”

Conclusions: Patient experience with rechargeable IPGs was largely positive. Dystonia patients had the highest satisfaction across multiple categories. Younger age did not correlate with higher satisfaction in any category our patient population. Pre-operative counseling about potential frustrations with coupling of the recharging system and recharging needs is necessary to allow informed decisions for patients.

References: Timmermann, L., Schüpbach, M., Hertel, F., Wolf, E., Eleopra, R., Franzini, A., … Maarouf, M. (2013). A new rechargeable device for deep brain stimulation: A prospective patient satisfaction survey. European Neurology, 69(4), 193–199. https://doi.org/10.1159/000342236

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-patient-satisfaction-with-rechargeable-deep-brain-stimulator-implantable-pulse-generators/