Abstract
Purpose
Recently, the feature of generating constant current output has been added to the implantable pulse generators (IPGs). The efficacy of the conventionally used constant voltage (CV) stimulation has been proved in different movement and psychiatric disorders. In this systematic review, we aimed to discuss the effect of constant current (CC) and constant voltage stimulation on patients with Parkinson’s disease (PD) who had subthalamic nucleus deep brain stimulation implantation; we also compared these methods of stimulation with each other.
Methods
Using the words “Deep brain stimulation”, “constant current” and “constant voltage”, we developed a broad search strategy and a systematic search was conducted in PubMed, Scopus, Web of Science and Cochrane electronic bibliographic databases. Studies on the Parkinson’s disease patients with subthalamic deep brain stimulation, which mentioned constant current or/and constant voltage setting stimulation were included.
Results
After screening of 284 articles, 10 reports were found eligible for this study. The score of unified Parkinson’s disease rating scale part 3 was improved compared to the baseline, whether the stimulation was CV at baseline or CC. No significant change in non-motor outcomes was found.
Conclusions
Although CC stimulation has shown a significant improvement in both motor and non-motor symptoms of PD, switching from CV to CC did not result in a significant change in the score of these items based on UPDRS. To sum up, implantation of constant current devices is safe and significantly improves motor function; it also maintains an acceptable safety profile in patients with PD.
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References
Lozano AM, Lipsman N, Bergman H, Brown P, Chabardes S, Chang JW et al (2019) Deep brain stimulation: current challenges and future directions. Nat Rev Neurol 15(3):148–160
Razmkon A, Yousefi O, Rezaei R, Salehi S, Petramfar P, Mani A et al (2019) Initial results of bilateral subthalamic nucleus stimulation for parkinson disease in a newly established center in a developing country: Shiraz. South Iran World neurosurg 121:e129–e135
Kuhn J, Gründler TO, Lenartz D, Sturm V, Klosterkötter J, Huff W (2010) Deep brain stimulation for psychiatric disorders. Deutsches Arzteblatt Int 107(7):105
Sarica C, Iorio-Morin C, Aguirre-Padilla DH, Najjar A, Paff M, Fomenko A et al (2021) Implantable pulse generators for deep brain stimulation: challenges, complications, and strategies for practicality and longevity. Front Human Neurosci. https://doi.org/10.3389/fnhum.2021.708481
Preda F, Cavandoli C, Lettieri C, Pilleri M, Antonini A, Eleopra R et al (2016) Switching from constant voltage to constant current in deep brain stimulation: a multicenter experience of mixed implants for movement disorders. Eur J Neurol 23(1):190–195
Butson CR, Maks CB, McIntyre CC (2006) Sources and effects of electrode impedance during deep brain stimulation. Clin Neurophysiol 117(2):447–454
de Noriega FR, Eitan R, Marmor O, Lavi A, Linetzky E, Bergman H et al (2015) Constant current versus constant voltage subthalamic nucleus deep brain stimulation in Parkinson’s disease. Stereotact Funct Neurosurg 93(2):114–121
Wharen RE Jr, Okun MS, Guthrie BL, Uitti RJ, Larson P, Foote K et al (2017) Thalamic DBS with a constant-current device in essential tremor: a controlled clinical trial. Parkinsonism Relat Disord 40:18–26
Stavrinou LC, Liouta E, Boviatsis EJ, Leonardos A, Gatzonis S, Stathis P et al (2019) Effect of constant-current pallidal deep brain stimulation for primary dystonia on cognition, mood and quality of life: results from a prospective pilot trial. Clin Neurol Neurosurg 185:105460
Beckhauser MT, Castro-Afonso LH, Dias FA, Nakiri GS, Monsignore LM, Martins Filho RK et al (2020) Extended time window mechanical thrombectomy for acute stroke in Brazil. J Stroke Cerebrovasc Dis 29(10):105134
Amami P, Mascia MM, Franzini A, Saba F, Albanese A (2017) Shifting from constant-voltage to constant-current in Parkinson’s disease patients with chronic stimulation. Neurol sci 38(8):1505–1508
Okun MS, Gallo BV, Mandybur G, Jagid J, Foote KD, Revilla FJ et al (2012) Subthalamic deep brain stimulation with a constant-current device in Parkinson’s disease: an open-label randomised controlled trial. Lancet Neurol 11(2):140–149
Timmermann L, Jain R, Chen L, Maarouf M, Barbe MT, Allert N et al (2015) Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson’s disease (the VANTAGE study): a non-randomised, prospective, multicentre, open-label study. Lancet Neurol 14(7):693–701
Troster AI, Jankovic J, Tagliati M, Peichel D, Okun MS (2017) Neuropsychological outcomes from constant current deep brain stimulation for Parkinson’s disease. Mov Disord 32(3):433–440
Vitek JL, Jain R, Chen L, Troster AI, Schrock LE, House PA et al (2020) Subthalamic nucleus deep brain stimulation with a multiple independent constant current-controlled device in Parkinson’s disease (INTREPID): a multicentre, double-blind, randomised, sham-controlled study. Lancet Neurol 19(6):491–501
Eguchi K, Yabe I, Shirai S, Iwata I, Matsushima M, Yamazaki K et al (2020) Constant current stimulation may improve apraxia of eyelid opening induced by deep brain stimulation. Interdiscip Neurosurg Adv Tech Case Manag 19:100565
Wolf ME, Klockziem M, Majewski O, Schulte DM, Krauss JK, Blahak C (2019) Implementation of new technology in patients with chronic deep brain stimulation: switching from non-rechargeable constant voltage to rechargeable constant current stimulation. Stereotact Funct Neurosurg 97(5–6):362–368
Wirth T, Laurencin C, Berthillier J, Brinzeu A, Polo G, Simon E et al (2020) Feasibility of changing for a rechargeable constant current neurostimulator in Parkinson’s disease. Revue neurolog 177:283
Krauss JK, Lipsman N, Aziz T, Boutet A, Brown P, Chang JW et al (2021) Technology of deep brain stimulation: current status and future directions. Nat Rev Neurol 17(2):75–87
Wong J, Gunduz A, Shute J, Eisinger R, Cernera S, Ho KWD et al (2018) Longitudinal follow-up of impedance drift in deep brain stimulation cases. Tremor Other Hyperkinet Mov (NY) 8:542
Lungu C, Malone P, Wu T, Ghosh P, McElroy B, Zaghloul K et al (2014) Temporal macrodynamics and microdynamics of the postoperative impedance at the tissue-electrode interface in deep brain stimulation patients. J Neurol Neurosurg Psychiatry 85(7):816–819
Lempka SF, Johnson MD, Miocinovic S, Vitek JL, McIntyre CC (2010) Current-controlled deep brain stimulation reduces in vivo voltage fluctuations observed during voltage-controlled stimulation. Clin Neurophysiol 121(12):2128–2133
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Abdollahifard, S., Farrokhi, A., Mosalamiaghili, S. et al. Constant current or constant voltage deep brain stimulation: short answers to a long story. Acta Neurol Belg 123, 1–8 (2023). https://doi.org/10.1007/s13760-022-02118-5
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DOI: https://doi.org/10.1007/s13760-022-02118-5