ArticleTremor and other hyperkinetic movements (New York, N.Y.)2017
Management of Elevated Therapeutic Impedances on Deep Brain Stimulation Leads.
Article in Tremor and other hyperkinetic movements (New York, N.Y.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Traceless Regulation of Genetic Circuitry.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Impedance Problems and Their Causes-A Single-Center Analysis of 601 Patients with De Novo Deep Brain Stimulation.Journal of clinical medicine · 2026Article
- Falsely reassuring impedance in a patient with deep brain stimulation: a case report.Journal of neurology · 2024Article
- Deep Brain Stimulation for Pediatric Dystonia: A Review of the Literature and Suggested Programming Algorithm.Journal of child neurology · 2022Review
- Prevalence of distinct types of hardware failures related to deep brain stimulation.Neurosurgical review · 2022Review
Corrections and comments
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Authors and funding
4 authors.
Funding
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Abstract
clinical vignetteA 64-year-old male with a history of essential tremor with bilateral thalamic ventralis intermedius deep brain stimulation implants had elevated therapeutic impedance values despite normal lead integrity impedances and good response to stimulation. CLINICAL DILEMMA: Do elevated therapeutic impedance values indicate a sign of hardware malfunction? What are the guidelines to approach deep brain stimulation hardware malfunction? CLINICAL SOLUTION: Lead integrity impedance values are a better evaluation of hardware integrity. The discrepancy between therapeutic and lead-integrity impedance values can arise when using low voltage settings. GAPS IN KNOWLEDGE: There are no established guidelines for the management of possible hardware malfunction in deep brain stimulation. The recommended approach is to distinguish between open and short circuit problems followed by an "inching" evaluation, assessing the structures from the implantable and programmable generator to the intracranial leads. Constant-current devices will deliver a more stable stimulation but the effect of their adoption is still not clear. EXPERT COMMENTARY: This case emphasizes the need for clinicians to understand fundamental differences in lead integrity and therapeutic impedance while utilizing a methodical approach in treating hardware malfunction. It highlights future avenues of investigation regarding the utility of constant current DBS technology.
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