Evidence map›Paper›PMID 34512295›Full record

ArticleFrontiers in human neuroscience2021

Implantable Pulse Generators for Deep Brain Stimulation: Challenges, Complications, and Strategies for Practicality and Longevity.

Can Sarica, Christian Iorio-Morin, David H Aguirre-Padilla, Ahmed Najjar, Michelle Paff, Anton Fomenko, Kazuaki Yamamoto, Ajmal Zemmar, Nir Lipsman, George M Ibrahim and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in human neuroscience, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 3 pooled it
5.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Biomarkers for Epilepsy Deep Brain Stimulation.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2025
    Review
  13. Review
  14. Article
  15. Seizure Detection and Lateralization Using Thalamic Deep Brain Stimulator Recordings.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2025
    Article
  16. Review
  17. Article
  18. Article
  19. Review
  20. The rise of bioelectronic medicine.Bioelectronic medicine · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 5 countries.

Can SaricaDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Christian Iorio-MorinDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
David H Aguirre-PadillaDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Ahmed NajjarDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Michelle PaffDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Anton FomenkoDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Kazuaki YamamotoDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Ajmal ZemmarDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Nir LipsmanDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
George M IbrahimDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Clement HamaniDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Mojgan HodaieDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Andres M LozanoDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Renato P MunhozKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Alfonso FasanoKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Suneil K KaliaDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
University of Toronto · CAKrembil Research InstituteSunnybrook Health Science Centre · CATaibah University · SAUniversité de Sherbrooke · CAUniversity Health Network · CAUniversity of Louisville · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Deep brain stimulation (DBS) represents an important treatment modality for movement disorders and other circuitopathies. Despite their miniaturization and increasing sophistication, DBS systems share a common set of components of which the implantable pulse generator (IPG) is the core power supply and programmable element. Here we provide an overview of key hardware and software specifications of commercially available IPG systems such as rechargeability, MRI compatibility, electrode configuration, pulse delivery, IPG case architecture, and local field potential sensing. We present evidence-based approaches to mitigate hardware complications, of which infection represents the most important factor. Strategies correlating positively with decreased complications include antibiotic impregnation and co-administration and other surgical considerations during IPG implantation such as the use of tack-up sutures and smaller profile devices.Strategies aimed at maximizing battery longevity include patient-related elements such as reliability of IPG recharging or consistency of nightly device shutoff, and device-specific such as parameter delivery, choice of lead configuration, implantation location, and careful selection of electrode materials to minimize impedance mismatch. Finally, experimental DBS systems such as ultrasound, magnetoelectric nanoparticles, and near-infrared that use extracorporeal powered neuromodulation strategies are described as potential future directions for minimally invasive treatment.

Indexed as

battery lifecomplicationsDBS (deep brain stimulation)IPG (implantable pulse generator)longevityneuromodulationnon-invasivewireless charging

Identifiers

PMID34512295
PMCPMC8427803
OpenAlexW3196847900

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.