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Prevalence of distinct types of hardware failures related to deep brain stimulation

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Abstract

Deep brain stimulation (DBS) is an effective treatment of several types of neurological conditions, including Parkinson’s disease, essential tremor, dystonia, and epilepsy. Despite technological progress in the past 10 years, the number of studies reporting side effects of DBS has increased, mainly due to hardware failures. This review investigated studies published between 2017 and 2021 to identify the prevalence of distinct types of hardware failures related to DBS. In total, fifteen studies were selected for the estimate of the prevalence of five distinct types of hardware failures: high impedance, fracture or failure of the lead or other parts of the implant, skin erosion and infection, lead malposition or migration, and implantable pulse generator (IPG) malfunction. The quality evaluation of the studies suggests a need to report results including populations from distinct regions of the world so that results can be generalized. The objective analysis of the prevalence of hardware failures showed that skin erosion and infection presented the highest prevalence in relation to other hardware failures. Despite the sophistication of the surgical technique of DBS over time, there is a considerable complication rate, about 7 per 100 individuals (\(\mathrm{prevalence}=6.67\%, CI = [2.26\%,12.49\%]\), in which CI is the confidence interval). Future research can also include correlation analysis with the aim of understanding the correlation between distinct hardware failures and variables such as gender, type of disorder, and age.

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Data availability

The data supporting the findings of this study are available. In addition, a summary of the information considered in the meta-analysis of each hardware failure and the assessment of the quality of the included studies are provided as supplementary tables.

Code availability

Code implemented for meta-analysis and visualization of the quality of studies is provided as supplementary material.

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Funding

The present work was carried out with the support of the National Council for Scientific and Technological Development (CNPq), Coordination for the Improvement of Higher Education Personnel (CAPES – Program CAPES/DFATD-88887.159028/2017–00, Program CAPES/COFECUB-88881.370894/2019–01), and the Foundation for Research Support of the State of Minas Gerais. A. O. Andrade, A. A. Pereira, A. M. Cabral, and M. F. Vieira are fellow of CNPq, Brazil (304818/2018–6, 310911/2017–6, 158524/2020–9, 304533/2020–3, respectively).

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Authors and Affiliations

  1. Centre for Innovation and Technology Assessment in Health, Faculty of Electrical Engineering, Postgraduate Program in Electrical and Biomedical Engineering, Federal University of Uberlândia, Campus Santa Mônica - Bloco 1E, Av. Joao Naves de Avila, 2121, Uberlandia, MG, 38408-100, Brazil

    Ariana Moura Cabral, Adriano Alves Pereira & Adriano de Oliveira Andrade

  2. Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Brazil

    Marcus Fraga Vieira

  3. Postgraduate Program in Neurology, Faculty of Medicine, Federal University of Fluminense, Niterói, Brazil

    Bruno Lima Pessôa

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  1. Ariana Moura Cabral
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  2. Adriano Alves Pereira
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  4. Bruno Lima Pessôa
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Contributions

Ariana Moura Cabral was responsible for the coding of programs for data analysis and storage, writing, and revising the paper.

Adriano Alves Pereira, Bruno Lima Pessôa, and Marcus Fraga Vieira contributed with the writing and revision of the paper.

Adriano de Oliveira Andrade was the principal supervisor of the study, contributing to all the steps from its conception to its conclusion, in addition to the paper writing and revision.

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Correspondence to Adriano de Oliveira Andrade.

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Cabral, A.M., Pereira, A.A., Vieira, M.F. et al. Prevalence of distinct types of hardware failures related to deep brain stimulation. Neurosurg Rev 45, 1123–1134 (2022). https://doi.org/10.1007/s10143-021-01673-4

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  • DOI: https://doi.org/10.1007/s10143-021-01673-4

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