Patient Experience With Rechargeable Deep Brain Stimulation Generators for Obsessive-Compulsive Disorder.

BACKGROUND AND

OBJECTIVES

Rechargeable deep brain stimulation (DBS) systems extend device lifespan and reduce replacement surgeries, but patients with obsessive-compulsive disorder (OCD) require higher stimulation and more frequent recharging. We highlight patient experiences with DBS rechargeable implantable pulse generators (RC IPGs) for treatment of OCD within a single-institution cohort, focusing on charging routines, perceived vs actual charge burden, and the unique considerations of RC technology in psychiatric DBS therapy.

METHODS

We interviewed OCD patients with implanted RC IPGs to evaluate their recharging experiences. Battery usage data were gathered directly from device data downloads. Surveys and device data provided insights into self-reported vs actual battery charging metrics, with charge burden calculated as minutes per week of charging.

RESULTS

Our study of 6 OCD patients with newly implanted RC IPGs revealed that recharge intervals for patients with OCD were much shorter (average interval 29.5 ± 20.9 hours) than those typical for patients with movement disorders. Despite integrating these frequent recharging sessions (mean duration 28.0 ± 18.3 minutes) into their daily routines and reporting overall favorable device function, the total weekly charge burden averaged 209.5 ± 158.5 minutes. Discrepancies exist between perceived and actual charge times, and some patients experienced anxiety or fixation on battery levels.

CONCLUSION

Rechargeable IPGs improved management of DBS therapy for OCD by prolonging the interval between surgical replacements and reducing the associated surgical risk and cost. As opposed to the 1-2 week recharging intervals for patients with movement disorders, patients with OCD demonstrated an average recharging interval of 1-2 days, a significant increase in frequency of battery charging routines. While RC IPGs offer significant benefits, personalized DBS therapy should account for individual patient needs, and primary cell systems might still be most suitable for those with difficulty managing charging routines.