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Volume 13
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10.3390/jcm13247509
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Article

Managing Lead Fractures in Deep Brain Stimulation for Movement Disorders: A Decade-Long Case Series from a National Neurosurgical Centre

by
Chingiz Nurimanov
1,
Iroda Mammadinova
1,*,
Karashash Menlibayeva
2,
Seitzhan Aidarov
1,
Nurtay Nurakay
1,
Assylbek Kaliyev
1,
Yerbol Makhambetov
1 and
Serik K. Akshulakov
2
1
Department of Vascular and Functional Neurosurgery, National Centre for Neurosurgery, 34/1 Turan Avenue, Astana 010000, Kazakhstan
2
Hospital Management Department, National Centre for Neurosurgery, 34/1 Turan Avenue, Astana 010000, Kazakhstan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(24), 7509; https://doi.org/10.3390/jcm13247509
Submission received: 20 November 2024 / Revised: 4 December 2024 / Accepted: 9 December 2024 / Published: 10 December 2024
(This article belongs to the Special Issue Deep Brain Stimulation for Parkinson’s Disease and Other Movement Disorders: The Long Road toward Personalized Medicine)
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Abstract

Background: Deep brain stimulation (DBS) is an effective treatment for movement disorders, but its long-term efficacy may be undermined by hardware complications such as lead fractures. These complications increase healthcare costs and necessitate surgical revisions. The frequency, timing, and clinical factors associated with lead fractures remain poorly understood. Objective: This study aimed to determine the incidence, timing, and clinical factors associated with lead fractures in a large cohort of DBS patients over a 10-year period. Methods: This retrospective study analyzed data from 325 patients who underwent bilateral DBS implantation at the National Centre for Neurosurgery from 2013 to 2023. The analysis specifically focused on 17 patients who experienced lead fractures during the long-term follow-up period. Results: Among the 325 patients, lead fractures were identified in 17 patients (5.23%), affecting 18 electrodes. The majority of cases involved patients with Parkinson’s disease (76.5%) or dystonia (23.5%), with an average age of 59.17 ± 8.77 years. Nearly all patients with lead fractures had a history of trauma. Additionally, two cases were associated with active engagement in sports, particularly activities involving movements like pulling up on a horizontal bar, while Twiddler’s Syndrome was identified in two other cases. All electrode fractures required surgical revision. Conclusions: Lead fractures, while rare, remain a significant complication in DBS systems. Precise surgical techniques, early detection, and advancements in DBS hardware design may help to mitigate this risk. Future innovations, such as durable leads or wireless systems, may improve long-term outcomes in DBS therapy for movement disorders.
Keywords: deep brain stimulation; hardware-related complication; lead fractures; extension failure deep brain stimulation; hardware-related complication; lead fractures; extension failure

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MDPI and ACS Style

Nurimanov, C.; Mammadinova, I.; Menlibayeva, K.; Aidarov, S.; Nurakay, N.; Kaliyev, A.; Makhambetov, Y.; Akshulakov, S.K. Managing Lead Fractures in Deep Brain Stimulation for Movement Disorders: A Decade-Long Case Series from a National Neurosurgical Centre. J. Clin. Med. 2024, 13, 7509. https://doi.org/10.3390/jcm13247509

AMA Style

Nurimanov C, Mammadinova I, Menlibayeva K, Aidarov S, Nurakay N, Kaliyev A, Makhambetov Y, Akshulakov SK. Managing Lead Fractures in Deep Brain Stimulation for Movement Disorders: A Decade-Long Case Series from a National Neurosurgical Centre. Journal of Clinical Medicine. 2024; 13(24):7509. https://doi.org/10.3390/jcm13247509

Chicago/Turabian Style

Nurimanov, Chingiz, Iroda Mammadinova, Karashash Menlibayeva, Seitzhan Aidarov, Nurtay Nurakay, Assylbek Kaliyev, Yerbol Makhambetov, and Serik K. Akshulakov. 2024. "Managing Lead Fractures in Deep Brain Stimulation for Movement Disorders: A Decade-Long Case Series from a National Neurosurgical Centre" Journal of Clinical Medicine 13, no. 24: 7509. https://doi.org/10.3390/jcm13247509

APA Style

Nurimanov, C., Mammadinova, I., Menlibayeva, K., Aidarov, S., Nurakay, N., Kaliyev, A., Makhambetov, Y., & Akshulakov, S. K. (2024). Managing Lead Fractures in Deep Brain Stimulation for Movement Disorders: A Decade-Long Case Series from a National Neurosurgical Centre. Journal of Clinical Medicine, 13(24), 7509. https://doi.org/10.3390/jcm13247509

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