Comprehensive Summary
Liu et al. (2025) investigated the experiences that patients with obsessive-compulsive disorder (OCD) have had with deep-brain stimulation (DBS) systems, particularly rechargeable implantable pulse generators (RC IPCs). They aimed to focus on charging routines and charge burden, as well as other various aspects of using rechargeable technology in DBS treatment. Six OCD patients with RC IPGs were interviewed within a single institution cohort. Data regarding their battery usage was obtained through device data downloads. Patients provided their perceived charging intervals and session durations to assess cognitive burden. The researchers found that the average recharge interval, or time needed for the device to be recharged, for OCD patients tended to be around 29.5 ± 20.9 hours. These durations were shorter than those for patients with movement-based conditions, which typically have recharging intervals of 1-2 weeks. The average recharging session lasted 28.0 ± 18.3 minutes; however, the average weekly charge burden was 209.5 ± 158.5 minutes. There were discrepancies between perceived and actual charge times, and some OCD patients reported a hyper-fixation on battery levels. The researchers overall concluded that the RC IPGs prolonged the time between surgical replacements, thus helping OCD patients better manage DBS treatment. However, there tended to be more frequency in battery charging routines compared to patients with movement disorders. Individualized DBS therapy must consider the needs of each patient, as primary cell (PC), or non-rechargeable, systems may be preferred for OCD patients who struggle with charging routines.
Outcomes and Implications
Rechargeable DBS technologies help extend device lifespan. RC IPGs, in particular, last around 15-25 years, much longer than non-rechargeable, primary cell IPGs, which last between 3 and 5 years. These technologies also alleviate the need for replacement surgeries. Frequent surgeries are invasive; thus, they help alleviate the burden of medical risk and its associated costs for patients. Therefore, it is overall more cost-effective for patients to use RC DBS models. OCD patients particularly need more stimulation and recharging, so these technologies require more consistent upkeep to remain effective. In psychiatric populations such as those with OCD, it is critical to consider the cognitive burden of maintenance and constant recharges due to any likely fixation on battery levels. To enhance individual patients' experience, it is important to consider their preferences, lifestyle needs, and potential cognitive burdens when choosing the best device. PC IPC options may be preferred for those with charging anxiety, with the option to upgrade to RC IPC once OCD symptoms improve. While the study does not provide a specific timeline for broader implementation, it supports a patient-centered approach to DBS technology that could influence clinical decision-making.