Objective: To investigate possible reasons behind some practices of deep brain stimulation (DBS) hardware providers.

Background: The global success of DBS in movement disorders has led new companies to enter the DBS business, and led the original company to develop new generations of implantable pulse generators (IPG). Since it has become evident that DBS is not “reversible” in the long term (“DBS withdrawal syndrome”; “once DBS, always DBS”- Mov Disord Clin Pract, 2016), patients may become “hooked” on DBS and will need regular battery replacements, with financial and clinical consequences. Rechargeable batteries may not be suitable to many DBS patients. Karl Marx´ seminal work “Das Kapital” (1867), and Rosa Luxemburg´s work “The Accumulation of Capital” (1913) established that the ultimate aim of Capital is to steadily accumulate itself. At the occasion of the centenary of Luxemburg’s death, The Lancet (January 2019) published an Editorial praising her work and discussing globalisation and the health crisis. Here we ask: could Capital´s inherent need to accumulate exert any influence on some decisions of the DBS industry?

Method: We reviewed the literature with respect to differences in battery longevity between older generation IPGs and newer ones, and to determine the influence of DBS industry on some industry-sponsored trials.

Results: 6 publications (from Germany, the UK, Korea, Israel, and France), as well as a survey of 80 DBS clinicians worldwide, confirmed that the battery of the newer brand of IPGs has significantly less battery life than the older brand, leading to un-necessary frequent and costly replacements, with attending cumulative risk for infection. As for the IPG with a rechargeable battery, the industry-set “apoptopic” limit of 9 years has magically been extended to 15 years on these same already implanted IPGs. Finally, industry has sponsored all too premature DBS trials for depression, which eventually failed, jeopardizing for the foreseeable future prospects of conducting investigations of DBS in psychiatric illness.

Conclusion: As predicted by Marx and Luxemburg, the fact remains that the ultimate aim of Capital is to accumulate through increased profit. With respect to DBS, this may result in sad consequences for patients & healthcare budgets, in many cases easily and practically avoidable, however, by using thalamotomy, pallidotomy or subthalamotomy

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MDS Abstracts - https://www.mdsabstracts.org/abstract/karl-marx-rosa-luxemburg-and-deep-brain-stimulation-is-there-a-connection/