Bilateral pallidal stimulation improves cervical dystonia for more than a decade.

Abstract:

INTRODUCTION:Deep brain stimulation (DBS) is an effective treatment in medically resistant cervical dystonia (CD) with a documented therapeutic effect. Long term outcome beyond a decade, however, has not been studied systematically. METHODS:To investigate the impact of pallidal DBS beyond 10 years in CD we followed a series of five consecutive patients with severe medication-resistant CD. Severity of head and neck deviation, disability, and pain related to dystonia were assessed by the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) in the frame of a prospective study. The primary endpoint of this study was a change in the TWSTRS total score. Secondary endpoints were changes in the subscores of the TWSTRS. RESULTS:The mean follow-up time was 11.5 years (range 10-12.8). Comparing baseline and the last follow-up, CD improved by 53% on the total TWSTRS score, by 54.1% on the severity score, and by 70.1% on the disability score, while pain did not improve significantly. Improvement was stable over time. Patients with a tonic pattern of CD responded less to DBS than patients with a phasic pattern. DBS had no significant effect on mood and cognition. Two patients underwent electrode revisions. One patient had an infection of the proximal cable two years after surgery. CONCLUSIONS:Chronic bilateral pallidal stimulation improves severity of dystonia and disability over more than a decade in treatment resistant CD. Results may vary among individual patients.

authors

Kaelin-Lang A,You H,Burgunder JM,Lönnfors-Weitze T,Loher TJ,Taub E,Isaias IU,Krauss JK,Michael Schüpbach WM

doi

10.1016/j.parkreldis.2020.10.028

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

78-81

eissn

1353-8020

issn

1873-5126

pii

S1353-8020(20)30819-1

journal_volume

81

pub_type

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