Pallidal deep brain stimulation for dystonia: a long term study.
BACKGROUND
Pallidal deep brain stimulation (globus pallidus internus (GPi) DBS) is the best therapeutic option for disabling isolated idiopathic (IID) and inherited (INH) dystonia. Acquired dystonia (AD) may also benefit from GPi DBS. Efficacy and safety in the long-term remained to be established.


OBJECTIVE
To retrospectively assess long-term clinical outcomes and safety in dystonic patients who underwent GPi DBS.


METHODS
Patients were videotaped and assessed preoperatively and postoperatively (1-year and at last available follow-up) using the Burke-Fahn-Marsden Dystonia Rating Scale (motor score (BFMDRS-M); disability score (BFMDRS-D)).


RESULTS
Sixty-one patients were included (follow-up 7.9±5.9 years; range 1-20.7). In IID and INH (n=37), the BFMDRS-M improved at first (20.4±24.5; p<0.00001) and last (22.2±18.2; p<0.001) follow-ups compared with preoperatively (50.5±28.0). In AD (n=19), the BFMDRS-M ameliorated at 1-year (40.8±26.5; p<0.02) and late follow-ups (44.3±24.3; p<0.04) compared with preoperatively (52.8±24.2). In INH dystonia with other neurological features (n=4) there was no motor benefit. In IID and INH, the BFMDRS-D improved at 1-year (9.5±7.5; p<0.0002) and late follow-ups (10.4±7.8; p<0.016) compared with preoperatively (13.3±6.9). In AD, the BFMDRS-D reduced at 1-year (12.0±8.1; p<0.01) and late follow-ups (12.7 ±6.1; p=0.2) compared with preoperatively (14.35±5.7). Most adverse events were hardware related.


CONCLUSIONS
GPi DBS is an effective and safe treatment in most patients with dystonia.
['Meoni|Sara|S|', 'Fraix|Valérie|V|', 'Castrioto|Anna|A|', 'Benabid|Alim Louis|AL|', 'Seigneuret|Eric|E|', 'Vercueil|Laurent|L|', 'Pollak|Pierre|P|', 'Krack|Paul|P|', 'Chevrier|Eric|E|', 'Chabardes|Stephan|S|', 'Moro|Elena|E|']
D000328:Adult D046690:Deep Brain Stimulation D020821:Dystonic Disorders D005260:Female D005500:Follow-Up Studies D005917:Globus Pallidus D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D016896:Treatment Outcome
deep brain stimulation dystonia globus pallidus motor outcome