Deep brain stimulation and pallidotomy in primary Meige syndrome: a prospective cohort study.

Autor: Hao QP; Department of Neurosurgery, Peking University People's Hospital, Xizhimen South Street, Xicheng DistrictBeijing, 100044, China., Zheng WT; Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, China., Zhang ZH; Department of Neurosurgery, Peking University People's Hospital, Xizhimen South Street, Xicheng DistrictBeijing, 100044, China., Ding H; Department of Neurosurgery, Peking University People's Hospital, Xizhimen South Street, Xicheng DistrictBeijing, 100044, China., Qin GB; Department of Neurology, Peking University People's Hospital, Beijing, China., Liu YZ; Department of Psychology, Peking University People's Hospital, Beijing, China., Tan Y; Clinical Research Institute, Peking University, Beijing, China., Liu Z; Department of Neurosurgery, Peking University People's Hospital, Xizhimen South Street, Xicheng DistrictBeijing, 100044, China. jylc143509@163.com.; Functional Neurosurgery Research Center, Peking University Health Science Center, Haidian District, Xueyuan Road, BeijingBeijing, 100191, No. 38, China. jylc143509@163.com., Liu RE; Department of Neurosurgery, Peking University People's Hospital, Xizhimen South Street, Xicheng DistrictBeijing, 100044, China. liuruen@pku.edu.cn.; Functional Neurosurgery Research Center, Peking University Health Science Center, Haidian District, Xueyuan Road, BeijingBeijing, 100191, No. 38, China. liuruen@pku.edu.cn.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2024 Sep 13. Date of Electronic Publication: 2024 Sep 13.
DOI: 10.1007/s10072-024-07752-w
Abstrakt: Background: Primary Meige syndrome (PMS) is a rare form of dystonia, and comparative analysis of globus pallidus internal deep brain stimulation (GPi-DBS), subthalamic nucleus deep brain stimulation (STN-DBS), and pallidotomy has been lacking. This study aims to compare the efficacy, safety, and psychiatric features of GPi-DBS, STN-DBS, and pallidotomy in patients with PMS.
Methods: This prospective cohort study was divided into three groups: GPi-DBS, STN-DBS, and pallidotomy. Clinical assessments, including motor and non-motor domains, were evaluated at baseline and at 1 year and 3 years after neurostimulation/surgery.
Results: Ninety-eight patients were recruited: 46 patients received GPi-DBS, 34 received STN-DBS, and 18 underwent pallidotomy. In the GPi-DBS group, the movement score of the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) improved from a mean (SE) of 13.8 (1.0) before surgery to 5.0 (0.7) (95% CI, -10.5 to -7.1; P < 0.001) at 3 years. Similarly, in the STN-DBS group, the mean (SE) score improved from 13.2 (0.8) to 3.5 (0.5) (95% CI, -10.3 to -8.1; P < 0.001) at 3 years, and in the pallidotomy group, it improved from 14.9 (1.3) to 6.0 (1.1) (95% CI, -11.3 to -6.5; P < 0.001) at 3 years. They were comparable therapeutic approaches for PMS that can improve motor function and quality of life without non-motor side effects.
Conclusions: DBS and pallidotomy are safe and effective treatments for PMS, and an in-depth exploration of non-motor symptoms may be a new entry point for gaining a comprehensive understanding of the pathophysiology.
(© 2024. Fondazione Società Italiana di Neurologia.)
Databáze: MEDLINE
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