Long-term effects of bilateral pallidal deep brain stimulation in dystonia: a follow-up between 8 and 16 years

Autor: Andrea A. Kühn, Andreas Kupsch, Patricia Krause, Siobhan Ewert, G.-H. Schneider, S. Völzmann
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Pediatrics
Neurology
Deep brain stimulation
Deep Brain Stimulation
medicine.medical_treatment
Globus Pallidus
Severity of Illness Index
Young Adult
03 medical and health sciences
Dysarthria
0302 clinical medicine
Swallowing
Quality of life
Outcome Assessment
Health Care
medicine
Humans
Affective Symptoms
030212 general & internal medicine
Torticollis
Depression (differential diagnoses)
Aged
Retrospective Studies
Dystonia
Original Communication
business.industry
Correction
Middle Aged
DBS and quality of life
medicine.disease
nervous system diseases
Mood
Dystonic Disorders
Quality of Life
Female
Long-term effects
Neurology (clinical)
medicine.symptom
business
600 Technik
Medizin
angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
030217 neurology & neurosurgery
Follow-Up Studies
Pallidal DBS
Zdroj: Journal of Neurology
ISSN: 1432-1459
0340-5354
DOI: 10.1007/s00415-020-09745-z
Popis: Objective Observational study to evaluate the long-term motor and non-motor effects of deep brain stimulation (DBS) of the globus pallidus internus (GPi) on medically refractory dystonia. Background Dystonia is a chronic disease affecting mainly young patients with a regular life expectancy and lifelong need for therapy. Pallidal DBS is an established treatment for severe isolated dystonia but long-term data are sparse. Methods We considered 36 consecutive patients with isolated generalized (n = 14) and cervical/segmental (n = 22) dystonia operated at Charité-University Hospital between 2000 and 2007 in a retrospective analysis for long-term outcome of pallidal DBS. In 19 of these patients, we could analyze dystonic symptoms and disability rated by the Burke–Fahn–Marsden Dystonia Rating scale (BFMDRS) at baseline, short-term (ST-FU, range 3–36 months) and long-term follow-up (LT-FU, range 93–197 months). Quality of life and mood were evaluated using the SF36 and Beck Depression Index (BDI) questionnaires. Results Patients reached an improvement in motor symptoms of 63.8 ± 5.7% (mean ± SE) at ST-FU and 67.9 ± 6.1% at LT-FU. Moreover, a significant and stable reduction in disability was shown following DBS (54.2 ± 9.4% at ST-FU and 53.8 ± 9.2% at LT-FU). BDI and SF36 had improved by 40% and 23%, respectively, at LT-FU (n = 14). Stimulation-induced adverse events included swallowing difficulties, dysarthria, and bradykinesia. Pulse generator (n = 3) and electrodes (n = 5) were revised in seven patients due to infection. Conclusions Pallidal DBS is a safe and efficacious long-term treatment for dystonia with sustained effects on motor impairment and disability, accompanied by a robust improvement in mood and quality of life.
Databáze: OpenAIRE
Externí odkaz: