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

Kaelin-Lang, Alain; You, Hana; Burgunder, Jean-Marc; Lönnfors-Weitze, Tarja; Loher, Thomas J.; Taub, Ethan; Isaias, Ioannis U; Krauss, Joachim K; Schüpbach, W. M. Michael (2020). Bilateral pallidal stimulation improves cervical dystonia for more than a decade. Parkinsonism & related disorders, 81, pp. 78-81. Elsevier 10.1016/j.parkreldis.2020.10.028

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Kaelin, Alain; You, Hana; Burgunder, Jean-Marc; Lönnfors-Weitzel, Tarja; Loher, Thomas and Schüpbach, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1353-8020

Publisher:

Elsevier

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

06 Nov 2020 12:22

Last Modified:

06 Nov 2020 12:22

Publisher DOI:

10.1016/j.parkreldis.2020.10.028

PubMed ID:

33075700

Uncontrolled Keywords:

Cervical dystonia Deep brain stimulation Globus pallidus internus Long term follow-up

BORIS DOI:

10.7892/boris.147443

URI:

https://boris.unibe.ch/id/eprint/147443

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