Deep brain stimulation for generalised dystonia and spasmodic torticollis

Bittar, R.G., Yianni, J., Wang, S., Liu, X., Nandi, D., Joint, C., Scott, R., Bain, P.G., Gregory, R., Stein, J. and Aziz, T.Z. (2005) Deep brain stimulation for generalised dystonia and spasmodic torticollis Journal of Clinical Neuroscience, 12, (1), pp. 12-16. (doi:10.1016/j.jocn.2004.03.025).


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Dystonia appears distinct from the other tremulous disorders in that improvement following deep brain stimulation frequently appears in a delayed and progressive manner. The rate of this improvement and the point at which no further progress can be expected are presently unknown. The establishment of these parameters is important in the provision of accurate and relevant prognostic information to these patients, their carers, and their treating physicians. We studied 12 consecutive patients with generalised dystonia (n = 6) and spasmodic torticollis (n = 6) who underwent bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) and were followed up for a minimum of 2 years postoperatively. Standard rating scales were used to quantify their neurological improvement. Both groups experienced a statistically significant improvement in their rating scores at both one and two years following surgery. At 2 years follow-up, the spasmodic torticollis group exhibited a 59% improvement in their total Toronto Western Spasmodic Torticoilis Rating Scale (TWSTRS) rating score and the generalised dystonia group attained a 46% improvement in their overall Burke, Fahn and Marsden Dystonia Rating Scale (BFMDRS) evaluation. Ninety-five percent of the final improvement was attained by 6.4 months in the generalised dystonia group and by 6.6 months in those with spasmodic torticollis. There was no significant improvement after one year postoperatively. These findings add further support to GPi DBS as an effective treatment for generalised dystonia and spasmodic torticollis, and furnish important information as to the expected rate of improvement and the point at which no further gains can be reasonably anticipated.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1016/j.jocn.2004.03.025
ISSNs: 0967-5868 (print)
Related URLs:
Keywords: deep brain stimulation, dystonia, spasmodic torticollis, rate of change

Organisations: Human Sciences Group
ePrint ID: 49601
Date :
Date Event
January 2005Published
Date Deposited: 21 Nov 2007
Last Modified: 16 Apr 2017 18:17
Further Information:Google Scholar

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