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Deep brain stimulation for generalised dystonia and spasmodic torticollis

Deep brain stimulation for generalised dystonia and spasmodic torticollis
Deep brain stimulation for generalised dystonia and spasmodic torticollis
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.
deep brain stimulation, dystonia, spasmodic torticollis, rate of change
0967-5868
12-16
Bittar, R.G.
398d329d-2830-44f9-8e06-5e868e226dd4
Yianni, J.
21ce1bbc-e397-449d-bf1d-e874ee38ada3
Wang, S.
8bce5bdb-420c-4b22-b009-8f4ce1febaa8
Liu, X.
878efcac-76c6-4ca0-8f4a-425f1e9abdac
Nandi, D.
89b4a04e-5bff-4833-ba6e-52a1a8aba507
Joint, C.
423119d0-8e94-47a6-8155-5245f6d4a144
Scott, R.
96283dba-5cb5-4ab5-9bbe-e368b68ca406
Bain, P.G.
6f63e03e-9273-426e-adc0-72eb1bec9e63
Gregory, R.
fb588148-f426-4235-bbc4-8caeefd82c5a
Stein, J.
060b38b3-f84f-4c31-a1e0-c388eac92628
Aziz, T.Z.
728d8821-5fa0-407f-a09f-5a52038ad170
Bittar, R.G.
398d329d-2830-44f9-8e06-5e868e226dd4
Yianni, J.
21ce1bbc-e397-449d-bf1d-e874ee38ada3
Wang, S.
8bce5bdb-420c-4b22-b009-8f4ce1febaa8
Liu, X.
878efcac-76c6-4ca0-8f4a-425f1e9abdac
Nandi, D.
89b4a04e-5bff-4833-ba6e-52a1a8aba507
Joint, C.
423119d0-8e94-47a6-8155-5245f6d4a144
Scott, R.
96283dba-5cb5-4ab5-9bbe-e368b68ca406
Bain, P.G.
6f63e03e-9273-426e-adc0-72eb1bec9e63
Gregory, R.
fb588148-f426-4235-bbc4-8caeefd82c5a
Stein, J.
060b38b3-f84f-4c31-a1e0-c388eac92628
Aziz, T.Z.
728d8821-5fa0-407f-a09f-5a52038ad170

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), 12-16. (doi:10.1016/j.jocn.2004.03.025).

Record type: Article

Abstract

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.

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More information

Published date: January 2005
Keywords: deep brain stimulation, dystonia, spasmodic torticollis, rate of change
Organisations: Human Sciences Group

Identifiers

Local EPrints ID: 49601
URI: http://eprints.soton.ac.uk/id/eprint/49601
ISSN: 0967-5868
PURE UUID: b76b4366-663d-4409-af7d-1d2a0b668442

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Date deposited: 21 Nov 2007
Last modified: 15 Mar 2024 09:57

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Contributors

Author: R.G. Bittar
Author: J. Yianni
Author: S. Wang
Author: X. Liu
Author: D. Nandi
Author: C. Joint
Author: R. Scott
Author: P.G. Bain
Author: R. Gregory
Author: J. Stein
Author: T.Z. Aziz

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