Subthalamus deep brain stimulation for primary dystonia patients: a long-term follow-up study

Mov Disord. 2013 Nov;28(13):1877-82. doi: 10.1002/mds.25586. Epub 2013 Jul 16.

Abstract

Background: Deep brain stimulation has generated sustained improvement in motor function for patients with dystonia, but the long-term impact of subthalamic nucleus stimulation on dystonia has not been elucidated.

Methods: Patients with primary dystonia underwent bilateral subthalamic nucleus stimulation and were evaluated with the Burke-Fahn-Marsden dystonia rating scale and the Medical Outcomes Study 36-item Short-Form General Health Survey at baseline and 1 month, 1 year, and 3 to 10 years postoperatively.

Results: Improvements in motor function according to the Burke-Fahn-Marsden dystonia rating scale at 1 month, 1 year, and 3 to 10 years of stimulation were 55%, 77%, and 79%, respectively. The quality of life improved after 1 month of stimulation (P < 0.001), progressed within 1 year (P < 0.001), and then remained stable. Disease duration was negatively correlated with an improvement in motor function.

Conclusions: Our results demonstrate that the subthalamus is an alternative to the globus pallidus internus as a target for deep brain stimulation to treat primary dystonia.

Keywords: Burke-Fahn-Marsden dystonia rating scale; Medical Outcomes Study 36-item Short-Form General Health Survey; deep brain stimulation; primary dystonia; subthalamic nucleus.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Deep Brain Stimulation / methods*
  • Disability Evaluation
  • Dystonic Disorders / therapy*
  • Female
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Subthalamic Nucleus / physiology*
  • Time Factors
  • Treatment Outcome
  • Young Adult