Effects of ventro-oral thalamic deep brain stimulation in a patient with musician's dystonia: illustrative case

J Neurosurg Case Lessons. 2023 Oct 30;6(18):CASE22569. doi: 10.3171/CASE22569. Print 2023 Oct 30.

Abstract

Background: Musician's dystonia is a task-specific focal hand dystonia characterized by involuntary contraction of muscles while playing a musical instrument. Current treatment options are often insufficient.

Observations: We present the effects of ventro-oral thalamic deep brain stimulation in a patient with musician's dystonia. The patient was a 67-year-old pianist with musician's dystonia who underwent deep brain stimulation with the ventralis oralis anterior and posterior nuclei of the thalamus as targets. The Tubiana and Chamagne rating scale was used to evaluate the effects of stimulation. The outcome was evaluated independently by four clinicians in a blinded manner at 3 months postoperatively. There was a distinct reduction of symptoms during stimulation. At 15 months postoperatively, the beneficial effect remained. No lasting side effects were observed.

Lessons: Further studies are warranted to evaluate the safety and long-term efficacy of this treatment modality.

Keywords: deep brain stimulation; focal hand dystonia; musician’s dystonia; ventralis oralis anterior; ventralis oralis posterior.