Deep brain stimulation for dystonia

Rodrigues, Filipe B; Duarte, Gonçalo S; Prescott, David S.; Ferreira, Joaquim J.; Costa, João

doi:10.1002/14651858.cd012405.pub2

Cited by 50 publications

(41 citation statements)

References 88 publications

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“…However, this procedure is relatively expensive. Thus, considering that DBS is cost-prohibitive [11], the patient's parents refused the implantation of electrodes at both GPi and VIM/VOA targets. On the contrary, thalamotomy produces irreversible lesions and may also carry the risks of possible severe complications [12,13,14].…”

Section: Discussionmentioning

confidence: 99%

Deep Brain Stimulation and Thalamotomy for the Treatment of Dystonia Acquired by Moyamoya Disease with Stroke

Wang

et al. 2020

Tremor and Other Hyperkinetic Movements

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Background: Moyamoya disease (MMD) is a type of chronic cerebrovascular disease. Currently, revascularization surgery including direct/indirect procedure is recommended for symptomatic patients. However, some patients still respond poorly to the treatment or develop secondary symptoms. Case report: We report the first case of an MMD patient treated with deep brain stimulation (DBS) and thalamotomy. Symptoms of dystonia due to hemorrhage in the thalamus responded poorly to revascularization surgery, but were considerably alleviated by stereotactic neurosurgery. Discussion: Our case report provides a potential strategy for management of refractory symptomatic MMD patients with dystonia and also supports the combined efficacy of DBS with thalamotomies. Highlights: Approximately 30% of patients with Moyamoya disease (MMD) presenting movement symptoms do not respond well to revascularization surgery. We reported an MMD patient treated with deep brain stimulation (DBS) and thalamotomy with significant dystonia and dystonic tremor symptom amelioration. It indicates that DBS or stereotactic lesioning might be a potential treatment for the refractory movement symptoms of MMD.

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Section: Discussionmentioning

confidence: 99%

Deep Brain Stimulation and Thalamotomy for the Treatment of Dystonia Acquired by Moyamoya Disease with Stroke

Wang

et al. 2020

Tremor and Other Hyperkinetic Movements

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“…The botulinum toxins are considered first-line treatments for many patients (16). Surgical interventions are offered for severe, medically refractory dystonias (17,18). Deep brain stimulation (DBS) is most popular, but ablative procedures involving the basal ganglia or thalamus can also be helpful (19).…”

Section: The Need For New Treatments Existing Treatmentsmentioning

confidence: 99%

The Dystonia Coalition: A Multicenter Network for Clinical and Translational Studies

et al. 2021

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Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal postures, repetitive movements, or both. Research in dystonia has been challenged by several factors. First, dystonia is uncommon. Dystonia is not a single disorder but a family of heterogenous disorders with varied clinical manifestations and different causes. The different subtypes may be seen by providers in different clinical specialties including neurology, ophthalmology, otolaryngology, and others. These issues have made it difficult for any single center to recruit large numbers of subjects with specific types of dystonia for research studies in a timely manner. The Dystonia Coalition is a consortium of investigators that was established to address these challenges. Since 2009, the Dystonia Coalition has encouraged collaboration by engaging 56 sites across North America, Europe, Asia, and Australia. Its emphasis on collaboration has facilitated establishment of international consensus for the definition and classification of all dystonias, diagnostic criteria for specific subtypes of dystonia, standardized evaluation strategies, development of clinimetrically sound measurement tools, and large multicenter studies that document the phenotypic heterogeneity and evolution of specific types of dystonia.

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“…Sham-controlled periods of 3 months have been used to evaluate the safety and efficacy of deep brain stimulation (DBS) to the internal globus pallidus nucleus for dystonia, 95 the subthalamic nucleus in Parkinson’s disease, 96 the anterior nucleus of the thalamus for partial epilepsy, 97 , 98 and various targets in obsessive-compulsive disorder. 99 To our knowledge, a sham-controlled period of 12 months has never been attempted with a brain stimulation treatment.…”

Section: Implications and Conclusionmentioning

confidence: 99%

<p>The Long and Winding Road of Vagus Nerve Stimulation: Challenges in Developing an Intervention for Difficult-to-Treat Mood Disorders</p>

Sackeïm

Dibué

Bunker

et al. 2020

NDT

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Purpose The Vagus Nerve Stimulation (VNS) Therapy System has been studied for more than 20 years in patients with severe, treatment-resistant, chronic mood disorder, i.e., difficult-to-treat depression (DTD). This review distills some of the implications of this research for future therapeutic trials in this population. Methods A narrative review is provided on VNS in DTD. Protocols for a new, large, sham-controlled trial and a global, longitudinal observational study are described. Results Following encouraging results in open studies, a randomized, masked, sham-controlled trial of VNS for DTD failed to demonstrate an effect on the primary outcome. The negative results may have been partly due to inadequate treatment duration (10 weeks). In long-term observational studies, adjunctive VNS, combined with treatment-as-usual (VNS+TAU), was administered to more than 1100 DTD patients and compared with TAU alone in more than 400 patients. VNS+TAU had superior antidepressant effects, but maximal symptom reduction was often observed after 12 months or longer of stimulation. VNS+TAU had also marked superiority in durability of benefit. Sustained levels of symptom reduction below the traditional cutoff for response (i.e. < 50%) were associated with improved quality of life. Limitations Most comparisons of VNS+TAU and TAU were derived from observational, open label studies. Conclusion The history of VNS in DTD has implications for interventional studies in this population, and perhaps other chronic medical disorders. The slow onset of benefit with VNS necessitates considerably longer controlled observation periods to establish efficacy. Durability of benefit should be routinely incorporated in efficacy assessment. New outcome metrics are needed to both categorically identify clinically meaningful benefit and to integrate information on symptom burden over time.

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Deep brain stimulation for dystonia

Cited by 50 publications

References 88 publications

Deep Brain Stimulation and Thalamotomy for the Treatment of Dystonia Acquired by Moyamoya Disease with Stroke

Deep Brain Stimulation and Thalamotomy for the Treatment of Dystonia Acquired by Moyamoya Disease with Stroke

The Dystonia Coalition: A Multicenter Network for Clinical and Translational Studies

<p>The Long and Winding Road of Vagus Nerve Stimulation: Challenges in Developing an Intervention for Difficult-to-Treat Mood Disorders</p>

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