Pallidal stimulation in cervical dystonia: clinical implications of acute changes in stimulation parameters

Moro, Elena; Piboolnurak, Panida; Arenovich, Tamara; Hung, Serena; Poon, Yu‐Yan; Lozano, Andrés M.

doi:10.1111/j.1468-1331.2008.02520.x

Cited by 70 publications

(61 citation statements)

References 28 publications

(44 reference statements)

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“…Several factors, in fact, including surgical protocols, contact position within the target [14,26] , stimulation parameters [27] , DYT1 status [28,29] , age at surgery [14] , and, particularly, disease duration [30,31] could be part of the explanation for the differences reported in the results of different studies [32] . In our population the improvement of the motor-BFMDRS score increased significantly at each follow-up for up to 3 years and was steady after 5 years.…”

Section: Discussionmentioning

confidence: 91%

Five-Year Follow-Up of 10 Patients Treated with Globus Pallidus Internus Deep Brain Stimulation for Segmental or Multisegmental Dystonia

Sarubbo¹,

Latini²,

Quatrale

et al. 2012

Stereotact Funct Neurosurg

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Introduction: Globus pallidus internus (GPi) deep brain stimulation (DBS) represents a validated, effective, and safe treatment for patients affected by generalized dystonia resistant to conservative treatment. Segmental and multisegmental dystonia have more recently been proposed as further indications for GPi DBS despite the lack of long-term homogenous follow-up. Here we present an original and detailed long-term follow-up (5 years) of a homogeneous population of 11 patients affected by segmental or multisegmental dystonia. Materials and Methods: Ten patients underwent bilateral GPi DBS electrode implantations under a Leksell stereotactic guide, with intraoperative neurophysiological monitoring. The follow-ups at 1, 3 and 5 years were collected using video-BFMDRS for motor and disability scores. The statistical analysis of the results is provided. Results: We reported a statistically significant improvement in motor and disability overall scores until 5 years after treatment. At the last follow-up, even the single motor subitems were statistically improved. Discussion: We observed a continuous and statistically significant improvement in all of the motor subitems and in the overall disability score until the 3-year follow-up. These results did not improve any further but they appeared steady at the last follow-up. We also report a significant improvement in the cranial-cervical subitems. Conclusions: GPi DBS should definitely be considered a safe and effective treatment also for segmental and multisegmental dystonia even in cases of relevant or prevalent cranial-cervical involvement.

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Section: Discussionmentioning

confidence: 91%

Five-Year Follow-Up of 10 Patients Treated with Globus Pallidus Internus Deep Brain Stimulation for Segmental or Multisegmental Dystonia

Sarubbo¹,

Latini²,

Quatrale

et al. 2012

Stereotact Funct Neurosurg

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“…The mean age of children at the time of surgery was 11.1 years (range 3. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. A diagnosis of primary dystonia had been made in 13 children, of secondary dystonia in 30 children and neuronal degeneration with brain iron accumulation (NBIA) in the remaining 11 children.…”

Section: Methodsmentioning

confidence: 99%

Battery life following pallidal deep brain stimulation (DBS) in children and young people with severe primary and secondary dystonia

et al. 2012

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“…Nevertheless, low-frequency stimulation has not been preferred because largescale studies demonstrated marked clinical improvement using 130 Hz or higher frequencies. A number of groups [5,6,8,9,19] have reported the results of their large-scale studies on GPi DBS for treatment of CD. Table 4 shows the parameters and mean improvement of the TWSTRS total scores for each large study.…”

Section: Discussionmentioning

confidence: 99%

“…troversial [8,9] . Especially the stimulation parameters employed to treat dystonia were not developed specifically for CD.…”

mentioning

confidence: 99%

Effects of Relative Low-Frequency Bilateral Globus Pallidus Internus Stimulation for Treatment of Cervical Dystonia

Kim

Chang

Park

et al. 2012

Stereotact Funct Neurosurg

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Objective: To assess the effect of relative lower amplitude and frequency for globus pallidus internus (GPi) deep brain stimulation (DBS) of cervical dystonia (CD). Materials and Methods: Between February 2005 and October 2008, 14 patients diagnosed with CD underwent bilateral GPi DBS and all the patients received low-frequency stimulation and were followed for more than 2 years. We activated the implantable pulse generator 3–4 days postoperatively and initial amplitude, pulse width, and frequency were set at 1.5 V, 120 µs, and 70 Hz. The Toronto Western Spasmodic Torticolis Rating Scale (TWSTRS) was applied preoperatively and at 1, 6, 12 and 24 months postoperatively. Results: The overall TWSTRS scores improved 71.2% 2 years postoperatively (p = 0.001). The mean improvement was 78.4% in severity subscores, 68.4% in disability, and 66.8% in pain scores for the 2-year follow-up period. The TWSTRS scores were significantly reduced (p < 0.05), suggesting that the most significant improvement of the TWSTRS scores occurred within 1 month. The final amplitude was 2.9/2.7 V with the pulse width of 147.9/147.9 µs and the frequency of 101.1/100 Hz. Conclusion: According to our results, the initial settings of low amplitude and especially relatively low frequency are safe and effective for treatment of CD.

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Pallidal stimulation in cervical dystonia: clinical implications of acute changes in stimulation parameters

Abstract: Frequency and amplitude appear to be the most important factors in the acute anti-dystonic effects in GPi-DBS patients with CD.

Cited by 70 publications

References 28 publications

Five-Year Follow-Up of 10 Patients Treated with Globus Pallidus Internus Deep Brain Stimulation for Segmental or Multisegmental Dystonia

Five-Year Follow-Up of 10 Patients Treated with Globus Pallidus Internus Deep Brain Stimulation for Segmental or Multisegmental Dystonia

Battery life following pallidal deep brain stimulation (DBS) in children and young people with severe primary and secondary dystonia

Effects of Relative Low-Frequency Bilateral Globus Pallidus Internus Stimulation for Treatment of Cervical Dystonia

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