Similar Long-Term Clinical Outcomes of Deep Brain Stimulation With Different Electrode Targets for Primary Meige Syndrome: One Institution’s Experience of 17 Cases

Tian, Han; Xiong, Nanxiang; Xiong, Nian; Liu, Xiaoming; Rao, Jingyi; Wei, Xiang; Jiang, Xiaobing; Zhao, Hongyang; Fu, Peng

doi:10.1111/ner.13304

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…BFMDRS disability subscore improvement was 71.6% with STN and 68.4% with GPi DBS. The stimulation voltage was significantly higher as expected in the GPi group (43).…”

Section: Studies Directly Comparing Pallidal and Subthalamic Dbs In D...supporting

confidence: 79%

“…Table 1 includes all published cases of STN DBS in isolated dystonia that describe four or more patients (25,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). The first blinded prospective study of STN DBS in dystonia was published in 2011, describing one-year outcomes in nine patients with predominantly cervical dystonia (4).…”

Section: Stn Dbs In Isolated Cervical and Generalized Dystoniamentioning

confidence: 99%

“…Evidence for both STN and GPi DBS in Meige syndrome (an adult-onset segmental dystonia manifesting predominantly with oromandibular dystonia and blepharospasm) remains primarily retrospective or based on case reports (38,39,43,44,51). The largest report has been from China describing 32 Meige syndrome patients treated with bilateral STN DBS with a mean improvement in the BFMDRS of 79%.…”

Section: Meige Syndromementioning

confidence: 99%

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Subthalamic Nucleus Deep Brain Stimulation for Dystonia: Evidence, Pros and Cons

Kilbane

Ostrem²

2022

Dystonia

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The primary target for deep brain stimulation (DBS) for medication refractory dystonia has traditionally been the globus pallidus internus (GPi), however alternate targets have also been explored with the hope they might offer similar or superior outcomes with less side effects and reduced battery demands. Recent studies have shown comparable outcomes with both pallidal and subthalamic (STN) DBS, although the level of evidence is still superior for the GPi. There may not be an “optimal target” for all dystonia patients, with both targets offering the potential for excellent control of dystonia but more comparison studies are needed. In this review, we will discuss the history, efficacy, as well as target specific benefits and possible side effects of STN DBS for dystonia.

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“…BFMDRS disability subscore improvement was 71.6% with STN and 68.4% with GPi DBS. The stimulation voltage was significantly higher as expected in the GPi group (43).…”

Section: Studies Directly Comparing Pallidal and Subthalamic Dbs In D...supporting

confidence: 79%

Section: Stn Dbs In Isolated Cervical and Generalized Dystoniamentioning

confidence: 99%

Section: Meige Syndromementioning

confidence: 99%

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Subthalamic Nucleus Deep Brain Stimulation for Dystonia: Evidence, Pros and Cons

Kilbane

Ostrem²

2022

Dystonia

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“…Targeting the STN had an advantage over targeting the GPi regarding long-term outcomes, particularly regarding the continuous improvement resulting from STN-DBS up to 1 year postoperatively. Long-term outcomes are rarely reported [16,21,23,24]. The fact that the p value was only slightly below 0.05 in the present study could be mainly attributed to the large study population.…”

Section: Discussioncontrasting

confidence: 74%

Globus pallidus internus versus subthalamic nucleus deep brain stimulation for isolated dystonia: A 3‐year follow‐up

Lin

Shu

Zhang

et al. 2023

Euro J of Neurology

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Background and purpose Bilateral deep brain stimulation (DBS) surgery targeting the globus pallidus internus (GPi) or the subthalamic nucleus (STN) is widely used in medication‐refractory dystonia. However, evidence regarding target selection considering various symptoms remains limited. This study aimed to compare the effectiveness of these two targets in patients with isolated dystonia. Methods This retrospective study evaluated 71 consecutive patients (GPi‐DBS group, n = 32; STN‐DBS group, n = 39) with isolated dystonia. Burke–Fahn–Marsden Dystonia Rating Scale scores and quality of life were evaluated preoperatively and at 1, 6, 12, and 36 months postoperatively. Cognition and mental status were assessed preoperatively and at 36 months postoperatively. Results Targeting the STN (STN‐DBS) yielded effects within 1 month (65% vs. 44%; p = 0.0076) and was superior at 1 year (70% vs. 51%; p = 0.0112) and 3 years (74% vs. 59%; p = 0.0138). For individual symptoms, STN‐DBS was preferable for eye involvement (81% vs. 56%; p = 0.0255), whereas targeting the GPi (GPi‐DBS) was better for axis symptoms, especially for the trunk (82% vs. 94%; p = 0.015). STN‐DBS was also favorable for generalized dystonia at 36‐month follow‐up (p = 0.04) and required less electrical energy (p < 0.0001). Disability, quality of life, and depression and anxiety measures were also improved. Neither target influenced cognition. Conclusions We demonstrated that the GPi and STN are safe and effective targets for isolated dystonia. The STN has the benefits of fast action and low battery consumption, and is superior for ocular dystonia and generalized dystonia, while the GPi is better for trunk involvement. These findings may offer guidance for future DBS target selection for different types of dystonia.

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“…Articles regarding STN-DBS in patients with secondary dystonia are shown in chronologic order in Table 3. 19,35,83,[92][93][94][95][96][97][98][99][100][101][102][103][104][105][106] A comparison of the details of the patients undergoing GPi-DBS and STN-DBS obtained from the literature review is shown in Table 4.…”

Section: Resultsmentioning

confidence: 99%

Deep Brain Stimulation of the Globus Pallidus Internus for Secondary Dystonia: Clinical Cases and Systematic Review of the Literature Regarding the Effectiveness of Globus Pallidus Internus versus Subthalamic Nucleus

et al. 2021

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Similar Long-Term Clinical Outcomes of Deep Brain Stimulation With Different Electrode Targets for Primary Meige Syndrome: One Institution’s Experience of 17 Cases

Cited by 11 publications

References 21 publications

Subthalamic Nucleus Deep Brain Stimulation for Dystonia: Evidence, Pros and Cons

Subthalamic Nucleus Deep Brain Stimulation for Dystonia: Evidence, Pros and Cons

Globus pallidus internus versus subthalamic nucleus deep brain stimulation for isolated dystonia: A 3‐year follow‐up

Deep Brain Stimulation of the Globus Pallidus Internus for Secondary Dystonia: Clinical Cases and Systematic Review of the Literature Regarding the Effectiveness of Globus Pallidus Internus versus Subthalamic Nucleus

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