Bilateral globus pallidus internus (GPi) deep brain stimulation for cervical dystonia: Effects on motor and non-motor symptoms within 5 years follow
Cervical Dystonia (“CD”) is a movement disorder characterised by sustained muscle contractions in the neck, causing involuntary posturing. Deep brain stimulation (“DBS”) of the globus pallidal internus (GPi) is advanced treatment for pharmaco-refractory patients. As CD is a rare disease, cohort stud...
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| Veröffentlicht in: | Journal of the neurological sciences 2023-09, Vol.452, p.120752-120752, Article 120752 |
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| creator | Khanom, Anjum Aarifa Franceschini, Paulo Roberto Lane, Steven Osman-Farah, Jibril Macerollo, Antonella |
| description | Cervical Dystonia (“CD”) is a movement disorder characterised by sustained muscle contractions in the neck, causing involuntary posturing. Deep brain stimulation (“DBS”) of the globus pallidal internus (GPi) is advanced treatment for pharmaco-refractory patients. As CD is a rare disease, cohort studies are often limited to patients of heterogenous disease profile, small sample size or short follow-up. This study firstly aimed to measure the efficacy of GPi-DBS on motor and non-motor symptoms of CD. A secondary aim was to evaluate if clinical factors – such as age, disease duration and baseline disease severity – influence variability of motor outcomes.
37 idiopathic CD patients were recruited from movement disorders clinics at The Walton NHS Foundation Trust, Liverpool, UK. Patients were assessed pre-operatively, and 1 year, 3 years and 5 years post-operatively with the following clinical scales: Toronto Western Spasmodic Torticollis Rating Scale (“TWSTRS”), Hospital Anxiety and Depression Scale and EuroQuol-5D.
GPI-DBS significantly improved overall TWSTRS scores by 57% from baseline to 5Y FU (p |
| doi_str_mv | 10.1016/j.jns.2023.120752 |
| format | Article |
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37 idiopathic CD patients were recruited from movement disorders clinics at The Walton NHS Foundation Trust, Liverpool, UK. Patients were assessed pre-operatively, and 1 year, 3 years and 5 years post-operatively with the following clinical scales: Toronto Western Spasmodic Torticollis Rating Scale (“TWSTRS”), Hospital Anxiety and Depression Scale and EuroQuol-5D.
GPI-DBS significantly improved overall TWSTRS scores by 57% from baseline to 5Y FU (p < 0.001). It also significantly improved TWSTRS severity, disability, and pain sub-scores by 72%, 59% and 46% respectively. We did not find a significant improvement in mood or quality of life scores at 5 years. Similarly, clinical factors at baseline did not correlate with variability in motor outcome.
We concluded that GPi-DBS is an effective treatment for motor symptoms and pain in CD. There was limited effect on mood and QoL, and no clinical predictive factors of outcome were identified.
[Display omitted]
•GPi-DBS is effective for motor symptoms in CD.•The benefit is maintained at the 5 years follow up.•GPi-DBS has limited impact on mood and quality of life in CD.•The present study did not identify clinical predictive factors of GPi-DBS outcome in CD.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2023.120752</identifier><identifier>PMID: 37542824</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cervical dystonia ; Deep brain stimulation ; Globus pallidus internus ; Non-motor symptoms ; Pain ; Toronto Western spasmodic torticollis rating scale</subject><ispartof>Journal of the neurological sciences, 2023-09, Vol.452, p.120752-120752, Article 120752</ispartof><rights>2023 The Authors</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2632-652feb517e189e662b937d4ac3a1c4f1faf4d3e435b46f2676eb5fea74733fe33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jns.2023.120752$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37542824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khanom, Anjum Aarifa</creatorcontrib><creatorcontrib>Franceschini, Paulo Roberto</creatorcontrib><creatorcontrib>Lane, Steven</creatorcontrib><creatorcontrib>Osman-Farah, Jibril</creatorcontrib><creatorcontrib>Macerollo, Antonella</creatorcontrib><title>Bilateral globus pallidus internus (GPi) deep brain stimulation for cervical dystonia: Effects on motor and non-motor symptoms within 5 years follow</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>Cervical Dystonia (“CD”) is a movement disorder characterised by sustained muscle contractions in the neck, causing involuntary posturing. Deep brain stimulation (“DBS”) of the globus pallidal internus (GPi) is advanced treatment for pharmaco-refractory patients. As CD is a rare disease, cohort studies are often limited to patients of heterogenous disease profile, small sample size or short follow-up. This study firstly aimed to measure the efficacy of GPi-DBS on motor and non-motor symptoms of CD. A secondary aim was to evaluate if clinical factors – such as age, disease duration and baseline disease severity – influence variability of motor outcomes.
37 idiopathic CD patients were recruited from movement disorders clinics at The Walton NHS Foundation Trust, Liverpool, UK. Patients were assessed pre-operatively, and 1 year, 3 years and 5 years post-operatively with the following clinical scales: Toronto Western Spasmodic Torticollis Rating Scale (“TWSTRS”), Hospital Anxiety and Depression Scale and EuroQuol-5D.
GPI-DBS significantly improved overall TWSTRS scores by 57% from baseline to 5Y FU (p < 0.001). It also significantly improved TWSTRS severity, disability, and pain sub-scores by 72%, 59% and 46% respectively. We did not find a significant improvement in mood or quality of life scores at 5 years. Similarly, clinical factors at baseline did not correlate with variability in motor outcome.
We concluded that GPi-DBS is an effective treatment for motor symptoms and pain in CD. There was limited effect on mood and QoL, and no clinical predictive factors of outcome were identified.
[Display omitted]
•GPi-DBS is effective for motor symptoms in CD.•The benefit is maintained at the 5 years follow up.•GPi-DBS has limited impact on mood and quality of life in CD.•The present study did not identify clinical predictive factors of GPi-DBS outcome in CD.</description><subject>Cervical dystonia</subject><subject>Deep brain stimulation</subject><subject>Globus pallidus internus</subject><subject>Non-motor symptoms</subject><subject>Pain</subject><subject>Toronto Western spasmodic torticollis rating scale</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAURi0EotPCA7BBXpZFBv_EdgZWpSoFqRIsQGJnOc41eOTYwU5azYOw51l4snqUwpKVr63zHcn3Q-gFJVtKqHy93-5j2TLC-JYyogR7hDa0U10juo4_RhtCGGsEJd9O0Gkpe0KI7LrdU3TClWhZx9oN-vXOBzNDNgF_D6lfCp5MCH6og4_1Pdbh_Pqzf4UHgAn32fiIy-zHpcZ8itiljC3kW2-rYjiUOUVv3uAr58DOBVdiTHNlTBxwTLFZb-UwTnMaC77z849qFH9-H8DkUnUhpLtn6IkzocDzh_MMfX1_9eXyQ3Pz6frj5cVNY5nkrJGCOegFVUC7HUjJ-h1XQ2ssN9S2jjrj2oFDy0XfSsekkpV2YFSrOHfA-Rk6X71TTj8XKLMefbEQgomQlqJZ18odU1IcUbqiNqdSMjg9ZT-afNCU6GMbeq9rG_rYhl7bqJmXD_qlH2H4l_i7_gq8XQGon7z1kHWxHqKFwee6Pj0k_x_9PVfNnkI</recordid><startdate>20230915</startdate><enddate>20230915</enddate><creator>Khanom, Anjum Aarifa</creator><creator>Franceschini, Paulo Roberto</creator><creator>Lane, Steven</creator><creator>Osman-Farah, Jibril</creator><creator>Macerollo, Antonella</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230915</creationdate><title>Bilateral globus pallidus internus (GPi) deep brain stimulation for cervical dystonia: Effects on motor and non-motor symptoms within 5 years follow</title><author>Khanom, Anjum Aarifa ; Franceschini, Paulo Roberto ; Lane, Steven ; Osman-Farah, Jibril ; Macerollo, Antonella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2632-652feb517e189e662b937d4ac3a1c4f1faf4d3e435b46f2676eb5fea74733fe33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cervical dystonia</topic><topic>Deep brain stimulation</topic><topic>Globus pallidus internus</topic><topic>Non-motor symptoms</topic><topic>Pain</topic><topic>Toronto Western spasmodic torticollis rating scale</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khanom, Anjum Aarifa</creatorcontrib><creatorcontrib>Franceschini, Paulo Roberto</creatorcontrib><creatorcontrib>Lane, Steven</creatorcontrib><creatorcontrib>Osman-Farah, Jibril</creatorcontrib><creatorcontrib>Macerollo, Antonella</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khanom, Anjum Aarifa</au><au>Franceschini, Paulo Roberto</au><au>Lane, Steven</au><au>Osman-Farah, Jibril</au><au>Macerollo, Antonella</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bilateral globus pallidus internus (GPi) deep brain stimulation for cervical dystonia: Effects on motor and non-motor symptoms within 5 years follow</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2023-09-15</date><risdate>2023</risdate><volume>452</volume><spage>120752</spage><epage>120752</epage><pages>120752-120752</pages><artnum>120752</artnum><issn>0022-510X</issn><eissn>1878-5883</eissn><abstract>Cervical Dystonia (“CD”) is a movement disorder characterised by sustained muscle contractions in the neck, causing involuntary posturing. Deep brain stimulation (“DBS”) of the globus pallidal internus (GPi) is advanced treatment for pharmaco-refractory patients. As CD is a rare disease, cohort studies are often limited to patients of heterogenous disease profile, small sample size or short follow-up. This study firstly aimed to measure the efficacy of GPi-DBS on motor and non-motor symptoms of CD. A secondary aim was to evaluate if clinical factors – such as age, disease duration and baseline disease severity – influence variability of motor outcomes.
37 idiopathic CD patients were recruited from movement disorders clinics at The Walton NHS Foundation Trust, Liverpool, UK. Patients were assessed pre-operatively, and 1 year, 3 years and 5 years post-operatively with the following clinical scales: Toronto Western Spasmodic Torticollis Rating Scale (“TWSTRS”), Hospital Anxiety and Depression Scale and EuroQuol-5D.
GPI-DBS significantly improved overall TWSTRS scores by 57% from baseline to 5Y FU (p < 0.001). It also significantly improved TWSTRS severity, disability, and pain sub-scores by 72%, 59% and 46% respectively. We did not find a significant improvement in mood or quality of life scores at 5 years. Similarly, clinical factors at baseline did not correlate with variability in motor outcome.
We concluded that GPi-DBS is an effective treatment for motor symptoms and pain in CD. There was limited effect on mood and QoL, and no clinical predictive factors of outcome were identified.
[Display omitted]
•GPi-DBS is effective for motor symptoms in CD.•The benefit is maintained at the 5 years follow up.•GPi-DBS has limited impact on mood and quality of life in CD.•The present study did not identify clinical predictive factors of GPi-DBS outcome in CD.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37542824</pmid><doi>10.1016/j.jns.2023.120752</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Cervical dystonia Deep brain stimulation Globus pallidus internus Non-motor symptoms Pain Toronto Western spasmodic torticollis rating scale |
| title | Bilateral globus pallidus internus (GPi) deep brain stimulation for cervical dystonia: Effects on motor and non-motor symptoms within 5 years follow |
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