Deep brain stimulation for dystonia: outcome at long-term follow-up
Objective Deep brain stimulation (DBS) has emerged as a useful therapeutic option for patients with insufficient benefit from conservative treatment. Methods Nine patients with chronic DBS who suffered from cervical dystonia (4), generalized dystonia (2), hemidystonia (1), paroxysmal dystonia (1) an...
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| Veröffentlicht in: | Journal of neurology 2008-06, Vol.255 (6), p.881-884 |
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| container_title | Journal of neurology |
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| creator | Loher, T. J. Capelle, H.-H. Kaelin-Lang, A. Weber, S. Weigel, R. Burgunder, J. M. Krauss, J. K. |
| description | Objective
Deep brain stimulation (DBS) has emerged as a useful therapeutic option for patients with insufficient benefit from conservative treatment.
Methods
Nine patients with chronic DBS who suffered from cervical dystonia (4), generalized dystonia (2), hemidystonia (1), paroxysmal dystonia (1) and Meige syndrome (1) were available for formal follow-up at three years postoperatively, and beyond up to 10 years. All patients had undergone pallidal stimulation except one patient with paroxysmal dystonia who underwent thalamic stimulation.
Results
Maintained improvement was seen in all patients with pallidal stimulation up to 10 years after surgery except in one patient who had a relative loss of benefit in dystonia ratings but continued to have improved disability scores. After nine years of chronic thalamic stimulation there was a mild loss of efficacy which was regained when the target was changed to the pallidum in the patient with paroxysmal dystonia. There were no major complications related to surgery or to chronic stimulation. Pacemakers had to be replaced within 1.5 to 2 years, in general.
Conclusion
DBS maintains marked long-term symptomatic and functional improvement in the majority of patients with dystonia. |
| doi_str_mv | 10.1007/s00415-008-0798-6 |
| format | Article |
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Deep brain stimulation (DBS) has emerged as a useful therapeutic option for patients with insufficient benefit from conservative treatment.
Methods
Nine patients with chronic DBS who suffered from cervical dystonia (4), generalized dystonia (2), hemidystonia (1), paroxysmal dystonia (1) and Meige syndrome (1) were available for formal follow-up at three years postoperatively, and beyond up to 10 years. All patients had undergone pallidal stimulation except one patient with paroxysmal dystonia who underwent thalamic stimulation.
Results
Maintained improvement was seen in all patients with pallidal stimulation up to 10 years after surgery except in one patient who had a relative loss of benefit in dystonia ratings but continued to have improved disability scores. After nine years of chronic thalamic stimulation there was a mild loss of efficacy which was regained when the target was changed to the pallidum in the patient with paroxysmal dystonia. There were no major complications related to surgery or to chronic stimulation. Pacemakers had to be replaced within 1.5 to 2 years, in general.
Conclusion
DBS maintains marked long-term symptomatic and functional improvement in the majority of patients with dystonia.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-008-0798-6</identifier><identifier>PMID: 18338193</identifier><identifier>CODEN: JNRYA9</identifier><language>eng</language><publisher>Darmstadt: Steinkopff-Verlag</publisher><subject>Adult ; Biological and medical sciences ; Brain - physiopathology ; Brain - surgery ; Deep brain stimulation ; Deep Brain Stimulation - methods ; Deep Brain Stimulation - standards ; Deep Brain Stimulation - statistics & numerical data ; Diseases of striated muscles. Neuromuscular diseases ; Dystonia ; Dystonia - physiopathology ; Dystonia - therapy ; Dystonic Disorders - physiopathology ; Dystonic Disorders - therapy ; Female ; Follow-Up Studies ; Globus Pallidus - physiology ; Humans ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Meige Syndrome - physiopathology ; Meige Syndrome - therapy ; Middle Aged ; Neural Pathways - physiology ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Original Communication ; Pacemaker, Artificial ; Patients ; Surgery ; Thalamus - physiology ; Time ; Torticollis - physiopathology ; Torticollis - therapy ; Treatment Outcome</subject><ispartof>Journal of neurology, 2008-06, Vol.255 (6), p.881-884</ispartof><rights>Steinkopff-Verlag 2008</rights><rights>2008 INIST-CNRS</rights><rights>Springer 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539t-b394c9172055ade7b100425a860c1fd18a38b6b32ed603edd3b7845f7c110ce3</citedby><cites>FETCH-LOGICAL-c539t-b394c9172055ade7b100425a860c1fd18a38b6b32ed603edd3b7845f7c110ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-008-0798-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-008-0798-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20492508$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18338193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loher, T. J.</creatorcontrib><creatorcontrib>Capelle, H.-H.</creatorcontrib><creatorcontrib>Kaelin-Lang, A.</creatorcontrib><creatorcontrib>Weber, S.</creatorcontrib><creatorcontrib>Weigel, R.</creatorcontrib><creatorcontrib>Burgunder, J. M.</creatorcontrib><creatorcontrib>Krauss, J. K.</creatorcontrib><title>Deep brain stimulation for dystonia: outcome at long-term follow-up</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Objective
Deep brain stimulation (DBS) has emerged as a useful therapeutic option for patients with insufficient benefit from conservative treatment.
Methods
Nine patients with chronic DBS who suffered from cervical dystonia (4), generalized dystonia (2), hemidystonia (1), paroxysmal dystonia (1) and Meige syndrome (1) were available for formal follow-up at three years postoperatively, and beyond up to 10 years. All patients had undergone pallidal stimulation except one patient with paroxysmal dystonia who underwent thalamic stimulation.
Results
Maintained improvement was seen in all patients with pallidal stimulation up to 10 years after surgery except in one patient who had a relative loss of benefit in dystonia ratings but continued to have improved disability scores. After nine years of chronic thalamic stimulation there was a mild loss of efficacy which was regained when the target was changed to the pallidum in the patient with paroxysmal dystonia. There were no major complications related to surgery or to chronic stimulation. Pacemakers had to be replaced within 1.5 to 2 years, in general.
Conclusion
DBS maintains marked long-term symptomatic and functional improvement in the majority of patients with dystonia.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain - physiopathology</subject><subject>Brain - surgery</subject><subject>Deep brain stimulation</subject><subject>Deep Brain Stimulation - methods</subject><subject>Deep Brain Stimulation - standards</subject><subject>Deep Brain Stimulation - statistics & numerical data</subject><subject>Diseases of striated muscles. Neuromuscular diseases</subject><subject>Dystonia</subject><subject>Dystonia - physiopathology</subject><subject>Dystonia - therapy</subject><subject>Dystonic Disorders - physiopathology</subject><subject>Dystonic Disorders - therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Globus Pallidus - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meige Syndrome - physiopathology</subject><subject>Meige Syndrome - therapy</subject><subject>Middle Aged</subject><subject>Neural Pathways - physiology</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Communication</subject><subject>Pacemaker, Artificial</subject><subject>Patients</subject><subject>Surgery</subject><subject>Thalamus - physiology</subject><subject>Time</subject><subject>Torticollis - physiopathology</subject><subject>Torticollis - therapy</subject><subject>Treatment Outcome</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqF0UtLxDAQAOAgirs-foAXKYLeopNXm3iT9QkLXvYe0jRdurTNmrSI_94su7ggiKcc5puZzAxCFwRuCUBxFwE4ERhAYiiUxPkBmhLOKCZcqEM0BcYBCyb4BJ3EuIIEU-AYTYhkTBLFpmj26Nw6K4Np-iwOTTe2Zmh8n9U-ZNVXHHzfmPvMj4P1ncvMkLW-X-LBhS6RtvWfeFyfoaPatNGd795TtHh-Wsxe8fz95W32MMdWMDXgkiluFSkoCGEqV5RpBk6FkTlYUldEGibLvGTUVTkwV1WsLNJ_68ISAtaxU3SzLbsO_mN0cdBdE61rW9M7P0adK86VyNW_kIKUnAMkePULrvwY-jSDpkQSUbBCJkS2yAYfY3C1XoemM-FLE9CbM-jtGXTart6cQecp53JXeCw7V-0zdntP4HoHTLSmrYPpbRN_HAWuqIBNc7p1MYX6pQv7H_7d_RsnWJ3P</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>Loher, T. J.</creator><creator>Capelle, H.-H.</creator><creator>Kaelin-Lang, A.</creator><creator>Weber, S.</creator><creator>Weigel, R.</creator><creator>Burgunder, J. M.</creator><creator>Krauss, J. K.</creator><general>Steinkopff-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080601</creationdate><title>Deep brain stimulation for dystonia: outcome at long-term follow-up</title><author>Loher, T. J. ; Capelle, H.-H. ; Kaelin-Lang, A. ; Weber, S. ; Weigel, R. ; Burgunder, J. M. ; Krauss, J. K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c539t-b394c9172055ade7b100425a860c1fd18a38b6b32ed603edd3b7845f7c110ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Brain - physiopathology</topic><topic>Brain - surgery</topic><topic>Deep brain stimulation</topic><topic>Deep Brain Stimulation - methods</topic><topic>Deep Brain Stimulation - standards</topic><topic>Deep Brain Stimulation - statistics & numerical data</topic><topic>Diseases of striated muscles. Neuromuscular diseases</topic><topic>Dystonia</topic><topic>Dystonia - physiopathology</topic><topic>Dystonia - therapy</topic><topic>Dystonic Disorders - physiopathology</topic><topic>Dystonic Disorders - therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Globus Pallidus - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meige Syndrome - physiopathology</topic><topic>Meige Syndrome - therapy</topic><topic>Middle Aged</topic><topic>Neural Pathways - physiology</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Communication</topic><topic>Pacemaker, Artificial</topic><topic>Patients</topic><topic>Surgery</topic><topic>Thalamus - physiology</topic><topic>Time</topic><topic>Torticollis - physiopathology</topic><topic>Torticollis - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loher, T. J.</creatorcontrib><creatorcontrib>Capelle, H.-H.</creatorcontrib><creatorcontrib>Kaelin-Lang, A.</creatorcontrib><creatorcontrib>Weber, S.</creatorcontrib><creatorcontrib>Weigel, R.</creatorcontrib><creatorcontrib>Burgunder, J. M.</creatorcontrib><creatorcontrib>Krauss, J. K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loher, T. J.</au><au>Capelle, H.-H.</au><au>Kaelin-Lang, A.</au><au>Weber, S.</au><au>Weigel, R.</au><au>Burgunder, J. M.</au><au>Krauss, J. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deep brain stimulation for dystonia: outcome at long-term follow-up</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>255</volume><issue>6</issue><spage>881</spage><epage>884</epage><pages>881-884</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><coden>JNRYA9</coden><abstract>Objective
Deep brain stimulation (DBS) has emerged as a useful therapeutic option for patients with insufficient benefit from conservative treatment.
Methods
Nine patients with chronic DBS who suffered from cervical dystonia (4), generalized dystonia (2), hemidystonia (1), paroxysmal dystonia (1) and Meige syndrome (1) were available for formal follow-up at three years postoperatively, and beyond up to 10 years. All patients had undergone pallidal stimulation except one patient with paroxysmal dystonia who underwent thalamic stimulation.
Results
Maintained improvement was seen in all patients with pallidal stimulation up to 10 years after surgery except in one patient who had a relative loss of benefit in dystonia ratings but continued to have improved disability scores. After nine years of chronic thalamic stimulation there was a mild loss of efficacy which was regained when the target was changed to the pallidum in the patient with paroxysmal dystonia. There were no major complications related to surgery or to chronic stimulation. Pacemakers had to be replaced within 1.5 to 2 years, in general.
Conclusion
DBS maintains marked long-term symptomatic and functional improvement in the majority of patients with dystonia.</abstract><cop>Darmstadt</cop><pub>Steinkopff-Verlag</pub><pmid>18338193</pmid><doi>10.1007/s00415-008-0798-6</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0340-5354 1432-1459 |
| language | eng |
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| source | MEDLINE; Springer Online Journals Complete |
| subjects | Adult Biological and medical sciences Brain - physiopathology Brain - surgery Deep brain stimulation Deep Brain Stimulation - methods Deep Brain Stimulation - standards Deep Brain Stimulation - statistics & numerical data Diseases of striated muscles. Neuromuscular diseases Dystonia Dystonia - physiopathology Dystonia - therapy Dystonic Disorders - physiopathology Dystonic Disorders - therapy Female Follow-Up Studies Globus Pallidus - physiology Humans Male Medical sciences Medicine Medicine & Public Health Meige Syndrome - physiopathology Meige Syndrome - therapy Middle Aged Neural Pathways - physiology Neurology Neuroradiology Neurosciences Neurosurgery Original Communication Pacemaker, Artificial Patients Surgery Thalamus - physiology Time Torticollis - physiopathology Torticollis - therapy Treatment Outcome |
| title | Deep brain stimulation for dystonia: outcome at long-term follow-up |
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