Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single‐Blind Cohort Study
Background The role of deep brain stimulation in the treatment of dystonia has been widely documented. However, there is limited literature on the outcome of lesioning surgery in unilateral dystonia. Objective We restrospectively reviewed our cases of focal and hemidystonia undergoing unilateral Pal...
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| Veröffentlicht in: | Movement disorders clinical practice (Hoboken, N.J.) N.J.), 2024-01, Vol.11 (1), p.30-37 |
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| container_title | Movement disorders clinical practice (Hoboken, N.J.) |
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| creator | Doshi, Paresh K. Baldia, Manish Mulroy, Eoin Krauss, Joachim K. Bhatia, Kailash |
| description | Background
The role of deep brain stimulation in the treatment of dystonia has been widely documented. However, there is limited literature on the outcome of lesioning surgery in unilateral dystonia.
Objective
We restrospectively reviewed our cases of focal and hemidystonia undergoing unilateral Pallidotomy at our institute to evaluate the short‐term and long‐term outcome.
Methods
Patients who underwent radiofrequency lesioning of GPi for unilateral dystonia between 1999 and 2019 were retrospectively reviewed. All patients were evaluated using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) and Dystonia Disability Scale (DDS) preoperatively at the short term follow‐up ( |
| doi_str_mv | 10.1002/mdc3.13912 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10828613</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2920572193</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3722-face462d9ba75bc4eda96004941cc6648311c82f6cd2d76b72789f301ab34c313</originalsourceid><addsrcrecordid>eNp90cFqFTEUBuAgii21Gx9AAm5EuDXnZG5m4kbqaK1QqVC7Dpkk06ZkknYyo8zOR_AZfRJzvbVUF64Sko-fc_gJeQrsABjDV4M1_AC4BHxAdpFztgIB8uG9-w7Zz_mKMQa4FgzhMdnhDUpoqnqX6NN5Mmlwmaaenkcf9ORGHehnHYK3aUrDQn2kR8mURx0tPXaDt0ueUvSatjq7_Joe0jMfL4L7-f3H2-ALatNlGid6Ns12eUIe9Tpkt3977pHzo_df2uPVyemHj-3hycrwGnHVa-MqgVZ2ul53pnJWS8FYJSswRoiq4QCmwV4Yi7YWXY11I3vOQHe8Mhz4Hnmzzb2eu8FZ4-JUFlHXox_0uKikvfr7J_pLdZG-KmANNgJ4SXhxmzCmm9nlSQ0-GxeCji7NWaFEtq4R5IY-_4depXmMZb-iQErJEFlRL7fKjCnn0fV30wBTm_bUpj31u72Cn92f_47-6aoA2IJvPrjlP1Hq07uWb0N_AZKspJQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919990220</pqid></control><display><type>article</type><title>Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single‐Blind Cohort Study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Doshi, Paresh K. ; Baldia, Manish ; Mulroy, Eoin ; Krauss, Joachim K. ; Bhatia, Kailash</creator><creatorcontrib>Doshi, Paresh K. ; Baldia, Manish ; Mulroy, Eoin ; Krauss, Joachim K. ; Bhatia, Kailash</creatorcontrib><description>Background
The role of deep brain stimulation in the treatment of dystonia has been widely documented. However, there is limited literature on the outcome of lesioning surgery in unilateral dystonia.
Objective
We restrospectively reviewed our cases of focal and hemidystonia undergoing unilateral Pallidotomy at our institute to evaluate the short‐term and long‐term outcome.
Methods
Patients who underwent radiofrequency lesioning of GPi for unilateral dystonia between 1999 and 2019 were retrospectively reviewed. All patients were evaluated using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) and Dystonia Disability Scale (DDS) preoperatively at the short term follow‐up (<1 year) and at long‐term follow‐up (2–7.5 years). Video recordings performed at these time points were independently reviewed by a blinded movement disorders specialist.
Results
Eleven patients were included for analysis. The preoperative, short‐term, and long‐term follow‐up motor BFMDRS and DDS scores were 15.5 (IQR [interquartile range]: 10.5, 23.75) and 10.5 (IQR: 6.0, 14.5); 3.0 (IQR: 1.0, 6.0, P = 0.02) and 3.0 (IQR: 3.0, 8.0, P = 0.016); and 14.25 (IQR: 4.0, 20.0, P = 0.20) and 10.5 (IQR: 2.0, 15.0, P = 0.71) respectively. For observers B, the BFMDRS scores at the same time points were 19 (IQR: 12.5, 27.0), 7.5 (IQR: 6.0, 15.0, P = 0.002), and 21 (IQR: 7.0, 22.0, P = 0.65) respectively. The improvement was statistically significant for all observations at short‐term follow‐up but not at long‐term follow‐up.
Conclusion
Pallidotomy is effective for hemidystonia or focal dystonia in the short term. Continued benefit was seen in the longer term in some patients, whereas others worsened. Larger studies may be able to explain this in future.</description><identifier>ISSN: 2330-1619</identifier><identifier>EISSN: 2330-1619</identifier><identifier>DOI: 10.1002/mdc3.13912</identifier><identifier>PMID: 38291847</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Cohort Studies ; Deep Brain Stimulation - adverse effects ; Dystonia ; Dystonia - surgery ; Dystonic Disorders - surgery ; Globus Pallidus - surgery ; hemidystonia ; Humans ; lesioning ; Pallidotomy ; Retrospective Studies ; Single-Blind Method ; Treatment Outcome</subject><ispartof>Movement disorders clinical practice (Hoboken, N.J.), 2024-01, Vol.11 (1), p.30-37</ispartof><rights>2023 International Parkinson and Movement Disorder Society.</rights><rights>2024 International Parkinson and Movement Disorder Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3722-face462d9ba75bc4eda96004941cc6648311c82f6cd2d76b72789f301ab34c313</cites><orcidid>0000-0002-6333-1494 ; 0000-0002-0675-9064 ; 0000-0001-8470-0589 ; 0000-0003-3057-0592 ; 0000-0001-8185-286X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828613/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828613/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,45550,45551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38291847$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doshi, Paresh K.</creatorcontrib><creatorcontrib>Baldia, Manish</creatorcontrib><creatorcontrib>Mulroy, Eoin</creatorcontrib><creatorcontrib>Krauss, Joachim K.</creatorcontrib><creatorcontrib>Bhatia, Kailash</creatorcontrib><title>Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single‐Blind Cohort Study</title><title>Movement disorders clinical practice (Hoboken, N.J.)</title><addtitle>Mov Disord Clin Pract</addtitle><description>Background
The role of deep brain stimulation in the treatment of dystonia has been widely documented. However, there is limited literature on the outcome of lesioning surgery in unilateral dystonia.
Objective
We restrospectively reviewed our cases of focal and hemidystonia undergoing unilateral Pallidotomy at our institute to evaluate the short‐term and long‐term outcome.
Methods
Patients who underwent radiofrequency lesioning of GPi for unilateral dystonia between 1999 and 2019 were retrospectively reviewed. All patients were evaluated using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) and Dystonia Disability Scale (DDS) preoperatively at the short term follow‐up (<1 year) and at long‐term follow‐up (2–7.5 years). Video recordings performed at these time points were independently reviewed by a blinded movement disorders specialist.
Results
Eleven patients were included for analysis. The preoperative, short‐term, and long‐term follow‐up motor BFMDRS and DDS scores were 15.5 (IQR [interquartile range]: 10.5, 23.75) and 10.5 (IQR: 6.0, 14.5); 3.0 (IQR: 1.0, 6.0, P = 0.02) and 3.0 (IQR: 3.0, 8.0, P = 0.016); and 14.25 (IQR: 4.0, 20.0, P = 0.20) and 10.5 (IQR: 2.0, 15.0, P = 0.71) respectively. For observers B, the BFMDRS scores at the same time points were 19 (IQR: 12.5, 27.0), 7.5 (IQR: 6.0, 15.0, P = 0.002), and 21 (IQR: 7.0, 22.0, P = 0.65) respectively. The improvement was statistically significant for all observations at short‐term follow‐up but not at long‐term follow‐up.
Conclusion
Pallidotomy is effective for hemidystonia or focal dystonia in the short term. Continued benefit was seen in the longer term in some patients, whereas others worsened. Larger studies may be able to explain this in future.</description><subject>Cohort Studies</subject><subject>Deep Brain Stimulation - adverse effects</subject><subject>Dystonia</subject><subject>Dystonia - surgery</subject><subject>Dystonic Disorders - surgery</subject><subject>Globus Pallidus - surgery</subject><subject>hemidystonia</subject><subject>Humans</subject><subject>lesioning</subject><subject>Pallidotomy</subject><subject>Retrospective Studies</subject><subject>Single-Blind Method</subject><subject>Treatment Outcome</subject><issn>2330-1619</issn><issn>2330-1619</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90cFqFTEUBuAgii21Gx9AAm5EuDXnZG5m4kbqaK1QqVC7Dpkk06ZkknYyo8zOR_AZfRJzvbVUF64Sko-fc_gJeQrsABjDV4M1_AC4BHxAdpFztgIB8uG9-w7Zz_mKMQa4FgzhMdnhDUpoqnqX6NN5Mmlwmaaenkcf9ORGHehnHYK3aUrDQn2kR8mURx0tPXaDt0ueUvSatjq7_Joe0jMfL4L7-f3H2-ALatNlGid6Ns12eUIe9Tpkt3977pHzo_df2uPVyemHj-3hycrwGnHVa-MqgVZ2ul53pnJWS8FYJSswRoiq4QCmwV4Yi7YWXY11I3vOQHe8Mhz4Hnmzzb2eu8FZ4-JUFlHXox_0uKikvfr7J_pLdZG-KmANNgJ4SXhxmzCmm9nlSQ0-GxeCji7NWaFEtq4R5IY-_4depXmMZb-iQErJEFlRL7fKjCnn0fV30wBTm_bUpj31u72Cn92f_47-6aoA2IJvPrjlP1Hq07uWb0N_AZKspJQ</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Doshi, Paresh K.</creator><creator>Baldia, Manish</creator><creator>Mulroy, Eoin</creator><creator>Krauss, Joachim K.</creator><creator>Bhatia, Kailash</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><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>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6333-1494</orcidid><orcidid>https://orcid.org/0000-0002-0675-9064</orcidid><orcidid>https://orcid.org/0000-0001-8470-0589</orcidid><orcidid>https://orcid.org/0000-0003-3057-0592</orcidid><orcidid>https://orcid.org/0000-0001-8185-286X</orcidid></search><sort><creationdate>202401</creationdate><title>Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single‐Blind Cohort Study</title><author>Doshi, Paresh K. ; Baldia, Manish ; Mulroy, Eoin ; Krauss, Joachim K. ; Bhatia, Kailash</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3722-face462d9ba75bc4eda96004941cc6648311c82f6cd2d76b72789f301ab34c313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cohort Studies</topic><topic>Deep Brain Stimulation - adverse effects</topic><topic>Dystonia</topic><topic>Dystonia - surgery</topic><topic>Dystonic Disorders - surgery</topic><topic>Globus Pallidus - surgery</topic><topic>hemidystonia</topic><topic>Humans</topic><topic>lesioning</topic><topic>Pallidotomy</topic><topic>Retrospective Studies</topic><topic>Single-Blind Method</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doshi, Paresh K.</creatorcontrib><creatorcontrib>Baldia, Manish</creatorcontrib><creatorcontrib>Mulroy, Eoin</creatorcontrib><creatorcontrib>Krauss, Joachim K.</creatorcontrib><creatorcontrib>Bhatia, Kailash</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Movement disorders clinical practice (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doshi, Paresh K.</au><au>Baldia, Manish</au><au>Mulroy, Eoin</au><au>Krauss, Joachim K.</au><au>Bhatia, Kailash</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single‐Blind Cohort Study</atitle><jtitle>Movement disorders clinical practice (Hoboken, N.J.)</jtitle><addtitle>Mov Disord Clin Pract</addtitle><date>2024-01</date><risdate>2024</risdate><volume>11</volume><issue>1</issue><spage>30</spage><epage>37</epage><pages>30-37</pages><issn>2330-1619</issn><eissn>2330-1619</eissn><abstract>Background
The role of deep brain stimulation in the treatment of dystonia has been widely documented. However, there is limited literature on the outcome of lesioning surgery in unilateral dystonia.
Objective
We restrospectively reviewed our cases of focal and hemidystonia undergoing unilateral Pallidotomy at our institute to evaluate the short‐term and long‐term outcome.
Methods
Patients who underwent radiofrequency lesioning of GPi for unilateral dystonia between 1999 and 2019 were retrospectively reviewed. All patients were evaluated using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) and Dystonia Disability Scale (DDS) preoperatively at the short term follow‐up (<1 year) and at long‐term follow‐up (2–7.5 years). Video recordings performed at these time points were independently reviewed by a blinded movement disorders specialist.
Results
Eleven patients were included for analysis. The preoperative, short‐term, and long‐term follow‐up motor BFMDRS and DDS scores were 15.5 (IQR [interquartile range]: 10.5, 23.75) and 10.5 (IQR: 6.0, 14.5); 3.0 (IQR: 1.0, 6.0, P = 0.02) and 3.0 (IQR: 3.0, 8.0, P = 0.016); and 14.25 (IQR: 4.0, 20.0, P = 0.20) and 10.5 (IQR: 2.0, 15.0, P = 0.71) respectively. For observers B, the BFMDRS scores at the same time points were 19 (IQR: 12.5, 27.0), 7.5 (IQR: 6.0, 15.0, P = 0.002), and 21 (IQR: 7.0, 22.0, P = 0.65) respectively. The improvement was statistically significant for all observations at short‐term follow‐up but not at long‐term follow‐up.
Conclusion
Pallidotomy is effective for hemidystonia or focal dystonia in the short term. Continued benefit was seen in the longer term in some patients, whereas others worsened. Larger studies may be able to explain this in future.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>38291847</pmid><doi>10.1002/mdc3.13912</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6333-1494</orcidid><orcidid>https://orcid.org/0000-0002-0675-9064</orcidid><orcidid>https://orcid.org/0000-0001-8470-0589</orcidid><orcidid>https://orcid.org/0000-0003-3057-0592</orcidid><orcidid>https://orcid.org/0000-0001-8185-286X</orcidid></addata></record> |
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| ispartof | Movement disorders clinical practice (Hoboken, N.J.), 2024-01, Vol.11 (1), p.30-37 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Cohort Studies Deep Brain Stimulation - adverse effects Dystonia Dystonia - surgery Dystonic Disorders - surgery Globus Pallidus - surgery hemidystonia Humans lesioning Pallidotomy Retrospective Studies Single-Blind Method Treatment Outcome |
| title | Outcomes of Unilateral Pallidotomy in Focal and Hemidystonia Cases: A Single‐Blind Cohort Study |
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