Effects of deep brain stimulation in dyskinetic cerebral palsy: a meta-analysis.
Identifieur interne : 000A09 ( Main/Exploration ); précédent : 000A08; suivant : 000A10Effects of deep brain stimulation in dyskinetic cerebral palsy: a meta-analysis.
Auteurs : Anne Koy [Allemagne] ; Martin Hellmich ; K Amande M. Pauls ; Warren Marks ; Jean-Pierre Lin ; Oliver Fricke ; Lars TimmermannSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2013.
English descriptors
- KwdEn :
- MESH :
- methods : Deep Brain Stimulation.
- psychology : Cerebral Palsy.
- statistics & numerical data : Databases, Factual.
- therapy : Cerebral Palsy.
- Humans, Outcome Assessment (Health Care), Predictive Value of Tests, Quality of Life.
Abstract
Secondary dystonia encompasses a heterogeneous group with different etiologies. Cerebral palsy is the most common cause. Pharmacological treatment is often unsatisfactory. There are only limited data on the therapeutic outcomes of deep brain stimulation in dyskinetic cerebral palsy. The published literature regarding deep brain stimulation and secondary dystonia was reviewed in a meta-analysis to reevaluate the effect on cerebral palsy. The Burke-Fahn-Marsden Dystonia Rating Scale movement score was chosen as the primary outcome measure. Outcome over time was evaluated and summarized by mixed-model repeated-measures analysis, paired Student t test, and Pearson's correlation coefficient. Twenty articles comprising 68 patients with cerebral palsy undergoing deep brain stimulation assessed by the Burke-Fahn-Marsden Dystonia Rating Scale were identified. Most articles were case reports reflecting great variability in the score and duration of follow-up. The mean Burke-Fahn-Marsden Dystonia Rating Scale movement score was 64.94 ± 25.40 preoperatively and dropped to 50.5 ± 26.77 postoperatively, with a mean improvement of 23.6% (P < .001) at a median follow-up of 12 months. The mean Burke-Fahn-Marsden Dystonia Rating Scale disability score was 18.54 ± 6.15 preoperatively and 16.83 ± 6.42 postoperatively, with a mean improvement of 9.2% (P < .001). There was a significant negative correlation between severity of dystonia and clinical outcome (P < .05). Deep brain stimulation can be an effective treatment option for dyskinetic cerebral palsy. In view of the heterogeneous data, a prospective study with a large cohort of patients in a standardized setting with a multidisciplinary approach would be helpful in further evaluating the role of deep brain stimulation in cerebral palsy. © 2013 Movement Disorder Society.
DOI: 10.1002/mds.25339
PubMed: 23408442
Affiliations:
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Pauls</name></author><author><name sortKey="Marks, Warren" sort="Marks, Warren" uniqKey="Marks W" first="Warren" last="Marks">Warren Marks</name></author><author><name sortKey="Lin, Jean Pierre" sort="Lin, Jean Pierre" uniqKey="Lin J" first="Jean-Pierre" last="Lin">Jean-Pierre Lin</name></author><author><name sortKey="Fricke, Oliver" sort="Fricke, Oliver" uniqKey="Fricke O" first="Oliver" last="Fricke">Oliver Fricke</name></author><author><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="doi">10.1002/mds.25339</idno><idno type="RBID">pubmed:23408442</idno><idno type="pmid">23408442</idno><idno type="wicri:Area/PubMed/Corpus">000A44</idno><idno type="wicri:Area/PubMed/Curation">000A44</idno><idno type="wicri:Area/PubMed/Checkpoint">000A17</idno><idno type="wicri:Area/Ncbi/Merge">003A37</idno><idno type="wicri:Area/Ncbi/Curation">003A37</idno><idno type="wicri:Area/Ncbi/Checkpoint">003A37</idno><idno type="wicri:Area/Main/Merge">000A09</idno><idno type="wicri:Area/Main/Curation">000A09</idno><idno type="wicri:Area/Main/Exploration">000A09</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Effects of deep brain stimulation in dyskinetic cerebral palsy: a meta-analysis.</title><author><name sortKey="Koy, Anne" sort="Koy, Anne" uniqKey="Koy A" first="Anne" last="Koy">Anne Koy</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University Hospital Cologne, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University Hospital Cologne</wicri:regionArea><wicri:noRegion>University Hospital Cologne</wicri:noRegion><wicri:noRegion>University Hospital Cologne</wicri:noRegion><wicri:noRegion>University Hospital Cologne</wicri:noRegion></affiliation></author><author><name sortKey="Hellmich, Martin" sort="Hellmich, Martin" uniqKey="Hellmich M" first="Martin" last="Hellmich">Martin Hellmich</name></author><author><name sortKey="Pauls, K Amande M" sort="Pauls, K Amande M" uniqKey="Pauls K" first="K Amande M" last="Pauls">K Amande M. Pauls</name></author><author><name sortKey="Marks, Warren" sort="Marks, Warren" uniqKey="Marks W" first="Warren" last="Marks">Warren Marks</name></author><author><name sortKey="Lin, Jean Pierre" sort="Lin, Jean Pierre" uniqKey="Lin J" first="Jean-Pierre" last="Lin">Jean-Pierre Lin</name></author><author><name sortKey="Fricke, Oliver" sort="Fricke, Oliver" uniqKey="Fricke O" first="Oliver" last="Fricke">Oliver Fricke</name></author><author><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cerebral Palsy (psychology)</term><term>Cerebral Palsy (therapy)</term><term>Databases, Factual (statistics & numerical data)</term><term>Deep Brain Stimulation (methods)</term><term>Humans</term><term>Outcome Assessment (Health Care)</term><term>Predictive Value of Tests</term><term>Quality of Life</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Cerebral Palsy</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Databases, Factual</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Cerebral Palsy</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Outcome Assessment (Health Care)</term><term>Predictive Value of Tests</term><term>Quality of Life</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Secondary dystonia encompasses a heterogeneous group with different etiologies. Cerebral palsy is the most common cause. Pharmacological treatment is often unsatisfactory. There are only limited data on the therapeutic outcomes of deep brain stimulation in dyskinetic cerebral palsy. The published literature regarding deep brain stimulation and secondary dystonia was reviewed in a meta-analysis to reevaluate the effect on cerebral palsy. The Burke-Fahn-Marsden Dystonia Rating Scale movement score was chosen as the primary outcome measure. Outcome over time was evaluated and summarized by mixed-model repeated-measures analysis, paired Student t test, and Pearson's correlation coefficient. Twenty articles comprising 68 patients with cerebral palsy undergoing deep brain stimulation assessed by the Burke-Fahn-Marsden Dystonia Rating Scale were identified. Most articles were case reports reflecting great variability in the score and duration of follow-up. The mean Burke-Fahn-Marsden Dystonia Rating Scale movement score was 64.94 ± 25.40 preoperatively and dropped to 50.5 ± 26.77 postoperatively, with a mean improvement of 23.6% (P < .001) at a median follow-up of 12 months. The mean Burke-Fahn-Marsden Dystonia Rating Scale disability score was 18.54 ± 6.15 preoperatively and 16.83 ± 6.42 postoperatively, with a mean improvement of 9.2% (P < .001). There was a significant negative correlation between severity of dystonia and clinical outcome (P < .05). Deep brain stimulation can be an effective treatment option for dyskinetic cerebral palsy. In view of the heterogeneous data, a prospective study with a large cohort of patients in a standardized setting with a multidisciplinary approach would be helpful in further evaluating the role of deep brain stimulation in cerebral palsy. © 2013 Movement Disorder Society.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country></list><tree><noCountry><name sortKey="Fricke, Oliver" sort="Fricke, Oliver" uniqKey="Fricke O" first="Oliver" last="Fricke">Oliver Fricke</name><name sortKey="Hellmich, Martin" sort="Hellmich, Martin" uniqKey="Hellmich M" first="Martin" last="Hellmich">Martin Hellmich</name><name sortKey="Lin, Jean Pierre" sort="Lin, Jean Pierre" uniqKey="Lin J" first="Jean-Pierre" last="Lin">Jean-Pierre Lin</name><name sortKey="Marks, Warren" sort="Marks, Warren" uniqKey="Marks W" first="Warren" last="Marks">Warren Marks</name><name sortKey="Pauls, K Amande M" sort="Pauls, K Amande M" uniqKey="Pauls K" first="K Amande M" last="Pauls">K Amande M. Pauls</name><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Koy, Anne" sort="Koy, Anne" uniqKey="Koy A" first="Anne" last="Koy">Anne Koy</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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