Movement Disorders (revue)

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Inclusion and exclusion criteria for DBS in dystonia

Identifieur interne : 001674 ( Main/Merge ); précédent : 001673; suivant : 001675

Inclusion and exclusion criteria for DBS in dystonia

Auteurs : Helen Bronte-Stewart [États-Unis] ; Takaomi Taira [Japon] ; Francesc Valldeoriola [Espagne] ; Marcello Merello [Argentine] ; William J. Marks Jr. [États-Unis] ; Alberto Albanese [Italie] ; Susan Bressman [États-Unis] ; And Elena Moro [Canada]

Source :

RBID : ISTEX:BD0C3E1D8440ABD409FF2D6318DE27DC3F2FFF9B

English descriptors

Abstract

When considering a patient with dystonia for deep brain stimulation (DBS) surgery several factors need to be considered. Level B evidence has shown that all motor features and associated pain in primary generalized and segmental dystonia are potentially responsive to globus pallidus internus (GPi) DBS. However, improvements in clinical series of ≥90% may reflect methods that need improvement, and larger prospective studies are needed to address these factors. Nevertheless, to date the selection criteria for DBS—specifically in terms of patient features (severity and nature of symptoms, age, time of evolution, or any other demographic or disease aspects)—have not been assessed in a systematic fashion. In general, dystonia patients are not considered for DBS unless medical therapies have been previously and extensively tested. The vast majority of reported patients have had DBS surgery when the disease was provoking important disability, with loss of independence and impaired quality of life. There does not appear to be an upper age limit or a minimum age limit, although there are no published data regarding the outcome of GPi DBS for dystonia in children younger than 7 years of age. There is currently no enough evidence to prove that subjects with primary‐generalized dystonia who undergo DBS at an early age and sooner rather than later after disease onset may gain more benefit from DBS than those undergoing DBS after the development of fixed skeletal deformities. There is no enough evidence to refuse or support consideration of DBS in patients with previous ablative procedures. © 2011 Movement Disorder Society

Url:
DOI: 10.1002/mds.23482

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ISTEX:BD0C3E1D8440ABD409FF2D6318DE27DC3F2FFF9B

Le document en format XML

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</author>
<author>
<name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name>
</author>
<author>
<name sortKey="Bressman, Susan" sort="Bressman, Susan" uniqKey="Bressman S" first="Susan" last="Bressman">Susan Bressman</name>
</author>
<author>
<name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
</author>
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<idno type="wicri:source">PubMed</idno>
<date when="2011">2011</date>
<idno type="doi">10.1002/mds.23482</idno>
<idno type="RBID">pubmed:21692112</idno>
<idno type="pmid">21692112</idno>
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<idno type="wicri:Area/Ncbi/Checkpoint">003317</idno>
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<biblStruct>
<analytic>
<title xml:lang="en">Inclusion and exclusion criteria for DBS in dystonia.</title>
<author>
<name sortKey="Bronte Stewart, Helen" sort="Bronte Stewart, Helen" uniqKey="Bronte Stewart H" first="Helen" last="Bronte-Stewart">Helen Bronte-Stewart</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Neurology and Neurological Sciences, Stanford University, Stanford, California 94305, USA. hbs@stanford.edu</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology and Neurological Sciences, Stanford University, Stanford, California 94305</wicri:regionArea>
<wicri:noRegion>California 94305</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Taira, Takaomi" sort="Taira, Takaomi" uniqKey="Taira T" first="Takaomi" last="Taira">Takaomi Taira</name>
</author>
<author>
<name sortKey="Valldeoriola, Francesc" sort="Valldeoriola, Francesc" uniqKey="Valldeoriola F" first="Francesc" last="Valldeoriola">Francesc Valldeoriola</name>
</author>
<author>
<name sortKey="Merello, Marcello" sort="Merello, Marcello" uniqKey="Merello M" first="Marcello" last="Merello">Marcello Merello</name>
</author>
<author>
<name sortKey="Marks, William J" sort="Marks, William J" uniqKey="Marks W" first="William J" last="Marks">William J. Marks</name>
</author>
<author>
<name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name>
</author>
<author>
<name sortKey="Bressman, Susan" sort="Bressman, Susan" uniqKey="Bressman S" first="Susan" last="Bressman">Susan Bressman</name>
</author>
<author>
<name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</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="2011" type="published">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Age Factors</term>
<term>Brain (pathology)</term>
<term>Brain (physiology)</term>
<term>Databases, Factual (statistics & numerical data)</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Deep Brain Stimulation (standards)</term>
<term>Dementia</term>
<term>Dystonia (diagnosis)</term>
<term>Dystonia (epidemiology)</term>
<term>Dystonia (therapy)</term>
<term>Guidelines as Topic</term>
<term>Humans</term>
<term>Mental Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Dystonia</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Dystonia</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Deep Brain Stimulation</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en">
<term>Brain</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en">
<term>Brain</term>
</keywords>
<keywords scheme="MESH" qualifier="standards" xml:lang="en">
<term>Deep Brain Stimulation</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>Dystonia</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Age Factors</term>
<term>Dementia</term>
<term>Guidelines as Topic</term>
<term>Humans</term>
<term>Mental Disorders</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">When considering a patient with dystonia for deep brain stimulation (DBS) surgery several factors need to be considered. Level B evidence has shown that all motor features and associated pain in primary generalized and segmental dystonia are potentially responsive to globus pallidus internus (GPi) DBS. However, improvements in clinical series of ≥ 90% may reflect methods that need improvement, and larger prospective studies are needed to address these factors. Nevertheless, to date the selection criteria for DBS-specifically in terms of patient features (severity and nature of symptoms, age, time of evolution, or any other demographic or disease aspects)--have not been assessed in a systematic fashion. In general, dystonia patients are not considered for DBS unless medical therapies have been previously and extensively tested. The vast majority of reported patients have had DBS surgery when the disease was provoking important disability, with loss of independence and impaired quality of life. There does not appear to be an upper age limit or a minimum age limit, although there are no published data regarding the outcome of GPi DBS for dystonia in children younger than 7 years of age. There is currently no enough evidence to prove that subjects with primary--generalized dystonia who undergo DBS at an early age and sooner rather than later after disease onset may gain more benefit from DBS than those undergoing DBS after the development of fixed skeletal deformities. There is no enough evidence to refuse or support consideration of DBS in patients with previous ablative procedures.</div>
</front>
</TEI>
</PubMed>
</double>
</record>

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