Pallidal deep brain stimulation in patients with cranial-cervical dystonia (Meige syndrome).
Identifieur interne : 002597 ( PubMed/Curation ); précédent : 002596; suivant : 002598Pallidal deep brain stimulation in patients with cranial-cervical dystonia (Meige syndrome).
Auteurs : Jill L. Ostrem [États-Unis] ; William J. Marks ; Monica M. Volz ; Susan L. Heath ; Philip A. StarrSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- Adult, Aged, Deep Brain Stimulation (adverse effects), Deep Brain Stimulation (instrumentation), Electrodes, Implanted, Female, Follow-Up Studies, Globus Pallidus (physiopathology), Humans, Male, Meige Syndrome (physiopathology), Meige Syndrome (therapy), Microcomputers, Middle Aged, Neurologic Examination, Pilot Projects, Pyramidal Tracts (physiopathology), Torticollis (physiopathology), Torticollis (therapy), Treatment Outcome.
- MESH :
- adverse effects : Deep Brain Stimulation.
- instrumentation : Deep Brain Stimulation.
- physiopathology : Globus Pallidus, Meige Syndrome, Pyramidal Tracts, Torticollis.
- therapy : Meige Syndrome, Torticollis.
- Adult, Aged, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Microcomputers, Middle Aged, Neurologic Examination, Pilot Projects, Treatment Outcome.
Abstract
Idiopathic cranial-cervical dystonia (ICCD) is an adult-onset dystonia syndrome affecting orbicularis oculi, facial, oromandibular, and cervical musculature. ICCD is frequently difficult to treat medically. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a highly effective treatment for idiopathic generalized dystonia, however less is known about the effect of GPi DBS on ICCD. In this article, we present the results from a pilot study assessing the effect of GPi DBS in a series of patients with ICCD. Six patients underwent bilateral stereotactic implantation of DBS leads into the sensorimotor GPi. Patients were evaluated with the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) and Toronto western spamodic torticollis rating scale (TWSTRS) before surgery and 6 months postoperatively. At 6 months, patients showed a 72% mean improvement in the BFMDRS total movement score (P < 0.028, Wilcoxin signed rank test). The mean BFMDRS disability score showed a trend toward improvement (P < 0.06). The total TWSTRS score improved 54% (P < 0.043). Despite improvement in dystonia, mild worsening of motor function was reported in previously nondystonic body regions with stimulation in 4 patients. Although GPi DBS was effective in these patients, the influence of GPi DBS on nondystonic body regions deserves further investigation.
DOI: 10.1002/mds.21580
PubMed: 17618522
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pubmed:17618522Le document en format XML
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<author><name sortKey="Volz, Monica M" sort="Volz, Monica M" uniqKey="Volz M" first="Monica M" last="Volz">Monica M. Volz</name>
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<author><name sortKey="Heath, Susan L" sort="Heath, Susan L" uniqKey="Heath S" first="Susan L" last="Heath">Susan L. Heath</name>
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<author><name sortKey="Starr, Philip A" sort="Starr, Philip A" uniqKey="Starr P" first="Philip A" last="Starr">Philip A. Starr</name>
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<front><div type="abstract" xml:lang="en">Idiopathic cranial-cervical dystonia (ICCD) is an adult-onset dystonia syndrome affecting orbicularis oculi, facial, oromandibular, and cervical musculature. ICCD is frequently difficult to treat medically. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a highly effective treatment for idiopathic generalized dystonia, however less is known about the effect of GPi DBS on ICCD. In this article, we present the results from a pilot study assessing the effect of GPi DBS in a series of patients with ICCD. Six patients underwent bilateral stereotactic implantation of DBS leads into the sensorimotor GPi. Patients were evaluated with the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) and Toronto western spamodic torticollis rating scale (TWSTRS) before surgery and 6 months postoperatively. At 6 months, patients showed a 72% mean improvement in the BFMDRS total movement score (P < 0.028, Wilcoxin signed rank test). The mean BFMDRS disability score showed a trend toward improvement (P < 0.06). The total TWSTRS score improved 54% (P < 0.043). Despite improvement in dystonia, mild worsening of motor function was reported in previously nondystonic body regions with stimulation in 4 patients. Although GPi DBS was effective in these patients, the influence of GPi DBS on nondystonic body regions deserves further investigation.</div>
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<Abstract><AbstractText>Idiopathic cranial-cervical dystonia (ICCD) is an adult-onset dystonia syndrome affecting orbicularis oculi, facial, oromandibular, and cervical musculature. ICCD is frequently difficult to treat medically. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a highly effective treatment for idiopathic generalized dystonia, however less is known about the effect of GPi DBS on ICCD. In this article, we present the results from a pilot study assessing the effect of GPi DBS in a series of patients with ICCD. Six patients underwent bilateral stereotactic implantation of DBS leads into the sensorimotor GPi. Patients were evaluated with the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) and Toronto western spamodic torticollis rating scale (TWSTRS) before surgery and 6 months postoperatively. At 6 months, patients showed a 72% mean improvement in the BFMDRS total movement score (P < 0.028, Wilcoxin signed rank test). The mean BFMDRS disability score showed a trend toward improvement (P < 0.06). The total TWSTRS score improved 54% (P < 0.043). Despite improvement in dystonia, mild worsening of motor function was reported in previously nondystonic body regions with stimulation in 4 patients. Although GPi DBS was effective in these patients, the influence of GPi DBS on nondystonic body regions deserves further investigation.</AbstractText>
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