Abstract
BackgroundDystonia is a movement disorder substantially affecting the quality of life and the ability to work. A proportion of patients does not respond to first line pharmacotherapy. Deep brain stimulation (DBS) is established as a primary operative treatment option for severe drug resistant dystonia. We studied dystonia patients treated with DBS in Finland between the years 2007–2016 to evaluate the use and outcomes of DBS treatment.MethodsWe analysed the hospital records of dystonia patients, who underwent DBS operation during 2007–2016 in Finland. The clinical and technical parameters were recorded as well as preoperative assessments and treatments. The response to DBS was evaluated retrospectively using the Global Dystonia Rating Scale (GDS).ResultsOut of 585 dB implantations during the study period, 37 were done for dystonia. The clinical response improved significantly with time in the isolated focal dystonia group, and at 12 months, 22 of 32 patients had over 50% alleviation of the GDS score. There was only one subclinical intracerebral haemorrhage, and four infections leading to revision. Speech impairment and limb coordination problems were common stimulation- related adverse events and were mostly resolved or relieved with the adjustment of stimulation parameters.ConclusionsDBS seems to be beneficial in dystonia. Although DBS is indicated for dystonia in Finland, the number of operations did not increase at the same rate as DBS operations in general. DBS appears to be a safe and effective treatment for focal as well as generalized dystonia.
Highlights
Dystonia is a movement disorder substantially affecting the quality of life and the ability to work
Dystonia is a heterogeneous group of disorders, characterized by sustained or intermittent muscle contraction causing abnormal postures and/or repetitive movements with unknown aetiology [1]
We specially focused on indications, response and adverse events
Summary
Dystonia is a movement disorder substantially affecting the quality of life and the ability to work. Dystonia is a heterogeneous group of disorders, characterized by sustained or intermittent muscle contraction causing abnormal postures and/or repetitive movements with unknown aetiology [1]. It is the third most common movement disorder after essential tremor and Parkinson’s disease (PD) considerably affecting the quality of life and ability to work [2]. High-frequency deep brain stimulation (DBS) targeting bilaterally globus pallidus interna (GPi) has been established as effective second line treatment in medically refractory dystonia with severely impaired quality of life [5,6,7,8,9]. DBS is considered less effective, with the exception of tardive dystonia (level C) [11]
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