Abstract
Deep brain stimulation (DBS) is an effective surgical treatment for medication-refractory movement disorders, and has been approved by the United States Food and Drug Administration for treatment of dystonia. The success of DBS in the treatment of dystonia depends on our understanding of the anatomy and physiology of this disorder and close collaboration between neurosurgeons, neurologists, clinical neurophysiologists, neuroradiologists and neuropsychologists. Currently, pallidal DBS is an established treatment option for medically refractive dystonia. This review is intended to provide a comprehensive review of the use of DBS for dystonia, focusing mainly on the surgical aspects, clinical outcome, MRI findings and side effects of DBS.
Highlights
Dystonia is a movement disorder characterized by patterned directional and often sustained muscle contractions and causing twisting and repetitive movements or abnormal postures [1,2]
The subthalamic nucleus (STN) has been reported to be useful target in dystonia patients [10,52,53], Sun et al proposed that STN Deep brain stimulation (DBS) could potentially have following advantages over Globus Pallidus pars Interna (GPi) DBS: immediately symptomatic improvement after programming, the lower stimulation parameters with longer battery life; and STN DBS results in better symptomatic control [53]
GPi stimulation is currently being regarded as the main DBS target for primary dystonias, focal, and segmental dystonias with substantial clinical benefit, we should continue studying the potential
Summary
Dystonia is a movement disorder characterized by patterned directional and often sustained muscle contractions and causing twisting and repetitive movements or abnormal postures [1,2]. Two multicenter studies on bilateral Globus Pallidus pars Interna (GPi) DBS have demonstrated convincing clinical benefit on a large number of patients with primary generalized/segmental dystonia [7,8,9]. Numerous studies have demonstrated that the GPi target can improve motor function and disability in primary dystonia [24,25,26,27].
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