Deep brain stimulation in dystonia: factors contributing to variability in outcome in short and long term follow-up.
Curr Opin Neurol
; 35(4): 510-517, 2022 08 01.
Article
in En
| MEDLINE
| ID: mdl-35787538
PURPOSE OF REVIEW: Deep brain stimulation (DBS) is currently the most effective treatment for medically refractory dystonia with globus pallidus internus (GPi) usually the preferred target. Despite the overall success of DBS in dystonia, there remains variability in treatment outcome in both short and long-term follow-up, due to various factors. Factors contributing to variability in outcome comprise 'Dystonia Related' including dystonia classification, semiology, duration, body distribution, orthopaedic deformity, aetiology and genetic cause. The majority of these factors are identifiable from clinical assessment, brain MRI and genetic testing, and therefore merit careful preoperative consideration. 'DBS related' factors include brain target, accuracy of lead placement, stimulation parameters, time allowed for response, neurostimulation technology employed and DBS induced side-effects. In this review, factors contributing to variability in short and long-term dystonia DBS outcome are reviewed and discussed. RECENT FINDINGS: The recognition of differential DBS benefit in monogenic dystonia, increasing experience with subthalamic nucleus (STN) DBS and in DBS for Meige syndrome, elucidation of DBS side effects and novel neurophysiological and imaging techniques to assist in predicting clinical outcome. SUMMARY: Improved understanding of factors contributing to variability of DBS outcome in dystonia may assist in patient selection and predicting surgical outcomes.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Subthalamic Nucleus
/
Dystonic Disorders
/
Deep Brain Stimulation
/
Dystonia
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Curr Opin Neurol
Journal subject:
NEUROLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Australia
Country of publication:
United kingdom