Deep brain stimulation and neuromodulation for torsion dystonia

• Main Authors: Jing WANG, Xin WANG, Tian LUO, Nan LI, Xue-lian WANG, Guo-dong GAO
• Format: Article
• Language: English
• Published: Tianjin Huanhu Hospital 2015-10-01
• Series: Chinese Journal of Contemporary Neurology and Neurosurgery
• Subjects: Dystonia musculorum deformans; Deep brain stimulation
• Online Access: http://www.cjcnn.org/index.php/cjcnn/article/view/1286

<p><strong>Objective</strong> To discuss the curative effect and safety of deep brain stimulation (DBS) and neuromodulation in the treatment of patients with torsion dystonia. <strong>Methods </strong> Ten patients with torsion dystonia underwent subthalamic nucleus DBS (STN-DBS) and 3 patients with torsion dystonia underwent globus pallidus internus DBS (GPi-DBS). Regulate the stimulus parameters, evaluate the improvement of torsion dystonia by using Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and record related adverse events. <strong>Results </strong> Among the 13 patients, 6 patients were improved by over 60% in 1-3 d and 3 patients one week after stimulation, and the improvement rate was &gt; 75% in 6 months and &gt; 85% in one year. Two patients showed improvement 2 months after stimulation, and the improvement rate was &gt; 60% in 6 months and &gt; 80% in one year. One patient showed slight improvement immediately after operation, and the improvement rate increased to 45% in 6 months and 75% in one year. One patient removed the stimulator. No adverse event related to the operation was found in all 13 patients. The stimulus parameters for STN-DBS were voltage 1.50-2.00 V, frequency 130-145 Hz, pulse width 60-90 μs at 6 months postoperatively, and were voltage 2.00-2.50 V, frequency 130-150 Hz, pulse width 60-90 μs at one year postoperatively. The stimulus parameters for GPi-DBS were voltage 2.50-2.80 V, frequency 130-160 Hz, pulse width 60-90 μs at 6 months postoperatively, and were voltage 2.50-4.00 V, frequency 145-170 Hz, pulse width 60-90 μs at one year postoperatively. <strong>Conclusions</strong> Both STN-DBS and GPi-DBS have good curative effect and safety in the treatment for torsion dystonia. Besides, patients should be treated with individual neuromodulation.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2015.10.007</p>