Long-term outcomes of pallidal DBS for cervical dystonia

Background: Cervical dystonia (CD) can be disabling and often fails medical therapy in the long-term. Pallidal deep brain stimulation (DBS) is an effective option for selected patients. Here, we assess its efficacy over 10 years. Methods: All patients undergoing DBS for CD in Calgary were assessed u...

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Published in:Canadian journal of neurological sciences 2014-05, Vol.41 (3), p.S16-S16
Main Authors: Bezchlibnyk, Y B, Gomes, K C, Hunka, K, Lawrence, P, Ranawaya, R, Kraft, S, Furtado, S, Kiss, Z H
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container_title Canadian journal of neurological sciences
container_volume 41
creator Bezchlibnyk, Y B
Gomes, K C
Hunka, K
Lawrence, P
Ranawaya, R
Kraft, S
Furtado, S
Kiss, Z H
description Background: Cervical dystonia (CD) can be disabling and often fails medical therapy in the long-term. Pallidal deep brain stimulation (DBS) is an effective option for selected patients. Here, we assess its efficacy over 10 years. Methods: All patients undergoing DBS for CD in Calgary were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) at baseline, 6 months and 1 year post-op, and bi-annually thereafter. Primary outcome was severity (range 0-30, higher scores indicating greater impairment). Results: Seventeen patients underwent surgery with at least 2 year follow-up. Mean baseline TWSTRS severity score was 16.9+/-3.4 (+/-SD, n=17). Follow-up ranged from 2 to 10 yrs. Outcomes at each follow-up were significantly different from baseline (p
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Pallidal deep brain stimulation (DBS) is an effective option for selected patients. Here, we assess its efficacy over 10 years. Methods: All patients undergoing DBS for CD in Calgary were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) at baseline, 6 months and 1 year post-op, and bi-annually thereafter. Primary outcome was severity (range 0-30, higher scores indicating greater impairment). Results: Seventeen patients underwent surgery with at least 2 year follow-up. Mean baseline TWSTRS severity score was 16.9+/-3.4 (+/-SD, n=17). Follow-up ranged from 2 to 10 yrs. Outcomes at each follow-up were significantly different from baseline (p&lt;0.001 in all cases, one-way ANOVA plus Holm-Sidak tests for multiple comparisons to baseline): 6 months - 6.5+/-4.2 (n=14); 1 year - 4.9+/-4.2 (n=15); 2 years - 4.8+/-3.3 (n=15); 3 years - 3.0+/-3.2 (n=9); 4 years -5.3+/-5.6 (n=7); 5 years - 5.2+/-4.1 (n=6); 6 years - 5.0+/-4.2 (n=4); 7 years - 3.0+/-2.7 (n=3); 8 years - 3.0+/-1.4 (n=2); 10 years - 1.00 (n=1). Adverse effects included mild speech dysarthria in 3 and balance disturbance with bradykinesia in 4 older patients. 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Pallidal deep brain stimulation (DBS) is an effective option for selected patients. Here, we assess its efficacy over 10 years. Methods: All patients undergoing DBS for CD in Calgary were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) at baseline, 6 months and 1 year post-op, and bi-annually thereafter. Primary outcome was severity (range 0-30, higher scores indicating greater impairment). Results: Seventeen patients underwent surgery with at least 2 year follow-up. Mean baseline TWSTRS severity score was 16.9+/-3.4 (+/-SD, n=17). Follow-up ranged from 2 to 10 yrs. Outcomes at each follow-up were significantly different from baseline (p&lt;0.001 in all cases, one-way ANOVA plus Holm-Sidak tests for multiple comparisons to baseline): 6 months - 6.5+/-4.2 (n=14); 1 year - 4.9+/-4.2 (n=15); 2 years - 4.8+/-3.3 (n=15); 3 years - 3.0+/-3.2 (n=9); 4 years -5.3+/-5.6 (n=7); 5 years - 5.2+/-4.1 (n=6); 6 years - 5.0+/-4.2 (n=4); 7 years - 3.0+/-2.7 (n=3); 8 years - 3.0+/-1.4 (n=2); 10 years - 1.00 (n=1). Adverse effects included mild speech dysarthria in 3 and balance disturbance with bradykinesia in 4 older patients. 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Pallidal deep brain stimulation (DBS) is an effective option for selected patients. Here, we assess its efficacy over 10 years. Methods: All patients undergoing DBS for CD in Calgary were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) at baseline, 6 months and 1 year post-op, and bi-annually thereafter. Primary outcome was severity (range 0-30, higher scores indicating greater impairment). Results: Seventeen patients underwent surgery with at least 2 year follow-up. Mean baseline TWSTRS severity score was 16.9+/-3.4 (+/-SD, n=17). Follow-up ranged from 2 to 10 yrs. Outcomes at each follow-up were significantly different from baseline (p&lt;0.001 in all cases, one-way ANOVA plus Holm-Sidak tests for multiple comparisons to baseline): 6 months - 6.5+/-4.2 (n=14); 1 year - 4.9+/-4.2 (n=15); 2 years - 4.8+/-3.3 (n=15); 3 years - 3.0+/-3.2 (n=9); 4 years -5.3+/-5.6 (n=7); 5 years - 5.2+/-4.1 (n=6); 6 years - 5.0+/-4.2 (n=4); 7 years - 3.0+/-2.7 (n=3); 8 years - 3.0+/-1.4 (n=2); 10 years - 1.00 (n=1). Adverse effects included mild speech dysarthria in 3 and balance disturbance with bradykinesia in 4 older patients. Conclusions: Pallidal DBS is an effective and durable therapy for CD persisting up to 10 years.</abstract></addata></record>
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title Long-term outcomes of pallidal DBS for cervical dystonia
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