Deep brain stimulation and neuromodulation for torsion dystonia

Abstract

Objective To discuss the curative effect and safety of deep brain stimulation (DBS) and neuromodulation in the treatment of patients with torsion dystonia. Methods 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. Results 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 > 75% in 6 months and > 85% in one year. Two patients showed improvement 2 months after stimulation, and the improvement rate was > 60% in 6 months and > 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. Conclusions 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.

DOI: 10.3969/j.issn.1672-6731.2015.10.007