BACKGROUND AND PURPOSE:Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is successful in dystonia, but the role of each electrical parameters of stimulation is unclear. We studied the clinical effects of acute changes of different parameters of GPi-DBS in cervical dystonia (CD). METHODS:Eight CD patients with bilateral GPi-DBS at 28.6 +/- 19.2 (mean +/- SD) months after surgery were recruited. Mean improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 54.5% compared to before surgery. Ten settings, including a combination of a wide range of pulse widths (PWs), low and high frequencies and voltage, were administered in a randomized double blinded fashion. Clinical benefit was assessed by two raters using the TWSTRS and by the patients using an analogue rating scale. RESULTS: The TWSTRS severity scores were reduced by 56.7% with stimulation at the best settings. Improvement was significantly associated with high frequency (> or = 60 Hz) and high voltage. Stimulation at 130 Hz showed the best clinical improvement. Increasing PWs (from 60 to 450 micros) did not result in a significant improvement. CONCLUSION: Frequency and amplitude appear to be the most important factors in the acute anti-dystonic effects in GPi-DBS patients with CD.
RCT Entities:
BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is successful in dystonia, but the role of each electrical parameters of stimulation is unclear. We studied the clinical effects of acute changes of different parameters of GPi-DBS in cervical dystonia (CD). METHODS: Eight CDpatients with bilateral GPi-DBS at 28.6 +/- 19.2 (mean +/- SD) months after surgery were recruited. Mean improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 54.5% compared to before surgery. Ten settings, including a combination of a wide range of pulse widths (PWs), low and high frequencies and voltage, were administered in a randomized double blinded fashion. Clinical benefit was assessed by two raters using the TWSTRS and by the patients using an analogue rating scale. RESULTS: The TWSTRS severity scores were reduced by 56.7% with stimulation at the best settings. Improvement was significantly associated with high frequency (> or = 60 Hz) and high voltage. Stimulation at 130 Hz showed the best clinical improvement. Increasing PWs (from 60 to 450 micros) did not result in a significant improvement. CONCLUSION: Frequency and amplitude appear to be the most important factors in the acute anti-dystonic effects in GPi-DBSpatients with CD.
Authors: Alberto Albanese; Francesca Del Sorbo; Cynthia Comella; H A Jinnah; Jonathan W Mink; Bart Post; Marie Vidailhet; Jens Volkmann; Thomas T Warner; Albert F G Leentjens; Pablo Martinez-Martin; Glenn T Stebbins; Christopher G Goetz; Anette Schrag Journal: Mov Disord Date: 2013-06-15 Impact factor: 10.338
Authors: Daniel E Lumsden; Margaret Kaminska; Kylie Tustin; Hortensia Gimeno; Lesley Baker; Keyoumars Ashkan; Richard Selway; Jean-Pierre Lin Journal: Childs Nerv Syst Date: 2012-03-18 Impact factor: 1.475
Authors: Takashi Tsuboi; Joshua K Wong; Leonardo Almeida; Christopher W Hess; Aparna Wagle Shukla; Kelly D Foote; Michael S Okun; Adolfo Ramirez-Zamora Journal: J Neurol Date: 2020-01-14 Impact factor: 4.849