Jairo Alberto Espinoza Martínez1, Marcus O Pinsker2, Gabriel J Arango3, Xiomara Garcia3, Andrés Escobar V Oscar3, Luciano Furlanetti4, Thomas Reithmeier5, Iñigo Alonso Aguirre Aranda6, Jorge Humberto Marin7, William Omar Contreras Lopez8. 1. Department of Stereotactic and Functional Neurosurgery, Movement Disorders and Pain Clinic - CIMAD, Carrera 19A No. 82-14, Bogotá, Colombia; Department of Neurosciences, Marly Clinic, Calle 50 No. 9-67, Bogotá, Colombia. Electronic address: jairoespinoza@cimad.net.co. 2. Department of Stereotactic and Functional Neurosurgery, HELIOS Klinikum Berlin-Buch Medical Center, Schwanebecker Chaussee 50, 13125 Berlin, Germany; Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany. 3. Department of Stereotactic and Functional Neurosurgery, Movement Disorders and Pain Clinic - CIMAD, Carrera 19A No. 82-14, Bogotá, Colombia; Department of Neurosciences, Marly Clinic, Calle 50 No. 9-67, Bogotá, Colombia. 4. Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany. 5. Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany; Neurosurgery Department. Städtisches Klinikum München, Thalkirchner Straße 48, 80337 München, Germany. 6. Institut des Neurosciences Cellulaires et Intégratives (INCI) CNRS/Université Louis Pasteur de Strasbourg, 5 rue Blaise Pascal, 67084 Strasbourg, France. 7. San Jose Hospital, Neuroradiology Department, Bogotá, Colombia. 8. Department of Stereotactic and Functional Neurosurgery, University Medical Center, Breisacher Straße 64, 79106 Freiburg, Germany; Division of Neurosurgery, Department of Neurology, Stereotactic & Functional neurosurgery, School of Medicine, University of Sao Paulo, Brazil. Electronic address: williamomarcontreraslopez@hotmail.com.
Abstract
INTRODUCTION: In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm. PATIENTS AND METHODS: Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and post-operative outcomes. Patients were followed from 12 to 114 months. RESULTS: Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskinetic patients (mean improvement of 61.2%). CONCLUSION: Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
INTRODUCTION: In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm. PATIENTS AND METHODS: Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and post-operative outcomes. Patients were followed from 12 to 114 months. RESULTS: Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskineticpatients (mean improvement of 61.2%). CONCLUSION: Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
Authors: David P McMullen; Paul Rosenberg; Jennifer Cheng; Gwenn S Smith; Constantine Lyketsos; William S Anderson Journal: Alzheimer Dis Assoc Disord Date: 2016 Jan-Mar Impact factor: 2.703
Authors: Corina N A M van den Heuvel; Marina A J Tijssen; Bart P C van de Warrenburg; Cathérine C S Delnooz Journal: Mov Disord Clin Pract Date: 2016-08-03
Authors: Lindsay Niccolai; Stephen L Aita; Harrison C Walker; Victor A Del Bene; Adam Gerstenecker; Dario Marotta; Meredith Gammon; Roy C Martin; Olivio J Clay; Michael Crowe; Kristen L Triebel Journal: Clin Neurol Neurosurg Date: 2021-06-08 Impact factor: 1.885