A Koy1, M Weinsheimer2, K A M Pauls2, A A Kühn3, P Krause3, J Huebl3, G-H Schneider4, G Deuschl5, R Erasmi5, D Falk6, J K Krauss7, G Lütjens7, A Schnitzler8, L Wojtecki8, J Vesper9, R Korinthenberg10, V A Coenen11, V Visser-Vandewalle12, M Hellmich13, L Timmermann14. 1. Department of Neurology, University Hospital of Cologne, Germany; Department of Paediatrics, University Hospital of Cologne, Germany. Electronic address: anne.koy@uk-koeln.de. 2. Department of Neurology, University Hospital of Cologne, Germany. 3. Department of Neurology, Charité University Medicine Berlin, Germany. 4. Department of Neurosurgery, Charité University Medicine Berlin, Germany. 5. Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany. 6. Department of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Kiel, Germany. 7. Department of Neurosurgery, Medical School, MHH, Hannover, Germany. 8. Department of Neurology, University Hospital of Düsseldorf, Germany. 9. Department of Stereotactic and Functional Neurosurgery, University Hospital of Düsseldorf, Germany. 10. Department of Paediatrics, Freiburg University Medical Centre, Germany. 11. Department Stereotactic and Functional Neurosurgery, Freiburg University Medical Centre, Germany. 12. Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Germany. 13. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany. 14. Department of Neurology, University Hospital of Cologne, Germany. Electronic address: lars.timmermann@uk-koeln.de.
Abstract
BACKGROUND: Data on paediatric deep brain stimulation (DBS) is limited, especially for long-term outcomes, because of small numbers in single center series and lack of systematic multi-center trials. OBJECTIVES: We seek to systematically evaluate the clinical outcome of paediatric patients undergoing DBS. METHODS: A German registry on paediatric DBS (GEPESTIM) was created to collect data of patients with dystonia undergoing DBS up to the age of 18 years. Patients were divided into three groups according to etiology (group 1 inherited, group 2 acquired, and group 3 idiopathic dystonia). RESULTS: Data of 44 patients with a mean age of 12.8 years at time of operation provided by 6 German centers could be documented in the registry so far (group 1 n = 18, group 2 n = 16, group 3 n = 10). Average absolute improvement after implantation was 15.5 ± 18.0 for 27 patients with pre- and postoperative Burke-Fahn-Marsden Dystonia Rating scale movement scores available (p < 0.001) (group 1: 19.6 ± 19.7, n = 12; group 2: 7.0 ± 8.9, n = 8; group 3: 19.2 ± 20.7, n = 7). Infection was the main reason for hardware removal (n = 6). 20 IPG replacements due to battery expiry were necessary in 15 patients at 3.7 ± 1.8 years after last implantation. DISCUSSION: Pre- and postoperative data on paediatric DBS are very heterogeneous and incomplete but corroborate the positive effects of DBS on inherited and acquired dystonia. Adverse events including relatively frequent IPG replacements due to battery expiry seem to be a prominent feature of children with dystonia undergoing DBS. The registry enables collaborative research on DBS treatment in the paediatric population and to create standardized management algorithms in the future.
BACKGROUND: Data on paediatric deep brain stimulation (DBS) is limited, especially for long-term outcomes, because of small numbers in single center series and lack of systematic multi-center trials. OBJECTIVES: We seek to systematically evaluate the clinical outcome of paediatric patients undergoing DBS. METHODS: A German registry on paediatric DBS (GEPESTIM) was created to collect data of patients with dystonia undergoing DBS up to the age of 18 years. Patients were divided into three groups according to etiology (group 1 inherited, group 2 acquired, and group 3 idiopathic dystonia). RESULTS: Data of 44 patients with a mean age of 12.8 years at time of operation provided by 6 German centers could be documented in the registry so far (group 1 n = 18, group 2 n = 16, group 3 n = 10). Average absolute improvement after implantation was 15.5 ± 18.0 for 27 patients with pre- and postoperative Burke-Fahn-Marsden Dystonia Rating scale movement scores available (p < 0.001) (group 1: 19.6 ± 19.7, n = 12; group 2: 7.0 ± 8.9, n = 8; group 3: 19.2 ± 20.7, n = 7). Infection was the main reason for hardware removal (n = 6). 20 IPG replacements due to battery expiry were necessary in 15 patients at 3.7 ± 1.8 years after last implantation. DISCUSSION: Pre- and postoperative data on paediatric DBS are very heterogeneous and incomplete but corroborate the positive effects of DBS on inherited and acquired dystonia. Adverse events including relatively frequent IPG replacements due to battery expiry seem to be a prominent feature of children with dystonia undergoing DBS. The registry enables collaborative research on DBS treatment in the paediatric population and to create standardized management algorithms in the future.
Authors: Katrina A Muñoz; Kristin Kostick; Laura Torgerson; Peter Zuk; Lavina Kalwani; Clarissa Sanchez; Jennifer Blumenthal-Barby; Eric A Storch; Gabriel Lázaro-Muñoz Journal: Brain Stimul Date: 2021-10-23 Impact factor: 8.955
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Authors: Natalia Szejko; Yulia Worbe; Andreas Hartmann; Veerle Visser-Vandewalle; Linda Ackermans; Christos Ganos; Mauro Porta; Albert F G Leentjens; Jan-Hinnerk Mehrkens; Daniel Huys; Juan Carlos Baldermann; Jens Kuhn; Carine Karachi; Cécile Delorme; Thomas Foltynie; Andrea E Cavanna; Danielle Cath; Kirsten Müller-Vahl Journal: Eur Child Adolesc Psychiatry Date: 2021-10-04 Impact factor: 4.785