Takashi Tsuboi1, Zakia Jabarkheel1, Kelly D Foote2, Michael S Okun1, Aparna Wagle Shukla3. 1. Department of Neurology, Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, USA. 2. Department of Neurosurgery, University of Florida, Gainesville, FL, USA. 3. Department of Neurology, Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, USA. Electronic address: aparna.shukla@neurology.ufl.edu.
Abstract
BACKGROUND: Long-term efficacy of deep brain stimulation (DBS) on health-related quality-of-life (HRQoL) for isolated dystonia is not well established. This study aims to determine the long-term impact of DBS on HRQoL outcomes and identify clinical predictors. METHODS: We retrospectively investigated 16 inherited or idiopathic isolated dystonia patients treated with bilateral globus pallidus internus DBS who were followed beyond 9 years at our center. The cohort consisted of 9 males, 7 females; 10 generalized, 6 segmental; mean (range) age at implantation, 37.0 (8-67) years; mean follow-up duration after implantation, 10.9 (9-13) years. We employed the Unified Dystonia Rating Scale for motor and Short Form Health Survey for HRQoL assessments to monitor the change longitudinally. We analyzed the changes in motor and HRQoL at 1-2 years (short-term) and ≥9 years (long-term) follow-up as compared to baseline with a Wilcoxon signed-rank test. We assessed the factors that predicted motor and HRQoL improvement with univariate regression analyses. RESULTS: Motor (41.6%; p = 0.004) and HRQoL (total score, p = 0.039) improvements remained significant at long-term follow-up and, in the regression analysis, change in HRQoL outcomes correlated significantly with change in motor outcomes (R2 = 0.384, p = 0.010). Additionally, short-term motor and HRQoL improvements predicted the long-term motor (R2 = 0.384, p = 0.010) and HRQoL (total score, R2 = 0.594, p < 0.001) outcomes, respectively. CONCLUSION: Motor and HRQoL improvements with DBS in isolated dystonia remain sustained for nearly a decade and may largely be predictable by the short-term response to DBS.
BACKGROUND: Long-term efficacy of deep brain stimulation (DBS) on health-related quality-of-life (HRQoL) for isolated dystonia is not well established. This study aims to determine the long-term impact of DBS on HRQoL outcomes and identify clinical predictors. METHODS: We retrospectively investigated 16 inherited or idiopathic isolated dystoniapatients treated with bilateral globus pallidus internus DBS who were followed beyond 9 years at our center. The cohort consisted of 9 males, 7 females; 10 generalized, 6 segmental; mean (range) age at implantation, 37.0 (8-67) years; mean follow-up duration after implantation, 10.9 (9-13) years. We employed the Unified Dystonia Rating Scale for motor and Short Form Health Survey for HRQoL assessments to monitor the change longitudinally. We analyzed the changes in motor and HRQoL at 1-2 years (short-term) and ≥9 years (long-term) follow-up as compared to baseline with a Wilcoxon signed-rank test. We assessed the factors that predicted motor and HRQoL improvement with univariate regression analyses. RESULTS: Motor (41.6%; p = 0.004) and HRQoL (total score, p = 0.039) improvements remained significant at long-term follow-up and, in the regression analysis, change in HRQoL outcomes correlated significantly with change in motor outcomes (R2 = 0.384, p = 0.010). Additionally, short-term motor and HRQoL improvements predicted the long-term motor (R2 = 0.384, p = 0.010) and HRQoL (total score, R2 = 0.594, p < 0.001) outcomes, respectively. CONCLUSION: Motor and HRQoL improvements with DBS in isolated dystonia remain sustained for nearly a decade and may largely be predictable by the short-term response to DBS.
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
Authors: L Okromelidze; T Tsuboi; R S Eisinger; M R Burns; M Charbel; M Rana; S S Grewal; C-Q Lu; L Almeida; K D Foote; M S Okun; E H Middlebrooks Journal: AJNR Am J Neuroradiol Date: 2020-02-13 Impact factor: 3.825
Authors: Ajay K Verma; Sergio Francisco Acosta Lenis; Joshua E Aman; David Escobar Sanabria; Jing Wang; Amy Pearson; Meghan Hill; Remi Patriat; Lauren E Schrock; Scott E Cooper; Michael C Park; Noam Harel; Michael J Howell; Colum D MacKinnon; Jerrold L Vitek; Luke A Johnson Journal: NPJ Parkinsons Dis Date: 2022-09-12
Authors: Katrina A MuÑoz; Jennifer Blumenthal-Barby; Eric A Storch; Laura Torgerson; Gabriel LÁzaro-MuÑoz Journal: Camb Q Healthc Ethics Date: 2020-10 Impact factor: 1.566