Session Information
Date: Thursday, June 23, 2016
Session Title: Dystonia
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an effective treatment for medically refractory dystonia and reduces not only motor impairment but also disability scores.
Background: However, only little is known about the long-term effects of this therapy. Objective: To evaluate the long-term effects of pallidal DBS in a cohort of 19 consecutive patients operated at the Charité between 2000-2007.
Methods: Retrospective analysis of long-term (64-195 months) outcome of pallidal DBS in 19 patients (age 30-82 years) suffering from primary generalized (8) and segmental (11) dystonia. Dystonic symptoms and disability were rated by the Burke-Fahn-Marsden Dystonia Rating scale (BFMDRS) and compared at three different time points: at baseline (BL, pre-operative), short-term (ST, 3-38 months) and long-term (LT, 64-195 months) pallidal DBS.
Results: Overall, patients reached an improvement in motor symptoms of 63& at ST- and 67% at LT-FU. Compared to pre-operative values, the BFMDR motor scores of all patients was substantially improved with stimulation at ST and LT follow-up (BL: 25.9±19.4; ST-FU: 9.5±6.5; LT-FU: 8.6±8.2) with similar reduction in the BFMDR disability scores (BL: 6.4±4.9; ST-FU: 2.5±2.6; LT-FU: 3.3±2.8). While patients suffering from segmental dystonia presented even better scores at LT-FU compared to ST-FU (BL: 14.7±6.7; ST-FU: 6.9±4.6; LT-FU: 4.6±4.6), the 8 patients with generalized dystonia experienced a minor increase in dystonic motor symptoms over time, but still presented with a >60% DBS-induced benefit compared to BL (BL: 41.3±20.8; ST-FU: 11.4±4.2; LT-FU: 13.2±8.2). Reported stimulation-induced adverse events included mild swallowing difficulties (2), slurring of speech (6) and shuffling gait (3). Three patients needed revision of the pulse generator due to wound-healing difficulties and two patients needed electrode re-implantation after infection.
Conclusions: Our long-term follow up study confirms a safe and sustained effect of DBS on motor impairment and disability for up to 16 years of chronic DBS in a cohort of patients with generalized and segmental dystonia.
To cite this abstract in AMA style:
P. Krause, S. Völzmann, A. Kupsch, G.H. Schneider, A. Kühn. Long-term effects of pallidal DBS in patients with primary dystonia [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/long-term-effects-of-pallidal-dbs-in-patients-with-primary-dystonia/. Accessed July 11, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effects-of-pallidal-dbs-in-patients-with-primary-dystonia/