Objective: This study aims to assess the response to GPi DBS in patients presenting with various types of dystonia and to co-relate the motor as well as non-motor outcomes with the surgical and programming parameters.

Background: Deep brain stimulation (DBS) of the Globus Pallidus internus (GPi) is an effective treatment for medically refractory dystonia. However, motor outcomes are variable and may be influenced by electrode position, stimulation parameters, and patient characteristics. There is limited literature discussing the non-motor outcomes in patients treated with DBS for dystonia.

Method: A retrospective analysis was conducted on 15 patients with primary dystonia (generalised, segmental, or cervical) who underwent bilateral GPi DBS over the past 3 years. The baseline motor and non-motor parameters of each patient were documented using few standard scales of assessment and individual patient response to DBS was assessed during the post-operative period and follow up visits (over a period ranging from 6 months to 3 years). The position of the active contact with respect to the mid-commissural point as well as its anatomical location within the lentiform nucleus based on post-operative MR images was studied in each patient. The final stimulation parameters that achieved optimal response were noted and co-relation between the recorded data was analysed in detail.

Results: 13 out of 15 patients demonstrated significant motor improvement following GPi DBS. Besides this, it was also noted that nonmotor symptoms also improved significantly across all domains.

Conclusion: GPI-DBS offers robust motor and non-motor benefits in dystonia. Electrode position, particularly in the mediolateral plane, is a key determinant of motor outcomes. Non-motor improvements, often underrecognized, highlight the broader therapeutic impact of DBS. Further studies that focus on patients’ non-motor and quality of life changes need to be undertaken.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-and-non-motor-outcomes-of-globus-pallidus-internus-deep-brain-stimulation-for-dystonia/