Objective: This study firstly aims to measure the efficacy of GPi-DBS on motor and non-motor symptoms of CD. A secondary aim was to evaluate if clinical factors – such as age, disease duration and baseline disease severity – influence variability of motor outcomes.

Background: Cervical Dystonia (“CD”) is a movement disorder characterised by sustained muscle contractions in the neck, causing involuntary movements and posturing. Deep brain stimulation (“DBS”) of the globus pallidal internus (GPi) is advanced treatment for medication-refractory patients. As CD is a rare disease, cohort studies are often limited to patients of heterogenous disease profile, small sample size or short follow up.

Method: 37 idiopathic CD patients were recruited from movement disorders clinics at The Walton NHS Foundation Trust. Patients were assessed pre-operatively, and 1 year, 3 years and 5 years post-operatively with the following clinical scales: Toronto Western Spasmodic Torticollis Rating Scale (“TWSTRS”), Hospital Anxiety and Depression Scale and EuroQuol-5D.

Results: GPi-DBS significantly improved overall TWSTRS scores by 57% from baseline at 5Y FU up (p <0.001). It also significantly improved TWSTRS severity, disability, and pain sub-scores by 72%, 59% and 46% respectively. We did not find a significant improvement in mood or quality of life scores at 5 years. Similarly, clinical factors at baseline did not correlate with variability in motor outcome.

Conclusion: We concluded that GPi-DBS is an effective treatment for motor symptoms in idiopathic CD, including specifically, disease severity, disability, and pain. There was limited effect on mood and QoL, and no clinical predictive factors of outcome were identified.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/bilateral-globus-pallidus-internus-deep-brain-stimulation-for-cervical-dystonia-effects-on-motor-and-non-motor-symptoms-within-5-years-follow-up/