Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: To find a biomarker of GPi-DBS efficacy in dystonia.
Background: GPi-DBS has been proven effective and safe in medically refractory dystonia. However, the heterogeneity of dystonia leads to a wide variety in effect of DBS, and is hard to predict in individual patients. A biomarker of GPi-DBS efficacy in dystonia could be used to optimize patient selection and programming of the stimulator.
Methods: Twelve dystonia patients (six cervical, four generalized, one oromandibular, and one segmental dystonia) receiving bilaterally GPi-DBS were prospectively included in this study. Clinical improvement was assessed using the BFMDRS and TWSTRS score (pre- and 12 months post-OR). In addition, EEG-EMG recording took place pre- and 1 year post-operatively ON and OFF stimulation, and during a rest, pinch, and flexion task (19 EEG-, 10 EMG channels; SCM and upper limb muscles L/R). Motorcortex cortico-muscular coherence (CMC) and intermuscular coherence (IMC) (wrist flexor-extensor, biceps-triceps, SCM left-right) were calculated. The main parameter studied as potential biomarker was the peak coherence in the low frequency band (4-12 Hz) and the beta band (13-30 Hz).
Results: The median BFMDRS score pre-surgery was 23 (IQR 16-43) and 15 (IQR 10-38) post-surgery ON stimulation. The median TWSTRS score pre-surgery was 22 (IQR 17-23) and 14 (IQR 9-19) post-surgery ON stimulation. Pre-surgery, in the low frequency band, 64% of the IMC and 12% of the CMC, and in the beta band, 48% IMC and 15% CMC were significant. Post-surgery ON stimulation, in the low frequency band, 40% IMC and 8% CMC, and in the beta band, 43% IMC and 13% CMC were significant. Post-operatively OFF stimulation, in the low frequency band, 62% IMC and 12% CMC, and in the beta band, 47% IMC and 19% CMC were significant. DBS significantly reduced IMC and CMC across the tasks. Low frequency band CMC and IMC decreased with DBS (p<0.05). In the beta band, DBS did not significantly decrease CMC and IMC (p>0.05). No significant correlations between the clinical assessment scores and the CMC or IMC have been found both pre- and post-operatively both bands.
Conclusions: Our study shows promising possibilities for coherence as a biomarker for DBS efficacy in dystonia patients. The use of coherence as biomarker and a predictor of efficacy in clinical practice requires a larger prospective study.
To cite this abstract in AMA style:E. Doldersum, J. van Zijl, M. Beudel, H. Eggink, R. Brandsma, D. Pina Fuentes, M. van Egmond, D. Oterdoom, J. van Dijk, J. Elting, M. de Koning-Tijssen. Corticomuscular and Intermuscular Coherence as a Biomarker of Pallidal Deep Brain Stimulation Efficacy in Dystonia [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/corticomuscular-and-intermuscular-coherence-as-a-biomarker-of-pallidal-deep-brain-stimulation-efficacy-in-dystonia/. Accessed December 11, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/corticomuscular-and-intermuscular-coherence-as-a-biomarker-of-pallidal-deep-brain-stimulation-efficacy-in-dystonia/