机构:[1]Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing.神经科系统神经外科功能神经外科首都医科大学宣武医院[2]Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong.[3]Neurosurgery Department, Tianjin Huanhu Hospital, Tianjin[4]Functional Neurosurgery Department, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.首都医科大学附属北京儿童医院
Craniocervical dystonia (CCD) is a common type of segmental dystonia, which is a disabling disease that has been frequently misdiagnosed. Blepharospasm or cervical dystonia is the most usual symptom initially. Although deep brain stimulation (DBS) of the globus pallidus internus (GPi) has been widely used for treating CCD, its clinical outcome has been primarily evaluated in small-scale studies. This research examines the sustained clinical effectiveness of DBS of the GPi in individuals diagnosed with CCD.The authors report 24 patients (14 women, 10 men) with refractory CCD who underwent DBS of the GPi between 2016 and 2023. The severity and disability of the dystonia were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). The BFMDRS scores were collected preoperatively, 6 months postoperatively, and at the most recent follow-up visit.The mean age at onset was 52.0 ± 11.0 years (range 33-71 years) and the mean disease duration was 63.3 ± 73.3 months (range 7-360 months) (values for continuous variables are expressed as the mean ± SD). The mean follow-up period was 37.5 ± 23.5 months (range 6-84 months). The mean total BFMDRS motor scores at the 3 different time points were 13.3 ± 9.4 preoperatively, 5.0 ± 4.7 (55.3% improvement, p < 0.001) at 6 months, and 4.5 ± 3.6 (56.6% improvement, p < 0.001) at last follow-up. The outcomes were deemed poor in 6 individuals.Inferences drawn from the findings suggest that DBS of the GPi has long-lasting effectiveness and certain limitations in managing refractory CCD. The expected stability of the clinical outcome is not achieved. Patients with specific types of dystonia might consider targets other than GPi for a more precise therapy.
基金:
Dr. Ren received funding from the Beijing Municipal Administration of Hospitals (grant no. PX2022034).
第一作者机构:[1]Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing.
通讯作者:
推荐引用方式(GB/T 7714):
Zhao Zhuoling,Ren Zhiwei,Hu Yongsheng,et al.Long-term follow-up of pallidal deep brain stimulation for craniocervical dystonia: is the globus pallidus internus the best target?[J].NEUROSURGICAL FOCUS.2024,56(6):E16.doi:10.3171/2024.3.FOCUS23890.
APA:
Zhao Zhuoling,Ren Zhiwei,Hu Yongsheng,Yu Kaijia,Yin Fangzhao...&Zhang Guojun.(2024).Long-term follow-up of pallidal deep brain stimulation for craniocervical dystonia: is the globus pallidus internus the best target?.NEUROSURGICAL FOCUS,56,(6)
MLA:
Zhao Zhuoling,et al."Long-term follow-up of pallidal deep brain stimulation for craniocervical dystonia: is the globus pallidus internus the best target?".NEUROSURGICAL FOCUS 56..6(2024):E16