1. Probabilistic mapping of the antidystonic effect of pallidal neurostimulation: a multicentre imaging study
- Author
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Siobhan Ewert, Nicolò Gabriele Pozzi, Andreas Horn, Jonas Roothans, Louis Soussand, Matthias Wittstock, Karsten Witt, Steffen Paschen, Günther Deuschl, Florian Lange, Gerd-Helge Schneider, Volker Sturm, Andrea A. Kühn, Volker A. Coenen, Joachim K. Krauss, Cordula Matthies, Ioannis U. Isaias, Ann-Kristin Helmers, Virgina Maltese, Werner Poewe, Martin M. Reich, Robert Nickl, Jens Volkmann, Joachim Runge, Fritz Wodarg, Wilhelm Eisner, and Philipp Mahlknecht
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Deep brain stimulation ,Deep Brain Stimulation ,medicine.medical_treatment ,Stimulation ,Globus Pallidus ,Brain mapping ,White matter ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Humans ,Cervical dystonia ,Neurostimulation ,Aged ,Probability ,Retrospective Studies ,Dystonia ,Brain Mapping ,business.industry ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Electrodes, Implanted ,Treatment Outcome ,030104 developmental biology ,Globus pallidus ,medicine.anatomical_structure ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Deep brain stimulation of the internal globus pallidus is a highly effective and established therapy for primary generalized and cervical dystonia, but therapeutic success is compromised by a non-responder rate of up to 25%, even in carefully-selected groups. Variability in electrode placement and inappropriate stimulation settings may account for a large proportion of this outcome variability. Here, we present probabilistic mapping data on a large cohort of patients collected from several European centres to resolve the optimal stimulation volume within the pallidal region. A total of 105 dystonia patients with pallidal deep brain stimulation were enrolled and 87 datasets (43 with cervical dystonia and 44 with generalized dystonia) were included into the subsequent 'normative brain' analysis. The average improvement of dystonia motor score was 50.5 ± 30.9% in cervical and 58.2 ± 48.8% in generalized dystonia, while 19.5% of patients did not respond to treatment (
- Published
- 2019