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Bilateral, pallidal, deep-brain stimulation in primary generalised dystonia: a prospective 3 year follow-up study.
- Source :
-
The Lancet. Neurology [Lancet Neurol] 2007 Mar; Vol. 6 (3), pp. 223-9. - Publication Year :
- 2007
-
Abstract
- Background: We have previously reported the efficacy and safety of bilateral pallidal stimulation for primary generalised dystonia in a prospective, controlled, multicentre study with 1 year of follow-up. Although long-term results have been reported by other groups, no controlled assessment of motor and non-motor results is available. In this prospective multicentre 3 year follow-up study, involving the same patients as those enrolled in the 1 year follow-up study, we assessed the effect of bilateral pallidal stimulation on motor impairment, disability, quality of life, cognitive performance, and mood.<br />Methods: We studied 22 patients with primary generalised dystonia after 3 years of bilateral pallidal stimulation. We compared outcome at 3 years with their status preoperatively and after 1 year of treatment. Standardised video recordings were scored by an independent expert. Data were analysed on an intention-to-treat basis.<br />Findings: Motor improvement observed at 1 year (51%) was maintained at 3 years (58%). The improvement in quality of life (SF-36 questionnaire) was similar to that observed at 1 year. Relative to baseline and to the 1 year assessment, cognition and mood were unchanged 3 years after surgery, but slight improvements were noted in concept formation, reasoning, and executive functions. Pallidal stimulation was stopped bilaterally in three patients because of lack of improvement, technical dysfunction, and infection, and unilaterally in two patients because of electrode breakage and stimulation-induced contracture. No permanent adverse effects were observed.<br />Interpretation: Bilateral pallidal stimulation provides sustained motor benefit after 3 years. Mild long-term improvements in quality of life and attention were also observed.
- Subjects :
- Adolescent
Adult
Affect
Age of Onset
Cognition physiology
Disability Evaluation
Dystonia physiopathology
Dystonia psychology
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Molecular Chaperones genetics
Movement physiology
Neuropsychological Tests
Prospective Studies
Psychiatric Status Rating Scales
Quality of Life
Surveys and Questionnaires
Treatment Outcome
Deep Brain Stimulation
Dystonia therapy
Globus Pallidus physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1474-4422
- Volume :
- 6
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Lancet. Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 17303528
- Full Text :
- https://doi.org/10.1016/S1474-4422(07)70035-2