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The Influence of Deep Brain Stimulation Intensity and Duration on Symptoms Evolution in an OFF Stimulation Dystonia Study
- Source :
- Brain Stimulation, Vol 6, Iss 4, Pp 500-505 (2013)
- Publication Year :
- 2013
- Publisher :
- Elsevier, 2013.
-
Abstract
- Background: Deep brain stimulation (DBS) of the internal globus pallidus (GPi) is an established therapy for primary generalized dystonia. However, the evolution of dystonia symptoms after DBS discontinuation after years of therapy has only rarely been reported. We therefore longitudinally studied the main physiological measurements known to be impaired in dystonia, with DBS ON and then again after termination of DBS, after at least five years of continuous DBS. Objective: We studied whether dystonia evolution after DBS discontinuation in patients benefiting from long-term GPi DBS is different from that observed in earlier stages of the therapy. Methods: In eleven DYT1 patients treated with bilateral GPi DBS for at least 5 years, dystonia was assessed ON-DBS, immediately after switch-off (OFF-DBS1) and 48 h after DBS termination (OFF-DBS2). We studied the influence of DBS intensity on dystonia when DBS was discontinued. Results: On average a significant difference in symptoms was measured only between ON-DBS and OFF-DBS1 conditions. Importantly, none of the patients returned to their preoperative dystonia severity, even 48 h after discontinuation. The amount of clinical deterioration in the OFF conditions positively correlated with higher stimulation current in the chronic ON-DBS condition. Conclusions: The duration of DBS application influences symptom evolution after DBS termination. DBS intensity seems to have a prominent role on evolution of dystonic symptoms when DBS is discontinued. In conclusion, DBS induces changing modulation of the motor network with less worsening of symptoms after long term stimulation, when DBS is stopped.
- Subjects :
- Adult
Male
endocrine system
Deep brain stimulation
Adolescent
Dystonia evolution
Deep brain stimulation duration
medicine.medical_treatment
Deep Brain Stimulation
Biophysics
Stimulation
Globus Pallidus
Severity of Illness Index
behavioral disciplines and activities
lcsh:RC321-571
Generalized dystonia
otorhinolaryngologic diseases
medicine
Intensity and arrest
Humans
Longitudinal Studies
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry
Aged
Dystonia
Internal globus pallidus
General Neuroscience
Middle Aged
medicine.disease
Intensity (physics)
nervous system diseases
Globus pallidus
Treatment Outcome
surgical procedures, operative
nervous system
Dystonic Disorders
Female
Neurology (clinical)
Psychology
Neuroscience
therapeutics
Dystonic disorder
Subjects
Details
- Language :
- English
- Volume :
- 6
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Brain Stimulation
- Accession number :
- edsair.doi.dedup.....fdb21351adb23c899083c7d062dfa42c