KeywordĬooper IS (1976) 20-Year follow up study of the neurosurgical treatment of dystonia musculorum deformans. GPi-DBS represents an important therapeutic option in many patients with primary generalized dystonia. Stimulation was being performed at an intensity of around 2.0 V with a pulse width of 0.21 ms at a high frequency ranging from 120 to 140 Hz. At 6 months after surgery, all patients were receiving bipolar stimulation with a wide interpolar distance, using contact 0 or 1 as the cathode and contact 2 or 3 as the anode. GPi-DBS produced a marked effect even in patients who had previously undergone thalamotomy or pallidotomy. The improvement in score ranged from −51% to −92%.
The score at 6 months after surgery reached a level ranging from 4 to 23. An improvement in the symptoms of dystonia was observed soon after the initiation of GPi-DBS, and additional progressive improvement was noted during a period of months or even years after surgery. The scores ranged from 18 to 62 before surgery. The symptoms of dystonia were scored by the Burke-Fahn-Marsden dystonia rating scale (BFMDRS). No surgical complications were encountered. Two of the patients had been treated previously by bilateral thalamotomy or unilateral pallidotomy at other clinics and then developed new symptoms or recurrence. The age at onset of dystonia ranged from 8 to 45 years and the age at surgery for GPi-DBS ranged from 17 to 59 years. A total of 5 patients with primary generalized dystonia underwent GPi-DBS.
Our experience of deep brain stimulation of the globus pallidus internus (GPi-DBS) for dystonia is summarized.
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