Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia
Tardive dystonia (TD) is a side effect of prolonged dopamine receptor antagonist intake. TD can be a chronic disabling movement disorder despite medical treatment. We previously demonstrated successful outcomes in six patients with TD using deep brain stimulation (DBS); however, more patients are ne...
| Автори: | , , , , , , , , , , |
|---|---|
| Формат: | Стаття |
| Мова: | English |
| Опубліковано: |
MDPI AG
2021-05-01
|
| Серія: | Life |
| Предмети: | |
| Онлайн доступ: | https://www.mdpi.com/2075-1729/11/6/477 |
| _version_ | 1827691620940644352 |
|---|---|
| author | Hiroshi Koyama Hideo Mure Ryoma Morigaki Ryosuke Miyamoto Kazuhisa Miyake Taku Matsuda Koji Fujita Yuishin Izumi Ryuji Kaji Satoshi Goto Yasushi Takagi |
| author_facet | Hiroshi Koyama Hideo Mure Ryoma Morigaki Ryosuke Miyamoto Kazuhisa Miyake Taku Matsuda Koji Fujita Yuishin Izumi Ryuji Kaji Satoshi Goto Yasushi Takagi |
| author_sort | Hiroshi Koyama |
| collection | DOAJ |
| description | Tardive dystonia (TD) is a side effect of prolonged dopamine receptor antagonist intake. TD can be a chronic disabling movement disorder despite medical treatment. We previously demonstrated successful outcomes in six patients with TD using deep brain stimulation (DBS); however, more patients are needed to better understand the efficacy of DBS for treating TD. We assessed the outcomes of 12 patients with TD who underwent globus pallidus internus (GPi) DBS by extending the follow-up period of previously reported patients and enrolling six additional patients. All patients were refractory to pharmacotherapy and were referred for surgical intervention by movement disorder neurologists. In all patients, DBS electrodes were implanted bilaterally within the GPi under general anesthesia. The mean ages at TD onset and surgery were 39.2 ± 12.3 years and 44.6 ± 12.3 years, respectively. The Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) performed the preoperative and postoperative evaluations. The average BFMDRS improvement rate at 1 month postoperatively was 75.6 ± 27.6% (<i>p</i> < 0.001). Ten patients were assessed in the long term (78.0 ± 50.4 months after surgery), and the long-term BFMDRS improvement was 78.0 ± 20.4%. Two patients responded poorly to DBS. Both had a longer duration from TD onset to surgery and older age at surgery. A cognitive and psychiatric decline was observed in the oldest patients, while no such decline ware observed in the younger patients. In most patients with TD, GPi-DBS could be a beneficial therapeutic option for long-term relief of TD. |
| first_indexed | 2024-03-10T11:05:14Z |
| format | Article |
| id | doaj.art-3ed5c17d9a1948fba0f866e16e133185 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T11:05:14Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-3ed5c17d9a1948fba0f866e16e1331852023-11-21T21:11:08ZengMDPI AGLife2075-17292021-05-0111647710.3390/life11060477Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive DystoniaHiroshi Koyama0Hideo Mure1Ryoma Morigaki2Ryosuke Miyamoto3Kazuhisa Miyake4Taku Matsuda5Koji Fujita6Yuishin Izumi7Ryuji Kaji8Satoshi Goto9Yasushi Takagi10Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanDepartment of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanDepartment of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanParkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima 770-8503, JapanDepartment of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanDepartment of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanParkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima 770-8503, JapanParkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima 770-8503, JapanDepartment of Neurology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanParkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima 770-8503, JapanDepartment of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, JapanTardive dystonia (TD) is a side effect of prolonged dopamine receptor antagonist intake. TD can be a chronic disabling movement disorder despite medical treatment. We previously demonstrated successful outcomes in six patients with TD using deep brain stimulation (DBS); however, more patients are needed to better understand the efficacy of DBS for treating TD. We assessed the outcomes of 12 patients with TD who underwent globus pallidus internus (GPi) DBS by extending the follow-up period of previously reported patients and enrolling six additional patients. All patients were refractory to pharmacotherapy and were referred for surgical intervention by movement disorder neurologists. In all patients, DBS electrodes were implanted bilaterally within the GPi under general anesthesia. The mean ages at TD onset and surgery were 39.2 ± 12.3 years and 44.6 ± 12.3 years, respectively. The Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) performed the preoperative and postoperative evaluations. The average BFMDRS improvement rate at 1 month postoperatively was 75.6 ± 27.6% (<i>p</i> < 0.001). Ten patients were assessed in the long term (78.0 ± 50.4 months after surgery), and the long-term BFMDRS improvement was 78.0 ± 20.4%. Two patients responded poorly to DBS. Both had a longer duration from TD onset to surgery and older age at surgery. A cognitive and psychiatric decline was observed in the oldest patients, while no such decline ware observed in the younger patients. In most patients with TD, GPi-DBS could be a beneficial therapeutic option for long-term relief of TD.https://www.mdpi.com/2075-1729/11/6/477tardive dystoniadeep brain stimulationglobus pallidus internuslong-term follow-up |
| spellingShingle | Hiroshi Koyama Hideo Mure Ryoma Morigaki Ryosuke Miyamoto Kazuhisa Miyake Taku Matsuda Koji Fujita Yuishin Izumi Ryuji Kaji Satoshi Goto Yasushi Takagi Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia Life tardive dystonia deep brain stimulation globus pallidus internus long-term follow-up |
| title | Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia |
| title_full | Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia |
| title_fullStr | Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia |
| title_full_unstemmed | Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia |
| title_short | Long-Term Follow-Up of 12 Patients Treated with Bilateral Pallidal Stimulation for Tardive Dystonia |
| title_sort | long term follow up of 12 patients treated with bilateral pallidal stimulation for tardive dystonia |
| topic | tardive dystonia deep brain stimulation globus pallidus internus long-term follow-up |
| url | https://www.mdpi.com/2075-1729/11/6/477 |
| work_keys_str_mv | AT hiroshikoyama longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT hideomure longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT ryomamorigaki longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT ryosukemiyamoto longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT kazuhisamiyake longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT takumatsuda longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT kojifujita longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT yuishinizumi longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT ryujikaji longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT satoshigoto longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia AT yasushitakagi longtermfollowupof12patientstreatedwithbilateralpallidalstimulationfortardivedystonia |