Pallidal and Thalamic Deep Brain Stimulation in the Treatment of Unilateral Dystonia: A Prospective Assessment.

IF 2.6 4区医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2024-08-02 DOI:10.1002/mdc3.14184

Juan Manuel Altamirano, Karla Salinas-Barboza

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Abstract

Background: The complexities of unilateral dystonia have led to exploring simultaneous (dual) globus pallidus internus (GPi) and motor ventral thalamus (Vim/Vop) deep brain stimulation (DBS), yet detailed assessments are lacking.

Objectives: To assess the efficacy of GPi, Vim/Vop, and dual DBS in unilateral dystonia.

Methods: Three patients with unilateral dystonia (two idiopathic, one acquired), implanted with two DBS electrodes targeting ipsilateral Vim/Vop and GPi, were included. Three stimulation modalities were assessed. First, one electrode was activated, then the other, and finally, both electrodes were activated simultaneously.

Results: DBS yielded substantial symptomatic reductions in all three evaluated stimulation modalities. Patients exhibited varying responses regarding quality-of-life and depressive symptoms. Treatment satisfaction didn't align with clinical improvements, potentially affected by unrealistic expectations.

Conclusions: This study contributes critical insights into GPi, Vim/Vop and simultaneous stimulation for unilateral dystonia. The safety of the procedure underscores the promise of this approach.

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苍白球和丘脑深部脑刺激治疗单侧肌张力障碍：前瞻性评估

背景：单侧肌张力障碍的复杂性促使人们探索同时（双重）刺激苍白球内肌（GPi）和运动丘脑腹侧（Vim/Vop）的脑深部刺激（DBS），但目前还缺乏详细的评估：评估 GPi、Vim/Vop 和双 DBS 对单侧肌张力障碍的疗效：方法：纳入三名单侧肌张力障碍患者（两名特发性患者，一名获得性患者），分别植入针对同侧 Vim/Vop 和 GPi 的两个 DBS 电极。对三种刺激模式进行了评估。首先激活一个电极，然后激活另一个电极，最后同时激活两个电极：结果：在所有三种评估的刺激模式中，DBS 都能显著减轻症状。患者对生活质量和抑郁症状的反应各不相同。治疗满意度与临床改善并不一致，这可能受到不切实际的期望的影响：这项研究为 GPi、Vim/Vop 和同步刺激治疗单侧肌张力障碍提供了重要见解。手术的安全性凸显了这种方法的前景。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders Clinical Practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

7.50%

发文量

218

期刊介绍： Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)

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