Clinical outcomes and prognostic factors in patients with primary Meige syndrome undergoing subthalamic nucleus deep brain stimulation: a retrospective study of 65 cases.
Zhebin Feng, Bin Liu, Junpeng Xu, Yanyang Zhang, Zhipei Ling, Xin Xu, Zhiguo Ma, Xinguang Yu, Zhiqi Mao
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引用次数: 0
Abstract
Objective: Subthalamic nucleus deep brain stimulation (STN-DBS) for primary Meige syndrome has been increasingly reported in recent years. Despite the potential of this therapeutic approach, only a limited number of studies have evaluated its clinical benefits. Moreover, the efficacy of STN-DBS varies among patients with Meige syndrome, and stable prognostic predictors are scarce. In this study, the authors assessed the therapeutic effect of STN-DBS for Meige syndrome and explored reliable prognostic indicators to facilitate patient selection and postoperative programming.
Methods: The authors enrolled 65 consecutive patients with Meige syndrome who underwent bilateral STN-DBS at their institution. Preoperative and postoperative motor symptoms were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale movement (BFMDRS-M) and disability (BFMDRS-D) subscales. Leads were reconstructed in the standard space by using the Lead-DBS toolbox, and the volume of tissue activated (VTA) was calculated for each lead. Group comparisons and multivariate logistic regression analyses were conducted to evaluate clinical and demographic factors influencing the improvement rates in BFMDRS-M scores.
Results: Significant postoperative improvements in the BFMDRS-M score (59.17% ± 28.0%, p < 0.001) and in the BFMDRS-D score (65.05% ± 38.9%, p < 0.001) were observed. Group comparisons indicated that the y-axis value of active contacts, the overlapping volume between VTAs and the STN sensorimotor region, as well as the distance from the center of active contacts to the surface of the STN sensorimotor region were significantly associated with the improvement rate of BFMDRS-M scores. Multivariate logistic regression analyses revealed that both the overlapping volume between VTAs and bilateral STN sensorimotor regions-along with the involvement of the left STN limbic region-emerged as independent prognostic indicators for the improvement in BFMDRS-M scores.
Conclusions: Bilateral STN-DBS proved to be a safe and effective treatment for Meige syndrome, and the STN sensorimotor region tended to be a desirable target. This study provided deeper insights into the clinical efficacy, patient selection, and targeting precision of STN-DBS treatment for Meige syndrome.
期刊介绍:
The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.