Could systemic infections influence the effectiveness of deep brain stimulation therapy in patients with dystonia?

Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions resulting from aberrant sensory integration, enhanced cortical plasticity, and lack of intracortical inhibition. Deep brain stimulation of the globus pallidus internus (GPi-DBS) effectively treats dystonia, reducing abnormal neural oscillations and improving motor function. However, systemic infections can significantly impact brain function, altering brain wave dynamics and cortical excitability. We hypothesize that dystonia patients treated with DBS exhibit altered cortical excitability and changes in brain wave dynamics during early recovery from systemic infections, necessitating DBS parameters adjustment to prevent symptoms exacerbation. We propose a two-year clinical study involving 15 dystonia patients with DBS capable of local field potential (LFP) recording to evaluate this hypothesis. The study will analyze brain activity patterns, symptom severity and infection impact on neural activity. Continuous and infection-triggered LFP recording will provide data for advanced analysis to identify LFP patterns associated with dystonia symptoms and the effects of infections. This paper underscored the importance of individualized and dynamic DBS management, especially post-infection. Systemic infections can induce neuroinflammation, disrupting neural circuits and increasing brain sensitivity to DBS. Timely DBS adjustments are crucial to mitigate overstimulation and optimize outcomes. Enhanced post-infection care, including thorough evaluations and parameter adjustments, is essential for managing dystonia patients with DBS. Future research into the neuroinflammatory mechanism and their effect on neural circuits will improve our understanding and treatment of dystonia in the context of systemic infections.