4.3 Review

Arching deep brain stimulation in dystonia types

Journal

JOURNAL OF NEURAL TRANSMISSION
Volume 128, Issue 4, Pages 539-547

Publisher

SPRINGER WIEN
DOI: 10.1007/s00702-021-02304-4

Keywords

Dystonia; Deep brain stimulation (DBS); Pallidal; Subthalamic; Inherited

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Deep brain stimulation (DBS) is an effective and safe treatment for certain types of dystonia, providing significant clinical improvement in patients who do not respond well to other treatments. However, further research is needed to evaluate the efficacy of DBS in other types of dystonia.
Although medical treatment including botulinum toxic injection is the first-line treatment for dystonia, response is insufficient in many patients. In these patients, deep brain stimulation (DBS) can provide significant clinical improvement. Mounting evidence indicates that DBS is an effective and safe treatment for dystonia, especially for idiopathic and inherited isolated generalized/segmental dystonia, including DYT-TOR1A. Other inherited dystonia and acquired dystonia also respond to DBS to varying degrees. For Meige syndrome (craniofacial dystonia), other focal dystonia, and some rare inherited dystonia, further evidences are still needed to evaluate the role of DBS. Because short disease duration at DBS surgery and absence of fixed musculoskeletal deformity are associated with better outcome, DBS should be considered as early as possible when indicated after careful evaluation including genetic work-up. This review will focus on the factors to be considered in DBS for patients with dystonia and the outcome of DBS in the different types of dystonia.

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