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Dual Pallidal and Thalamic Deep Brain Stimulation for Complex Ipsilateral Dystonia

Authors
 Kyung Won Chang  ;  Myung Ji Kim  ;  So Hee Park  ;  Won Seok Chang  ;  Hyun Ho Jung  ;  Jin Woo Chang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.63(2) : 166-172, 2022-02 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2022-02
MeSH
Deep Brain Stimulation* ; Dystonia* / therapy ; Dystonic Disorders* / therapy ; Globus Pallidus ; Humans ; Treatment Outcome
Keywords
Dystonia ; deep brain stimulation ; globus pallidus ; multi target dbs ; ventralis oralis
Abstract
Purpose: Globus pallidus pars interna (GPi) has become an established target for deep brain stimulation (DBS) in dystonia. Previous studies suggest that targeting the ventralis oralis (Vo) complex nucleus improves dystonic tremor or even focal dystonia. Research has also demonstrated that multi-target DBS shows some benefits over single target DBS. In this study, we reviewed patients who had undergone unilateral DBS targeting the GPi and Vo.

Materials and methods: Five patients diagnosed with medically refractory upper extremity dystonia (focal or segmental) underwent DBS. Two DBS electrodes each were inserted unilaterally targeting the ipsilateral GPi and Vo. Clinical outcomes were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and Disability Rating Scale.

Results: BFMDRS scores decreased by 55% at 1-month, 56% at 3-month, 59% at 6-month, and 64% at 12-month follow up. Disability Rating Scale scores decreased 41% at 1-month, 47% at 3-month, 50% at 6-month, and 60% at 12-month follow up. At 1 month after surgery, stimulating both targets improved clinical scores better than targeting GPi or Vo alone.

Conclusion: Unilateral thalamic and pallidal dual electrode DBS may be as effective or even superior to DBS of a single target for dystonia. Although the number of patients was small, our results reflected favorable clinical outcomes.
Files in This Item:
T202201341.pdf Download
DOI
10.3349/ymj.2022.63.2.166
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Park, So Hee(박소희)
Chang, Kyung Won(장경원)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Hyun Ho(정현호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188494
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