Freezing of Gait After Bilateral Globus Pallidus Interna Deep Brain Stimulation in Generalized Dystonia

Deep Brain Stimulation ◽

10.1093/med/9780190647209.003.0021 ◽

2020 ◽

pp. 105-108

Author(s):

Mariana Moscovich

Keyword(s):

Deep Brain Stimulation ◽

Globus Pallidus ◽

Brain Stimulation ◽

Freezing Of Gait ◽

Left Handed ◽

Old Left ◽

Generalized Dystonia ◽

Walking Difficulty ◽

Deep Brain

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a safe and long-term effective treatment for medication-refractory dystonia. However, complications and side effects may occur. Freezing of gait (FOG) is a rare phenomenon in patients with dystonia, although very frequently this complication is observed in patients with Parkinson disease (PD). FOG can be disabling and may severely impair quality of life, even when episodic. This chapter reports on a case of a 49-year-old left-handed man presenting with FOG, impairment in balance, and walking difficulty. These issues emerged 3 years after successful bilateral GPi DBS for primary generalized dystonia.

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Disease Stabilization of DYT1-Positive Primary Generalized Dystonia With Deep Brain Stimulation of the Globus Pallidus Interna: A 15-Year Follow-up

Operative Neurosurgery ◽

10.1093/ons/opx137 ◽

2017 ◽

Vol 14 (5) ◽

pp. E53-E57 ◽

Cited By ~ 2

Author(s):

Derrick A Dupre ◽

Raj Nangunoori ◽

Sravanthi Koduri ◽

Cindy Angle ◽

Diane Cantella ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Globus Pallidus ◽

Brain Stimulation ◽

Disease Stabilization ◽

Long Term Follow Up ◽

Generalized Dystonia ◽

The Right ◽

Deep Brain

Abstract BACKGROUND AND IMPORTANCE Primary generalized dystonia (PGD) is a genetic form of dystonia that frequently displays pharmacological resistance and progresses quickly after onset. Deep brain stimulation (DBS) has been used successfully to treat refractory dystonia, specifically globus pallidus interna (GPi) DBS for DYT1-positive PGD patients. Long-term follow-up of the safety and efficacy falls short of the longevity seen in other diseases treated with DBS. CASE PRESENTATION A male patient presented for neurosurgical evaluation with scapular winging, hand contractures, and violent truncal spasms, which forced him to be bedridden. After failing conservative therapy, the 18-yr-old patient was implanted with bilateral GPi-DBS. DBS parameter adjustments were made primarily within the first 3 yr after implantation, with nominal changes thereafter. Initial settings were contact of 3 + 0−, amplitude of 4.9 V, frequency of 185 Hz, and pulse width of 270 μsec on the left and 3 + 0−, 2.8 V, 185 Hz, and 120 μsec on the right. Current settings are 3 + 2 + 1−, 5.2 V, 130 Hz, 330 μsec on the left and 3 + 0−, 3.5 V, 185 Hz, and 180 μsec on the right and have been relatively unchanged in the past 4 yr. Unified dystonia rating scale scores reveal a significant decrease in dystonic symptoms. CONCLUSION While prior reports have shown that GPi-DBS is effective for dystonia, this is the first with 15 yr of long-term follow-up showing disease stabilization, suggesting that stimulation is efficacious and can potentially prevent disease progression. This report reaffirms previous reports that recommend early surgical intervention before the onset of permanent musculoskeletal deficits.

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Freezing of Gait 3 Years After Bilateral Globus Pallidus Internus Deep Brain Stimulation in Generalized Dystonia

Movement Disorders Clinical Practice ◽

10.1002/mdc3.12071 ◽

2014 ◽

Vol 1 (3) ◽

pp. 263-264

Author(s):

Mariana Moscovich ◽

Alexandre Novicki Francisco ◽

Erich Talamoni Fonoff ◽

Manoel Jacobsen Teixeira ◽

Helio A.G. Teive

Keyword(s):

Deep Brain Stimulation ◽

Globus Pallidus ◽

Brain Stimulation ◽

Freezing Of Gait ◽

Globus Pallidus Internus ◽

Generalized Dystonia ◽

Deep Brain

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Deep brain stimulation treatment in dystonia: a bibliometric analysis

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200016 ◽

2020 ◽

Vol 78 (9) ◽

pp. 586-592

Author(s):

Clarice LISTIK ◽

Eduardo LISTIK ◽

Rubens Gisbert CURY ◽

Egberto Reis BARBOSA ◽

Manoel Jacobsen TEIXEIRA ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Bibliometric Analysis ◽

Brain Stimulation ◽

The United States ◽

Scientific Journals ◽

Long Term Outcomes ◽

Generalized Dystonia ◽

Research Domain ◽

Deep Brain

ABSTRACT Background: Dystonia is a heterogeneous disorder that, when refractory to medical treatment, may have a favorable response to deep brain stimulation (DBS). A practical way to have an overview of a research domain is through a bibliometric analysis, as it makes it more accessible for researchers and others outside the field to have an idea of its directions and needs. Objective: To analyze the 100 most cited articles in the use of DBS for dystonia treatment in the last 30 years. Methods: The research protocol was performed in June 2019 in Elsevier’s Scopus database, by retrieving the most cited articles regarding DBS in dystonia. We analyzed authors, year of publication, country, affiliation, and targets of DBS. Results: Articles are mainly published in Movement Disorders (19%), Journal of Neurosurgery (9%), and Neurology (9%). European countries offer significant contributions (57% of our sample). France (192.5 citations/paper) and Germany (144.1 citations/paper) have the highest citation rates of all countries. The United States contributes with 31% of the articles, with 129.8 citations/paper. The publications are focused on General outcomes (46%), followed by Long-term outcomes (12.5%), and Complications (11%), and the leading type of dystonia researched is idiopathic or inherited, isolated, segmental or generalized dystonia, with 27% of articles and 204.3 citations/paper. Conclusions: DBS in dystonia research is mainly published in a handful of scientific journals and focused on the outcomes of the surgery in idiopathic or inherited, isolated, segmental or generalized dystonia, and with globus pallidus internus as the main DBS target.

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