Dual Pallidal and Thalamic Deep Brain Stimulatifor Complex Ipsilateral Dystonia

Kyung Won Chang, Myung Ji Kim, So Hee Park, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Globus pallidus pars interna (GPi) has become an established target for deep brain stimulation (DBS) in dystonia. Pre-vious 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 evalu-ated 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.

Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalYonsei medical journal
Volume63
Issue number2
DOIs
Publication statusPublished - 2022 Feb

Bibliographical note

Publisher Copyright:
© Yonsei University College of Medicine 2022.

All Science Journal Classification (ASJC) codes

  • General Medicine

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