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Analysis of Gene Expression Changes in the Rat Hippocampus After Deep Brain Stimulation of the Anterior Thalamic Nucleus
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Deep brain stimulation for dystonia.

Marie Vidailhet1, Marie-France Jutras, Emmanuel Roze

  • 1Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Research Center of the Brain and Spinal Cord Institute, Université Paris 6/Inserm UMR S975, Paris, France; Pierre et Marie Curie Paris-6 University, Paris, France.

Handbook of Clinical Neurology
|October 12, 2013
PubMed
Summary
This summary is machine-generated.

Deep brain stimulation (DBS) of the globus pallidus interna is effective for hyperkinetic disorders. However, optimal target selection and outcome prediction for dystonia subtypes remain challenging.

Keywords:
GPicerebral palsydeep brain stimulationdystoniadystonia–choreoathetosismyoclonus dystoniapallidumsecondary dystoniasubthalamic nucleus (STN)tardive dyskinesiathalamus

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Area of Science:

  • Neurology
  • Neurosurgery
  • Movement Disorders

Background:

  • Bilateral globus pallidus interna (GPi) deep brain stimulation (DBS) is established for hyperkinetic disorders.
  • Limited controlled data exist for secondary dystonia and other subtypes, hindering target selection and efficacy assessment.

Purpose of the Study:

  • To review the literature on DBS for primary dystonia, focusing on risk:benefit and predictive factors.
  • To analyze DBS efficacy in myoclonus dystonia, tardive dystonia-dyskinesia, and various secondary dystonias.
  • To highlight challenges in predicting treatment timelines and assessing global outcomes.

Main Methods:

  • Comprehensive literature review of controlled studies and case reports on DBS for dystonia.
  • Analysis of target selection, efficacy, safety, and predictive factors for different dystonia types.
  • Evaluation of outcomes in primary, secondary, myoclonus, and tardive dystonia.

Main Results:

  • GPi DBS is safe and effective for primary dystonia, myoclonus dystonia, and tardive dystonia-dyskinesia.
  • Evidence for secondary dystonia is limited, showing moderate benefit in some cases.
  • Pallidal stimulation is more effective than thalamic for myoclonus dystonia.
  • Predicting benefit timescale and global functional outcomes remains difficult due to interpatient variability.

Conclusions:

  • DBS is a viable treatment for specific dystonia types, particularly primary and related disorders with normal imaging/cognition.
  • Target selection requires careful consideration of individual symptoms and variability.
  • Further research with standardized evaluation tools is needed to optimize DBS treatment and outcome prediction.