Bilateral subthalamic nucleus deep brain stimulation for refractory isolated cervical dystonia

Area of Science:

• Neurology
• Neurosurgery
• Movement Disorders

Background:

• Refractory isolated cervical dystonia (CD) presents significant challenges for treatment.
• Subthalamic nucleus (STN) deep brain stimulation (DBS) is an emerging therapeutic option for CD.
• Limited data exists on the long-term safety and efficacy of STN DBS for CD.

Purpose of the Study:

• To evaluate the short and long-term safety and efficacy of bilateral STN DBS in patients with refractory isolated CD.
• To assess the sustained effectiveness of STN DBS on dystonic symptoms and quality of life.

Main Methods:

• Retrospective study of nine consecutive patients with refractory isolated CD who underwent bilateral STN DBS.
• Assessment of dystonic symptom improvement using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores at multiple time points.
• Evaluation of quality of life changes using the 36-item Short-Form General Health Survey (SF-36).

Main Results:

• All patients tolerated the surgery well and demonstrated observable clinical benefits.
• Significant and persistent improvements in TWSTRS scores were observed post-operation.
• Substantial improvements in quality of life (SF-36 scores) were reported at the last follow-up.
• Hardware-related adverse events were manageable, and stimulation-related adverse events were ameliorated through programming.

Conclusions:

• Bilateral STN DBS is a safe and effective treatment for refractory isolated CD.
• STN DBS provides persistent and remarkable improvements in both motor function and quality of life.
• This study supports STN DBS as a viable therapeutic strategy for challenging CD cases.