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Published on: August 12, 2018
Systematic Review and Descriptive Pooled Analysis: Deep Brain Stimulation Efficacy for Laryngeal Dystonia
Miraan Jhaveri1, Mary Hawkshaw2, Robert T Sataloff2
1Downingtown STEM Academy, Downingtown, Pennsylvania.
Journal of Voice : Official Journal of the Voice Foundation
|August 6, 2026
Summary
Deep brain stimulation (DBS) shows promise for treating laryngeal dystonia (LD) when botulinum toxin type-A (BTX-A) fails. This review found significant voice improvements in patients receiving DBS, particularly in the Ventral Intermediate nucleus.
Area of Science:
- Neurology
- Otolaryngology
- Neurosurgery
Background:
- Laryngeal dystonia (LD) causes involuntary vocal cord spasms, impairing speech.
- Botulinum toxin type-A (BTX-A) is the standard treatment, but some patients develop resistance or experience inadequate relief.
- Deep brain stimulation (DBS) presents a potential alternative therapy for refractory LD.
Purpose of the Study:
- To systematically review and analyze the existing evidence on the efficacy of DBS for treating laryngeal dystonia.
- To synthesize voice outcome data from studies reporting on DBS interventions for LD.
Main Methods:
- A comprehensive systematic literature search was performed across major scientific databases (MEDLINE, Web of Science, Scopus, Google Scholar) following PRISMA 2020 guidelines.
- Studies including adult LD patients who underwent DBS and reported voice outcomes were eligible for inclusion.
- Due to heterogeneity, outcomes were descriptively pooled, reporting absolute changes and percentage improvements from baseline.
Main Results:
- Ten studies (2 RCTs, 2 case series, 6 case reports) involving 24 patients were analyzed.
- Patients predominantly had adductor LD and received Ventral Intermediate nucleus (VIM) DBS.
- Significant voice improvements were observed: 47.6% on the Unified Spasmodic Dysphonia Rating Scale (USDRS), 49.5% on the Voice Handicap Index (VHI), and >74% on the Voice-Related Quality of Life (VR-QOL) scale.
Conclusions:
- Deep brain stimulation (DBS), specifically targeting the Ventral Intermediate (VIM) nucleus, demonstrates efficacy in improving voice in patients with laryngeal dystonia (LD) resistant to BTX-A.
- The current evidence is largely based on case-level data, highlighting the need for more robust prospective studies.
- Future research, including multicenter trials and randomized controlled studies, is essential to confirm DBS efficacy and assess treatment durability for LD.
