Document Detail


The Canadian multicenter trial of pallidal deep brain stimulation for cervical dystonia: preliminary results in three patients.
MedLine Citation:
PMID:  15264774     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is beneficial for generalized dystonia and has been proposed as a treatment for cervical dystonia. The Canadian Stereotactic/Functional and Movement Disorders Groups designed a pilot project to investigate the following hypothesis: that bilateral DBS of the GPi will reduce the severity of cervical dystonia at 1 year of follow up, as scored in a blinded fashion by two neurologists using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Secondary outcome measures included pain and disability subscores of the TWSTRS, Short Form-36 quality of life index, and the Beck Depression Inventory. METHODS: Three patients have undergone surgery in Calgary with a follow-up duration of 7.4 +/- 5.9 months (mean +/- standard deviation). One patient underwent inadvertent ineffective stimulation for the first 3 months and did not experience a benefit until DBS programming was corrected. All three patients had rapid response to stimulation, with the muscles relaxing immediately and abnormal movements improving within days. Total TWSTRS scores improved by 79%, and severity subscores improved significantly, from 15.7 +/- 2.1 to 7.7 +/- 2.9 (paired t-test, p = 0.02). Pain and disability subscores improved from 25.5 +/- 4.1 to 3.3 +/- 3.1 (paired t-test, p = 0.002) and from 13.3 +/- 4.9 to 3.3 +/- 4.2 (paired t-test, p = 0.06), respectively. CONCLUSIONS: Although it is too early to reach broad conclusions, this report of preliminary results confirms the efficacy of DBS of the GPi for cervical dystonia.
Authors:
Zelma H Kiss; Kristina Doig; Michael Eliasziw; Ranjiit Ranawaya; Oksana Suchowersky
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Publication Detail:
Type:  Case Reports; Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2004-07-15
Journal Detail:
Title:  Neurosurgical focus     Volume:  17     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-21     Completed Date:  2004-10-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E5     Citation Subset:  IM    
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Alberta, Canada. zkiss@ucalgary.ca
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MeSH Terms
Descriptor/Qualifier:
Amitriptyline / therapeutic use
Botulinum Toxins / therapeutic use
Cannabis
Combined Modality Therapy
Drug Therapy, Combination
Dysarthria / etiology,  therapy
Electric Stimulation Therapy*
Electrodes, Implanted
Feasibility Studies
Female
Globus Pallidus / physiopathology*
Humans
Lactones / therapeutic use
Lorazepam / therapeutic use
Magnetic Resonance Imaging
Male
Middle Aged
Propranolol / therapeutic use
Rhizotomy
Sulfones
Torticollis / complications,  drug therapy,  physiopathology,  surgery,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Botulinum Toxins; 0/Lactones; 0/Sulfones; 0/rofecoxib; 50-48-6/Amitriptyline; 525-66-6/Propranolol; 846-49-1/Lorazepam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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