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01.06.2010 | Clinical Article

Regional cerebral blood flow changes induced by deep brain stimulation in secondary dystonia

verfasst von: Zinovia Kefalopoulou, Anna Paschali, Elli Markaki, John Ellul, Elisabeth Chroni, Pavlos Vassilakos, Constantine Constantoyannis

Erschienen in: Acta Neurochirurgica | Ausgabe 6/2010

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Abstract

Purpose

The purpose of the present study is to investigate the effect of deep brain stimulation (DBS) on regional cerebral blood flow (rCBF) in cases of secondary dystonia as well as to correlate the rCBF changes with clinical outcomes.

Methods

Six patients with medically intractable secondary dystonia who underwent DBS surgery were included in this study. Burke–Fahn–Mardsen Dystonia Rating Scale (BFMDRS) was used for the assessment of dystonia, before and after surgery. Single photon emission computed tomography (SPECT) of the brain was performed postoperatively in the two stimulation states (ON-DBS and OFF-DBS) and the changes of rCBF in the three following brain regions of interest (ROIs): primary motor cortex, premotor and supplementary motor cortex, and prefrontal cortex were evaluated.

Results

Two patients exhibited excellent response to DBS, two patients got moderate benefit after the procedure, and in two patients, no clinical improvement was achieved. A mean improvement of 49.1% (0–90.7%) in BFMDRS total scores was found postoperatively. Brain SPECT data analysis revealed an overall decrease in rCBF in the investigated ROIs, during the ON-DBS state. Clinical improvement was significantly correlated with the observed decrease in rCBF in the presence of DBS.

Conclusions

When conservative treatment fails to relieve severely disabled patients suffering from secondary dystonia, DBS may be a promising therapeutic alternative. Moreover, this study indicates a putative role of brain SPECT imaging as a postoperative indicator of clinical responsiveness to DBS.

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Titel: Regional cerebral blood flow changes induced by deep brain stimulation in secondary dystonia
verfasst von: Zinovia Kefalopoulou
Anna Paschali
Elli Markaki
John Ellul
Elisabeth Chroni
Pavlos Vassilakos
Constantine Constantoyannis
Publikationsdatum: 01.06.2010
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 6/2010
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-010-0612-y

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