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29.10.2019 | Original Article - Functional Neurosurgery - Movement disorders

Range of voluntary neck motility predicts outcome of pallidal DBS for cervical dystonia

Zeitschrift:
Acta Neurochirurgica
Autoren:
Ryoong Huh, Moonyoung Chung
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00701-019-04076-z) contains supplementary material, which is available to authorized users.
This article is part of the Topical Collection on Functional Neurosurgery - Movement disorders

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Abstract

Background

The effectiveness of pallidal deep brain stimulation (GPi DBS) for cervical dystonia has been extensively described, but controversies exist about which prognostic factor is clinically useful. We previously reported that classification of tonic- or phasic-type cervical dystonia is useful for predicting clinical prognosis; however, the approach used by physicians to distinguish between the two types remains subjective.

Objective

The aim of this study was to develop a prognostic factor of GPi DBS for cervical dystonia.

Methods

By identifying distributions of range of motion scores between phasic- and tonic-type cervical dystonia, a new prognostic factor group was developed based on whether the patients could voluntarily move their head to the opposite side against dystonic motions. The prognosis for GPi DBS in the two groups was analyzed according to the time sequence.

Results

Patients who were able to move their head past the midline had a better long-term prognosis after GPi DBS than did those who could not. In the early post-operative phase, there were no significant differences in the clinical outcomes between the two groups.

Conclusion

A range of voluntary neck motility with respect to the midline is an objective factor that is useful in predicting the prognosis of patients with cervical dystonia. This result renders needs for future study addressing neuroplastic changes in the brain network caused by GPi DBS.

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