Open AccessDeep brain stimulation in dystonia: factors contributing to variability in outcome in short and long term follow-up
Author(s) -
Stephen Tisch
Publication year - 2022
Publication title -
current opinion in neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 119
eISSN - 1473-6551
pISSN - 1350-7540
DOI - 10.1097/wco.0000000000001072
Subject(s) - deep brain stimulation , dystonia , subthalamic nucleus , physical medicine and rehabilitation , medicine , neurostimulation , psychology , neuroscience , parkinson's disease , stimulation , disease
Deep brain stimulation (DBS) is currently the most effective treatment for medically refractory dystonia with globus pallidus internus (GPi) usually the preferred target. Despite the overall success of DBS in dystonia, there remains variability in treatment outcome in both short and long-term follow-up, due to various factors. Factors contributing to variability in outcome comprise 'Dystonia Related' including dystonia classification, semiology, duration, body distribution, orthopaedic deformity, aetiology and genetic cause. The majority of these factors are identifiable from clinical assessment, brain MRI and genetic testing, and therefore merit careful preoperative consideration. 'DBS related' factors include brain target, accuracy of lead placement, stimulation parameters, time allowed for response, neurostimulation technology employed and DBS induced side-effects. In this review, factors contributing to variability in short and long-term dystonia DBS outcome are reviewed and discussed.