Open AccessImprovement of non-motor symptoms and quality of life after DBS stimulation for dystonia: one-year follow-up
Author(s) -
Clarice Listik,
Rubens Gisbert Cury,
Sara Carvalho Barbosa Casagrande,
Eduardo Listik,
Débora Arnaut,
Natally Santiago,
Júlia de Lima Arantes Machado,
Jéssica de Souza Almeida,
Egberto Reis Barbosa,
Manoel Jacobsen Teixeira,
Daniel Ciampi de Andrade
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.253
Subject(s) - deep brain stimulation , brief pain inventory , medicine , dystonia , mcgill pain questionnaire , hospital anxiety and depression scale , parkinson's disease , quality of life (healthcare) , depression (economics) , prospective cohort study , refractory (planetary science) , rating scale , physical therapy , chronic pain , anxiety , neuropathic pain , visual analogue scale , anesthesia , surgery , psychology , disease , psychiatry , developmental psychology , physics , nursing , astrobiology , economics , macroeconomics
Background: DBS is an established treatment option in refractory dystonia, and motor outcomes have been extensively evaluated instead of the usually neglected NMS (e.g., pain). Objective: To describe the non-motor symptoms (NMS) after Deep Brain Stimulation (DBS) surgery for refractory generalized inherited/idiopathic dystonia in a prospective study. Design and setting: A prospective study that evaluated patients in the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. Methods: This study evaluated patients before and one year after DBS surgery. We applied the following scales: Burke-Fahn-Marsden Rating Scale (BFMRS), Hospital Anxiety and Depression Scale (HADS), Non-Motor Symptoms Scale for Parkinson’s Disease (NMSS-PD), Parkinson’s Disease Questionnaire-8 (PDQ8) Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and McGill pain questionnaire. Results: 11 patients (38.35 ± 11.30 years) underwent surgery (36.3% women). Motor BFMRS subscore was 64.36 ± 22.94 at baseline and 33.55 ± 17.44 after surgery (p=0.003, 47.9% improvement on motor symptoms). HADS scores remained unchanged. NMSS-PD had a significant change after DBS, from 70.91 ± 59.07 to 37.18 ± 55.05 (p=0.013, 47,5% improvement). Seven patients reported pain before DBS surgery, and after one year, four patients reported chronic pain (i.e., pain improved by 42.28%). BPI’s severity and interference scores were 4.61 ± 2.84 and 4.12 ± 2.67, respectively before surgery, and 2.79 ± 2.31 (0.00–6.25) and 1.12 ± 1.32 (0.00–3.00) after DBS (p=0.043 and p=0.028). NPSI total score was 15.29 ± 13.94 before DBS, and reduced to 2.29 ± 2.98 afterward (p=0.028). McGill’s total score was 9.00 ± 3.32 before DBS, achieving 2.71 ± 2.93 after surgery (p=0.028), mostly driven by the sensory sub-score. Conclusions: We found that DBS improves NMS in dystonia, including chronic pain, anxiety, gastrointestinal symptoms, besides the already established improvement in QoL and motor symptoms.