Surgical Treatment for Spasticity
Deep brain stimulation for spasmodic torticollis
Fan Shiying, Meng Fan′gang, Zhang Kai, Yang Anchao, Liu Huanguang, Zhang Jianguo
Published 2019-01-28
Cite as Chin J Neurosurg, 2019, 35(1): 10-15. DOI: 10.3760/cma.j.issn.1001-2346.2019.01.004
Abstract
ObjectiveTo evaluate the safety and efficiency of deep brain stimulation (DBS) in the treatment of spasmodic torticollis (ST) and to compare the difference between the efficiency of STN (subthalamic nucleus)-DBS and GPi (globus pallidus internus)-DBS.
MethodsFourteen patients underwent DBS from February 2005 to February 2018 at Neurosurgery Department of Beijing Tiantan Hospital, Capital Medical University and were retrospectively enrolled into our study. Seven cases were treated with STN-DBS and seven cases with GPi-DBS. The effects of stimulation on cervical dystonia were analyzed based on the Toronto Western Spasmodic Torticollis Scale (TWSTRS). The scores were collected at baseline and the latest follow-up. Related side effects were also documented.
ResultsThe fourteen patients were followed up for the median of 24 (3-150) months. Eleven out of fourteen patients showed a significant improvement from baseline in TWSTRS (P=0.003). The median improvement rate was 69.6% (46.2%-83.6%). However, there was no significant difference between STN-DBS and GPi-DBS with the improvement rates of 69.8%(46.2%-83.6%) and 68.7%(56.0%-74.0%) respectively (P=1.000). Of all 14 patients, there was 1 case of lead breakage, 4 cases of dyskinesia, 1 case of face tic and 1 case of dysarthria, dysphagia and neck fatigue.
ConclusionDBS seems to be an effective and safe therapy method of ST. Both STN and GPi are effective targets for the treatment of ST.
Key words:
Spasmodic torticollis; Deep brain stimulation; Treatment outcome; Subthalamic nucleus; Globus pallidus internus
Contributor Information
Fan Shiying
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Meng Fan′gang
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Zhang Kai
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Yang Anchao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Liu Huanguang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Zhang Jianguo
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
