Bilateral Pallidal Stimulation for “Sticking-Out Tongue” Feature in Patients With Primary Focal Tongue Protrusion Dystonia

Chung, Jong Chul; Kim, Joo Pyung; Chang, Won Seok; Kim, Hae Yu; Chang, Jin Woo

doi:10.1111/ner.12077

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…Although we could not quantitatively evaluate the effect of each contact stimulus, it was possible to achieve subtle subjective changes in symptoms by selecting a program that changed the stimulus direction and allowing the patient to change the program and stimulus intensity using the remote controller. Similar to our case, previous cases have been reported not to achieve a dystonia score of 0 at 2 years after DBS [6]. Although this suggests that the DBS efficacy is limited in dystonia, DBS attenuated the everyday difficulties experienced by our patient.…”

Section: Rt Gpisupporting

confidence: 89%

“…We encountered a case of idiopathic lingual dystonia that was adequately treated with bilateral GPi-DBS. Chung et al [6] reported 2 cases of lingual dystonia with tongue protrusion where symptomatic improvement was achieved through bilateral GPi-DBS; however, they did not describe the stimulating contact location. We placed the directional contacts in the posteroventral side of the GPi (the Laitinen target) [10] for DBS.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…However, there is scarce evidence regarding the DBS efficacy for other dystonia types with only case series being published [5]. Furthermore, there are currently only 2 published case reports on lingual dystonia [6]. Here, we present a rare case of idiopathic lingual dystonia where bilateral GPi-DBS with a directional lead (D-lead) improved its symptoms.…”

Section: Introductionmentioning

confidence: 91%

See 2 more Smart Citations

Bilateral Pallidal Stimulation with Directional Leads for Primary Focal Lingual Dystonia

Asahi

Ikeda

Yamamoto

et al. 2020

Stereotact Funct Neurosurg

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There have been limited studies regarding stereotactic and functional neurosurgery for lingual dystonia. Here, we report a patient with primary lingual dystonia who showed significant improvement after bilateral deep brain stimulation (DBS). A 42-year-old woman presented with a 5- to 6-year history of tongue protrusion; however, she lacked a significant medical or medication history before onset. She presented with gradually worsening symptoms and was diagnosed with idiopathic lingual dystonia. Her tongue was injected with botulinum toxin on 6 occasions; however, it had a limited effect. Oral medications were ineffective. She underwent DBS since her involuntary tongue movements were causing nocturnal breathing problems. Directional leads were bilaterally inserted into the internal segment of the globus pallidus (GPi). The directional part of each lead was inserted at the GPi bottom on both sides. The posteromedial contacts were used to deliver stimulation. After 1.5 years, the patient’s Burke-Fahn-Marsden dystonia rating scale score improved from 9 to 1.5 and 2 to 1 for movement and disability, respectively. This case demonstrated the effectiveness of bilateral GPi-DBS. Placing the directional part of the lead in the GPi bottom could improve the stimulation effects.

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Section: Rt Gpisupporting

confidence: 89%

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

See 1 more Smart Citation

Bilateral Pallidal Stimulation with Directional Leads for Primary Focal Lingual Dystonia

Asahi

Ikeda

Yamamoto

et al. 2020

Stereotact Funct Neurosurg

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“…By contrast, limb regions of the motor cortex do not project to the OFC or insula in this species. Final ly, Chung and colleagues 18 have recently shown that deep brain stimulation of the globus pallidus internus, a neural region firing in response to reward contingencies during task 19 and reinforcement learning, 20 normalized tongue movements in 2 patients affected by tongue protrusion dystonia.…”

Section: Introductionmentioning

confidence: 99%

Enhanced corticobulbar excitability in chronic smokers during visual exposure to cigarette smoking cues

Vicario

Komeilipoor

Cesari

et al. 2014

J Psychiatry Neurosci

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“…Several case reports from the past two decades have described the use of DBS of the bilateral Gpi for the treatment of lingual dystonia [19][20][21][22]. This bilateral approach is based on the neurophysiological principle that tongue movements are regulated by the bilateral central regions through the corticobulbar tract, which differs from the contralateral regulation of the limbs (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Neurophysiological Basis of Deep Brain Stimulation and Botulinum Neurotoxin Injection for Treating Oromandibular Dystonia

Maezawa

Hirata

Yoshida

2022

Toxins

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Oromandibular dystonia (OMD) induces severe motor impairments, such as masticatory disturbances, dysphagia, and dysarthria, resulting in a serious decline in quality of life. Non-invasive brain-imaging techniques such as electroencephalography (EEG) and magnetoencephalography (MEG) are powerful approaches that can elucidate human cortical activity with high temporal resolution. Previous studies with EEG and MEG have revealed that movements in the stomatognathic system are regulated by the bilateral central cortex. Recently, in addition to the standard therapy of botulinum neurotoxin (BoNT) injection into the affected muscles, bilateral deep brain stimulation (DBS) has been applied for the treatment of OMD. However, some patients’ OMD symptoms do not improve sufficiently after DBS, and they require additional BoNT therapy. In this review, we provide an overview of the unique central spatiotemporal processing mechanisms in these regions in the bilateral cortex using EEG and MEG, as they relate to the sensorimotor functions of the stomatognathic system. Increased knowledge regarding the neurophysiological underpinnings of the stomatognathic system will improve our understanding of OMD and other movement disorders, as well as aid the development of potential novel approaches such as combination treatment with BoNT injection and DBS or non-invasive cortical current stimulation therapies.

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Bilateral Pallidal Stimulation for “Sticking-Out Tongue” Feature in Patients With Primary Focal Tongue Protrusion Dystonia

Cited by 4 publications

References 14 publications

Bilateral Pallidal Stimulation with Directional Leads for Primary Focal Lingual Dystonia

Bilateral Pallidal Stimulation with Directional Leads for Primary Focal Lingual Dystonia

Enhanced corticobulbar excitability in chronic smokers during visual exposure to cigarette smoking cues

Neurophysiological Basis of Deep Brain Stimulation and Botulinum Neurotoxin Injection for Treating Oromandibular Dystonia

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