Pallidal deep brain stimulation improves quality of life in segmental and generalized dystonia: Results from a prospective, randomized sham‐controlled trial

Mueller, Joerg; Skogseid, Inger Marie; Benecke, Reiner; Kupsch, Andreas; Trottenberg, Thomas; Poewe, Werner; Schneider, G.-H.; Eisner, Wilhelm; Wolters, Alexander; Müller, Jan‐Uwe; Deuschl, Günther; Pinsker, Marcus O.; Roeste, Geir Ketil; Vollmer–Haase, Juliane; Brentrup, Angela; Krause, Martín; Tronnier, V.; Schnitzler, Alfons; Voges, J.; Nikkhah, Guido; Vesper, Jan; Naumann, Markus; Volkmann, Jens

doi:10.1002/mds.21783

Cited by 125 publications

(93 citation statements)

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“…15,18,28,29,32 This improvement could be secondary to the GPi DBS motor benefit, and the consequent reduction in disability and improvement of quality of life. 32 In our population, the postoperative reduction of pain could also have contributed to improve depression.…”

Section: Classification Of Evidencementioning

confidence: 99%

“…Our 3 patients with tardive dystonia showed stable psychiatric outcome, providing further evidence about the long-term safety of GPi DBS on mood and psychotic symptoms in this particular population. 17,31,32,37 The effect of GPi DBS on addictive behavior remains uncertain. Cannabis abuse in one patient with secondary dystonia remained unchanged after surgery.…”

Section: Classification Of Evidencementioning

confidence: 99%

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Long-term neuropsychiatric outcomes after pallidal stimulation in primary and secondary dystonia

et al. 2015

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Objective: To evaluate changes in the diagnosis of Axis I psychiatric disorders in patients with primary and secondary dystonia after deep brain stimulation (DBS) of the globus pallidus internus (GPi).Methods: Structured Clinical Interviews for the DSM-IV, Axis I psychiatric disorders, were prospectively performed before and after surgery. Diagnoses were made based on DSM-IV criteria. Psychiatric disorders were grouped into 5 categories: mood, anxiety, addiction, obsessivecompulsive disorders, and psychosis. Patients could be stratified to more than one category. Rates for unchanged diagnoses, diagnoses in remission, and new-onset diagnoses after surgery for each category were calculated.Results: Fifty-seven patients with primary and secondary dystonia were included. Mean 6 SD age at surgery and dystonia duration at time of surgery was 50.6 6 13.8 and 19.0 6 13.2 years, respectively. Preoperatively, 37 Axis I diagnoses were made in 25 patients, 43.8% of those presenting with at least 1 Axis I diagnosis (mostly mood and anxiety disorders). Mean 6 SD duration of psychiatric follow-up was 24.4 6 19.6 months. Overall, after surgery no significant changes (p 5 0.16) were found in Axis I diagnoses (23 patients, 40.3%): 27 (73%) unchanged, 10 (27%) in complete remission, and 4 (12.9%) new-onset diagnoses. Conclusions:Our results support the overall psychiatric stability of patients with primary and secondary dystonia treated with GPi DBS. However, considering the high psychiatric morbidity in the dystonia population, psychiatric assessments before and after surgery are strongly recommended.

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Section: Classification Of Evidencementioning

confidence: 99%

Section: Classification Of Evidencementioning

confidence: 99%

Long-term neuropsychiatric outcomes after pallidal stimulation in primary and secondary dystonia

et al. 2015

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“…При этом тяжесть депрессивных расстройств не зависит от тяжести дистонического гиперкинеза, позволяя предположить их первичный характер. С другой стороны, улучшение эмоционального фона после успеш-ного лечения дистонии подтверждает вклад двигатель-ных расстройств и боли в развитие депрессии [10,11].…”

Section: эмоциональные расстройстваunclassified

Focal Dystonias: Non-Motor Symptoms and Comorbidities

Толмачёва¹

2017

Med. sov.

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Дистония является распространенным экстрапирамидным заболеванием. Для нее характерны как моторные, так и немоторные проявления, к которым относятся боль, сенсорные нарушения, избыточная двигательная активность. Обсуждается вклад тревож-ных и депрессивных расстройств, нарушений сна в течение фокальной дистонии. Нередко именно немоторные проявления являются начальными симптомами дистонии. В ряде случаев немоторные проявления можно выделить в самостоятельные заболевания, которые сопутствуют дистоническому гиперкинезу и способствуют ухудшению качества жизни таких больных. Лечение немоторных симптомов позволит повысить эффективность терапии дистонии, а также повлиять на течение заболевания.Ключевые слова: дистония, немоторные симптомы, коморбидность, лечение. V.A. TOLMACHYOVA, PhD in medicine, Sechenov First Moscow State Medical University FOCAL DYSTONIAS: NON-MOTOR SYMPTOMS AND COMORBIDITIESDystonia is a common extrapyramidal disease. It is characterized by both motor and non-motor manifestations, which include pain, sensory disorders and excessive physical activity. The contribution of disturbing and depressed disorders, sleep disorders during the focal dystonia has been discussed. It is often the non-motor manifestations that are the initial symptoms of dystonia. In some cases, unmotorized manifestations can be isolated diseases that accompany dystonic hyperkinesis and contribute to the deterioration of the quality of life of such patients. Treatment of nonmotor symptoms will improve the effectiveness of dystonia therapy as well as affect the course of the disease.

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“…Deep brain stimulation of 1 of the output nuclei of the basal ganglia, the globus pallidus internus, can alleviate symptoms in a variety of dystonia patients, and it is currently the most common and well-studied site of surgical intervention [30][31][32][33]. Although this intervention can be quite successful, it is clear that some patient populations respond better than others, possibly reflecting underlying differences in the neural basis of dystonia generation between these populations [34].…”

Section: Clues From Surgical Interventionsmentioning

confidence: 99%