Reliability and responsiveness of the Barry–Albright Dystonia Scale

Barry, Margaret J.; VanSwearingen, Jessie M.; Albright, A. Leland

doi:10.1111/j.1469-8749.1999.tb00626.x

Cited by 88 publications

(109 citation statements)

References 21 publications

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“…and A.P.) independently evaluated these sessions and scored performance using the BADS 3 and the BFM-DRS-M. 7 The BADS scores were calculated monthly for the first 6 months, then every 3 months for the following 6 months, and finally every 6 months thereafter. Only preoperative and latest postoperative BFMDRS-M scores were recorded.…”

Section: Data Collectionmentioning

confidence: 99%

“…3 It rates dystonia severity in 8 body regions, including eyes, mouth, neck, trunk, and extremities, ranging from 0 (no dystonia) to 4 (severe dystonia present more than 50% of the time), with a maximum total score of 32. In contrast, the BFMDRS-M rates dystonia severity as well as provoking factors in 9 body regions, including eyes, mouth, speech and swallowing, neck, trunk, and extremities.…”

Section: Data Collectionmentioning

confidence: 99%

“…In these instances, the particular body region was assigned the previous month's score. Although the BFMDRS-M may be limited in evaluating secondary dystonia, 3,5,10,22,24,27 scores were included to allow for comparison with other published literature.…”

Section: Data Collectionmentioning

confidence: 99%

“…16,22,24,27,36 Vidailhet et al demonstrated sustained mean improvement of 24.4% in motor symptoms at the 1-year follow-up, with additional improvements in functional disability, pain, and mental health-related quality of life. 36 For children specifically, Marks et al observed significant improvements in Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFMDRS-M) 7 and disability (BFMDRS-D) scores as well as Barry-Albright Dystonia Scale (BADS) 3 scores at 6 months, and when directly comparing children with DYT1 primary dystonia and those with dystonic CP, the latter group responded more favorably (7% vs 24% reduction in overall BFMDRS-rated motor impairment, respectively. 22,24 Furthermore, Marks et al advocated for early intervention in the CP group.…”

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confidence: 99%

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Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Keen¹,

Przekop

Olaya

et al. 2014

PED

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Object Deep brain stimulation (DBS) for dystonic cerebral palsy (CP) has rarely been reported, and its efficacy, though modest when compared with that for primary dystonia, remains unclear, especially in the pediatric population. The authors present a small series of children with dystonic CP who underwent bilateral pallidal DBS, to evaluate the treatment's efficacy and safety in the pediatric dystonic CP population. Methods The authors conducted a retrospective review of patients (under the age of 18 years) with dystonic CP who had undergone DBS of the bilateral globus pallidus internus between 2010 and 2012. Two of the authors independently assessed outcomes using the Barry-Albright Dystonia Scale (BADS) and the Burke-Fahn-Marsden Dystonia Rating Scale–movement (BFMDRS-M). Results Five children were diagnosed with dystonic CP due to insults occurring before the age of 1 year. Mean age at surgery was 11 years (range 8–17 years), and the mean follow-up was 26.6 months (range 2–42 months). The mean target position was 20.6 mm lateral to the midcommissural point. The mean preoperative and postoperative BADS scores were 23.8 ± 4.9 (range 18.5–29.0) and 20.0 ± 5.5 (range 14.5–28.0), respectively, with a mean overall percent improvement of 16.0% (p = 0.14). The mean preoperative and postoperative BFMDRS-M scores were 73.3 ± 26.6 (range 38.5–102.0) and 52.4 ± 21.5 (range 34.0–80.0), respectively, with a mean overall percent improvement of 28.5% (p = 0.10). Those stimulated at least 23 months (4 patients) improved 18.3% (p = 0.14) on the BADS and 30.5% (p = 0.07) on the BFMDRS-M. The percentage improvement per body region yielded conflicting results between rating scales; however, BFMDRS-M scores for speech showed some of the greatest improvements. Two patients required hardware removal (1 complete system, 1 unilateral electrode) within 4 months after implantation because of infections that resolved with antibiotics. Conclusions All postoperative dystonia rating scale scores improved with pallidal stimulation, and the greatest improvements occurred in those stimulated the longest. The results were modest but comparable to findings in other similar series. Deep brain stimulation remains a viable treatment option for childhood dystonic CP, although young children may have an increased risk of infection. Of particular note, improvements in the BFMDRS-M subscores for speech were comparable to those for other muscle groups, a finding not previously reported.

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Section: Data Collectionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

mentioning

confidence: 99%

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Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Keen¹,

Przekop

Olaya

et al. 2014

PED

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“…1,24,26 This scale was specifically developed to assess patients with secondary dystonia. 4 The BFMDRS assesses movement primarily related to function, but many patients with secondary dystonia have significant cognitive impairments, making it difficult to assess their voluntary control of movements and ultimate functional capacity. 4 …”

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confidence: 99%

Deep brain stimulation in children and young adults with secondary dystonia: the Children's Hospital Los Angeles experience

Olaya

Christian

Ferman

et al. 2013

FOC

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Background Dystonia is a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. It can be classified as primary or secondary. There is no cure for dystonia and the goal of treatment is to provide a better quality of life for the patient. Surgical intervention is considered for patients in whom an adequate trial of medical treatment has failed. Deep brain stimulation (DBS), specifically of the globus pallidus interna (GPi), has been shown to be extremely effective in primary generalized dystonia. There is much less evidence for the use of DBS in patients with secondary dystonia. However, given the large number of patients with secondary dystonia, the significant burden on the patients and their families, and the potential for DBS to improve their functional status and comfort level, it is important to continue to investigate the use of DBS in the realm of secondary dystonia. Object The objective of this study is to review a series of cases involving patients with secondary dystonia who have been treated with pallidal DBS. Methods A retrospective review of 9 patients with secondary dystonia who received treatment with DBS between February 2011 and February 2013 was performed. Preoperative and postoperative videos were scored using the Barry-Albright Dystonia Scale (BADS) and Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) by a neurologist specializing in movement disorders. In addition, the patients' families completed a subjective questionnaire to assess the perceived benefit of DBS. Results The average age at DBS unit implantation was 15.1 years (range 6–20 years). The average time to follow-up for the BADS evaluation from battery implantation was 3.8 months (median 3 months). The average time to follow-up for the subjective benefit evaluation was 10.6 months (median 9.5 months). The mean BADS scores improved by 9% from 26.5 to 24 (p = 0.04), and the mean BFMDRS scores improved by 9.3% (p = 0.055). Of note, even in patients with minimal functional improvement, there seemed to be decreased contractures and spasms leading to improved comfort. There were no complications such as infections or hematoma in this case series. In the subjective benefit evaluation, 3 patients' families reported “good” benefit, 4 reported “minimal” benefit, and 1 reported no benefit. Conclusions These early results of GPi stimulation in a series of 9 patients suggest that DBS is useful in the treatment of secondary generalized dystonia in children and young adults. Objective improvements in BADS and BFMDRS scores are demonstrated in some patients with generalized secondary dystonia but not in others. Larger follow-up studies of DBS for secondary dystonia, focusing on patient age, history, etiology, and patterns of dystonia, are needed to learn which patients will respond best to DBS.