Sixty hertz pallidal deep brain stimulation for primary torsion dystonia

Alterman, Ron L.; Miravite, Joan; Weisz, Donald J.; Shils, Jay L.; Bressman, Susan; Tagliati, Michele

doi:10.1212/01.wnl.0000267430.95106.ff

Cited by 164 publications

(101 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This limitation may be overcome by rechargeable devices. A recent study found significant benefit using a much lower frequency of stimulation at 60 Hz [36]. The mean DBS parameters at the time of maximal improvement in our study were: mean amplitude 3.2 V, pulse width 170 μs and frequency 102 Hz, which were comparable to the previous studies.…”

Section: Discussionsupporting

confidence: 87%

“…Two of our patients with primary dystonia had lower stimulation rates (60 and 80 Hz, respectively) and 1 with secondary dystonia had low stimulation rate (60 Hz). All of them showed good clinical response as noted by Alterman et al [36]. Adverse effects related to DBS are classified into three categories: surgical, hardware related, and stimulation related [37].…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Deep Brain Stimulation in Children with Dystonia: Experience from a Tertiary Care Center

Ghosh¹,

Machado

Deogaonkar

et al. 2012

Pediatr Neurosurg

View full text Add to dashboard Cite

Objective: To investigate the efficacy and safety of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in children with dystonia. Methods: Retrospective chart review of patients (≤21 years) with dystonia who underwent GPi DBS. Outcome measures were assessed by the Burke-Fahn-Marsden Dystonia Rating (BFMDR) movement and disability scales pre- and post-DBS. Results: Eight patients underwent DBS; mean age of onset was 7.5 ± 4.8 years (7 were male). Mean age at DBS was 14.1 ± 4.6 years. Etiology of dystonia was primary in 6 patients and secondary in 2. There was significant improvement of BFMDR movement as well as BFMDR disability scales in 6 patients with primary dystonia with modest improvement in those scales in 2 patients with secondary dystonia. Hardware-related problems were observed in 2 and infection was noted in 1. Conclusions: GPi DBS is an effective and safe therapy in pediatric patients with primary as well as selected cases of secondary dystonia.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 88%

Deep Brain Stimulation in Children with Dystonia: Experience from a Tertiary Care Center

Ghosh¹,

Machado

Deogaonkar

et al. 2012

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…The therapeutic benefit of pallidal DBS has been widely established in the dystonic syndrome irrespective of primary, 1,[5][6][7]10,12,14,16,19,20,22,29 secondary, or heredodegenerative dystonia. 15,39,41 Some studies found the DYT1 mutation to be a prognostic factor of a successful outcome of pallidal DBS, [3][4][5]13,37,42 while others did not.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical results of pallidal DBS in pediatric patients (≤ 10 years of age) who underwent pallidal DBS are summarized in Table 1. As in adult cases, marked improvements of over 80% in dystonic symptoms, according to the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) for movement, were documented in some early pediatric cases; 1,5,16,29,33 on the other hand, there also exist improvements below 30% on the BFMDRS, 26,32,46 suggesting that a careful evaluation is necessary before attempting surgical intervention in the brain of a patient who is too young. 26 To date, there have been few reports of dystonia recurrence, which may reflect a possible bias that poor outcomes were not published.…”

mentioning

confidence: 99%

Tolerance of early pallidal stimulation in pediatric generalized dystonia

Miyagi

Koike²

2013

PED

View full text Add to dashboard Cite

The authors report on 2 cases of pediatric generalized dystonia with a DYT1 mutation; the patients, an 11-year-old girl and a 9-year-old boy, underwent chronic, pallidal deep brain stimulation (DBS) of the globus pallidus internus (GPi). The dystonic postures in both cases showed dramatic improvements with pallidal DBS, but each patient's symptoms gradually recurred within a year, irrespective of exhaustive readjustments of the stimulation settings. After the recurrence of the dystonic symptoms, the DBS leads were replaced within the GPi in one patient (Case 1) and additional DBS leads were implanted into the bilateral subthalamic nuclei in the other patient (Case 2). Neither measure produced any further clinical benefit, and the patient in Case 2 died of status dystonicus 2 days after reoperation. These findings suggest that early pallidal DBS for pediatric dystonia is indeed effective, although there are some cases in which its therapeutic effect is lost. One possible reason may be the ability of the preadolescent brain to tolerate chronic electrical stimuli during the active maturation process.

show abstract

“…11,21 Despite these seemingly positive outcomes, it appears that children with secondary dystonia respond less robustly to treatment in general, and to DBS in particular. 2 Clearly, the rarity of these disorders precludes the design of adequate trials, but it appears that the experiences of multiple institutions supports continued research into the application of DBS for secondary dystonia in medically refractory cases.…”

Section: Current Indications For Pediatric Dbsmentioning

confidence: 99%

Current and future indications for deep brain stimulation in pediatric populations

Lipsman¹,

Ellis²,

Lozano³

2010

FOC

View full text Add to dashboard Cite

Deep brain stimulation (DBS) has proven to be an effective and safe treatment option in patients with various advanced and treatment-refractory conditions. Thus far, most of the experience with DBS has been in the movement disorder literature, and more specifically in the adult population, where its use in conditions such as Parkinson disease has revolutionized management strategies. The pediatric population, however, can also be afflicted by functionally incapacitating neurological conditions that remain refractory despite the clinicians' best efforts. In such cases, DBS offers an additional treatment alternative. In this paper, the authors review their institution's experience with DBS in the pediatric population, and provide an overview of the literature on DBS in children. The authors conclude that DBS in children can and should be considered a valid and effective treatment option, albeit in highly specific and carefully selected cases.

show abstract

Sixty hertz pallidal deep brain stimulation for primary torsion dystonia

Abstract: Stimulation of the internal globus pallidus at 60 Hz is safe and effective for treating medically refractory primary dystonia.

Cited by 164 publications

References 21 publications

Deep Brain Stimulation in Children with Dystonia: Experience from a Tertiary Care Center

Deep Brain Stimulation in Children with Dystonia: Experience from a Tertiary Care Center

Tolerance of early pallidal stimulation in pediatric generalized dystonia

Current and future indications for deep brain stimulation in pediatric populations

Contact Info

Product

Resources

About