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The effectiveness of deep brain stimulation in dystonia: a patient-centered approach

Eggink, Hendriekje, Toonen, Rivka F., van Zijl, Jonathan C., van Egmond, Martje E., Bartels, Anna L., Brandsma, Rick, Contarino, M. Fiorella, Peall, Kathryn J. ORCID:, van Dijk, J. Marc C., Oterdoom, D. L. Marinus, Beudel, Martijn and Tijssen, Marina A. J. 2020. The effectiveness of deep brain stimulation in dystonia: a patient-centered approach. Tremor and Other Hyperkinetic Movements 10 , 2. 10.5334/tohm.69

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Background: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living. Methods: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8–65) receiving GPi-DBS were recruited. All patients underwent a multidisciplinary evaluation before and 1-year post DBS implantation. The Canadian Occupational Performance Measure (COPM) first identified and then measured changes in functional priorities. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to evaluate dystonia severity. Results: Priorities in daily functioning substantially varied between patients but showed significant improvements on performance and satisfaction after DBS. Clinically significant COPM-score improvements were present in 7/8 motor responders, but also in 4/7 motor non-responders. Discussion: The use of a patient-oriented approach to measure GPi-DBS effectiveness in dystonia provides an unique insight in patients’ priorities and demonstrates that tangible improvements can be achieved irrespective of motor response. Highlights • Functional priorities in life of dystonia patients and their caregivers vary greatly • The effect of DBS on functional priorities did not correlate with motor outcome • Half of the motor ‘non-responder’ patients reported important changes in their priorities • The effect of DBS in dystonia should not be measured by motor outcome alone

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
Neuroscience and Mental Health Research Institute (NMHRI)
Publisher: Columbia University, Library/Information Service
ISSN: 2160-8288
Date of First Compliant Deposit: 20 April 2020
Date of Acceptance: 11 April 2020
Last Modified: 12 Nov 2023 01:41

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