Efficacy and safety of pallidal stimulation in primary dystonia: results of the Spanish multicentric study
- F Valldeoriola1,
- I Regidor2,
- A Mínguez-Castellanos3,
- E Lezcano4,
- P García-Ruiz5,
- A Rojo6,
- A Salvador7,
- A Castro8,
- F Grandas9,
- J Kulisevsky10,
- M J Martí1,
- P Martínez-Martín11,
- L Relova8,
- J Rumià1,
- A Cámara1,
- J A Burguera12,
- G Linazasoro13,
- J López de Val14,
- J Obeso15,
- M C Rodríguez-Oroz15,
- E Tolosa1
- 1Hospital Clínic, University of Barcelona, Barcelona, Spain
- 2Hospital Ramón y Cajal, Madrid, Spain
- 3Hospital Universitario Virgen de las Nieves, Granada, Spain
- 4Hospital de Cruces, Baracaldo, Spain
- 5Fundación Jiménez-Díaz, Madrid, Spain
- 6Hospital Mútua de Terrassa, Spain
- 7Hospital Clínic, València, Spain
- 8Hospital Universitario, Santiago de Compostela, Spain
- 9Hospital Gregorio Marañón, Madrid, Spain
- 10Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- 11Instituto Nacional de Epidemiología, CIBERNED, Instituto de Salud Carlos III, Madrid, Spain
- 12Hospital La Fe, Valencia, Spain
- 13Clínica Donosti, San Sebastián, Spain
- 14Hospital Clínico, Zaragoza, Spain
- 15Clínica Universitaria de Navarra, Madrid, Spain
- Correspondence to Dr F Valldeoriola, Parkinson’s Disease and Movement Disorders Unit, Institut Clínic de Neurociències, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona 08036, Spain; fvallde{at}clinic.ub.es
- Received 3 February 2009
- Revised 22 June 2009
- Accepted 22 June 2009
- Published Online First 10 September 2009
Abstract
Background: Dystonia is a complex clinical syndrome originated by a wide range of aetiologies. The diagnosis of dystonia is made after the evaluation of aetiological, phenomenological and genetic factors.1 Medications, except in patients with dopa-responsive dystonia, are of limited efficacy. Botulinum toxin injections are not applicable to patients with generalised dystonia, since many muscular groups contribute to disability.2
Clinical studies in children and adults with primary generalised dystonia (PGD) have reported beneficial effects of bilateral GPi deep brain stimulation (DBS) in both motor symptoms and disability produced by dystonia3 4 5 as well as a favourable impact of DBS in the health-related quality of life (HRQoL).6 Some clinical aspects of GPi stimulation in primary dystonia still remain controversial such as the influence of disease duration or age at onset in determining the postoperative clinical outcome.
Results: The authors report the results of a multicentric study designed to assess the tolerability and clinical effects of bilateral pallidal DBS on motor impairment, functional disability, quality of life, pain and mood in patients with medically refractory primary generalised or segmental dystonia.
Footnotes
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Members of “GESPALDIS”: C Magariños, R Figueiras, L Cabañes (H Ramón y Cajal, Madrid); F Escamilla-Sevilla, MJ Katati, JM Martin-Linares (H Universitario Virgen de las Nieves, Granada); G Bilbao, I Lambarri, JC Gómez, O Rodriguez, R Villoria (H de Cruces, Baracaldo); F Alonso, J Ayerbe, J Muñiz (Fundación Jiménez Díaz, Madrid); B Oliver, M Aguilar, D Badenes (H Mútua de Terrassa); P Roldán, F Talamantes (H Clínic, València); A Sésar, M Gelabert (H Clínico Universitario, Santiago de Compostela); L López, S Giménez-Roldán, F Garcia (H Gregorio Marañón, Madrid); A Gironell, J Molet, RB Pascual-Sedano, R Rodríguez (Hospital de la Santa Creu i Sant Pau, Barcelona).
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Competing interests None.
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Ethics approval Ethics approval was provided by the Ethics Committee at each institution participating in the study.
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Patient consent Obtained.
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Members of “GESPALDIS”: C Magariños, R Figueiras, L Cabañes (H Ramón y Cajal, Madrid); F Escamilla-Sevilla, MJ Katati, JM Martin-Linares (H Universitario Virgen de las Nieves, Granada); G Bilbao, I Lambarri, JC Gómez, O Rodriguez, R Villoria (H de Cruces, Baracaldo); F Alonso, J Ayerbe, J Muñiz (Fundación Jiménez Díaz, Madrid); B Oliver, M Aguilar, D Badenes (H Mútua de Terrassa); P Roldán, F Talamantes (H Clínic, València); A Sésar, M Gelabert (H Clínico Universitario, Santiago de Compostela); L López, S Giménez-Roldán, F Garcia (H Gregorio Marañón, Madrid); A Gironell, J Molet, RB Pascual-Sedano, R Rodríguez (Hospital de la Santa Creu i Sant Pau, Barcelona).
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Provenance and Peer review Not commissioned; externally peer reviewed.
