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Efficacy and safety of pallidal stimulation in primary dystonia: results of the Spanish multicentric study
  1. Francesc Valldeoriola (fvallde{at}clinic.ub.es)
  1. Parkinson Disease Unit, ICN. CIBERNED. IDIBAPS. Universitat de Barcelona, Spain
    1. Ignacio Regidor (iregidor.hrc{at}salud.madrid.org)
    1. Neurology Service, Hospital Ramón y Cajal, Madrid, Spain
      1. Adolfo Mínguez-Castellanos (aminguezc{at}meditex.es)
      1. Neurology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
        1. Elena Lezcano (elena.lezcanogarcia{at}osakidetza.net)
        1. Servicio de Neurología, Hospital de Cruces, Barakaldo, Vizcaya, Spain
          1. Pedro García-Ruiz (pgarcia{at}fjd.es)
          1. Fundación jiménez Díaz. Coordinatrion of the Grupo Español Trastornos del Movimiento de la SEN, Spain
            1. Ana Rojo (anarojosebastian{at}gmail.com)
            1. Neurology Service, Hospital Mútua de Terrassa, Spain
              1. Antonio Salvador (tonisalvador{at}telefonica.net)
              1. Neurology Service, Hospital Clínic, València, Spain
                1. Alfonso Castro (mecastro{at}usc.es)
                1. Neurology Service, Hospital Clínico Universitario, Santiago de Compostela, Spain
                  1. Francisco Grandas (fgrandasp{at}hotmail.com)
                  1. Neurology Service, Hospital Gregorio Marañón, Spain
                    1. Maria José Martí (mjmarti{at}clinic.ub.es)
                    1. Parkinson’s Disease and Movement Disorders Unit, Institut Clínic de Neurociències, and Centro de In, Spain
                      1. Pablo Martínez-Martín (pmartinez{at}isciii.es)
                      1. Centro Nacional de Epidemiología. CIBERNED. Instituto de Salud Carlos III, Spain
                        1. Jaime Kulisevsky (jkulisevsky{at}santpau.es)
                        1. Neurology Service. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
                          1. Luis Relova (fsrelova{at}usc.es)
                          1. Neurology Service, Hospital Clínico Universitario, Santiago de Compostela, Spain
                            1. Jordi Rumià (jrumia{at}clinic.ub.es)
                            1. Institut Clínic de malalties del Sistema Nerviós, Hospital Clínic, Barcelona, Spain
                              1. Ana Cámara (acamara{at}clinic.ub.es)
                              1. Parkinson disease and Movement Disorders Unit, ICN, Hospital Clínic, Barcelona, Spain
                                1. Juan Andrés Burguera (jburguerah{at}meditex.es)
                                1. Neurology Service, Hospital Universitario La Fe, Valencia, Spain
                                  1. Gurutz Linazasoro (glinazasoro{at}terra.es)
                                  1. Clinica Donosti, San Sebastián, Spain
                                    1. Javier López Del Val (javivineuro{at}telefonica.net)
                                    1. Neurology Service, Hospital Clínico Zaragoza, Spain
                                      1. José Obeso (jobeso{at}unav.es)
                                      1. Neurology Service, Clinica Universitaria de Navarra. CIBERNED., Spain
                                        1. Mari Cruz Rodríguez-Oroz (mcroroz{at}unav.es)
                                        1. Neurology Service, Clinica Universitaria de Navarra. CIBERNED., Spain
                                          1. Eduardo Tolosa (etolosa{at}clinic.ub.es)
                                          1. Parkinson Disease Unit, ICN. CIBERNED. IDIBAPS. Universitat de Barcelona, Spain

                                            Abstract

                                            We report the results of a prospective, multicenter study with open-label, blinded, as well as self-assessed evaluations to investigate the efficacy and safety of bilateral GPi DBS in patients with primary dystonia. Twenty-four patients from ten different hospitals were included and followed for one year. Clinical assessments were done through blinded scoring of video recordings, open-label evaluations, and self-assessment scales. One year after surgery, baseline motor scores were significantly reduced as revealed by both open and blinded assessments. A similar reduction in disability and pain associated with dystonia was also observed. A marked reduction of anti-dystonic medications was observed postoperatively. At six months and one year follow-up, we found correlation between improvement of both motor and functional BFMDRS scores and the age of patients at the moment of surgery. Significant improvement was also seen in quality of life. Despite global improvements in the majority of our dystonic patients, these were not associated with any significant changes in caregiver burden. Six of the 24 patients in this study presented adverse events.

                                            GPi DBS is an effective symptomatic treatment in patients with primary dystonia refractory to medical treatment; younger age at the moment of surgery correlates positively with motor and functional outcome.

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