Objectives To study the efficacy and safety of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) in refractory Meige syndrome (MS) and evaluate the psychiatric disorders before and after surgery.
Methods Twenty-two patients with MS treated with bilateral GPi-DBS were retrospectively analysed before surgery and after continuous neurostimulation. Before surgery, patients were assessed by the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Self-Rating Depression Scale, Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36) and Pittsburgh Sleep Quality Index (PQSI), which corresponded to motor symptoms, depressive state, quality of life and sleep quality, respectively. The implantable pulse generator of each patient was activated at 1 month after surgery. At 1 month, 3 months, 6 months and 12 months after continuous neurostimulation, all patients were evaluated by the same scales above.
Results The BFMDRS movement scores decreased from 15.0±5.3 before surgery to 3.5±4.5 at 12 months after neurostimulation, with a mean improvement of 78% (p<0.001). The BFMDRS disability scores improved from 7.4±4.9 before surgery to 4.0±4.6 at 12 months after neurostimulation, with a mean improvement of 56% (p<0.001). The postoperative SF-36 scores had the remarkable improvement compared with baseline scores. Impaired sleep quality was found in 82% of patients and depression in 64% before surgery, which didn’t neither obtained amelioration after continuous neurostimulation.
Conclusions Bilateral pallidal neurostimulation is a beneficial therapeutic option for refractory MS, which could improve the motor symptoms except for depression and sleep quality.
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Contributors QH, DW and JO are joint first authors and contributed equally to the paper. QH contributed to the study design, data acquisition, data analysis, drafting and revision of the manuscript, and is the guarantor of the paper. DW contributed to the data acquisition, data analysis and revision of the manuscript. JOY contributed to the data acquisition, data analysis and revision of the manuscript. HD contributed to the study design, data collection and drafting of the manuscript. GW contributed to data analysis, drafting and revision of the manuscript. ZL contributed to data acquisition, data analysis and drafting of the manuscript. RL contributed to the study design, data collection, data analysis, revision of the manuscript and approved final version of the manuscript. All authors have read and approved the final manuscript.
Funding This study was supported by grants from Chinese Institute for Brain Research (Beijing) (Grant Number Z181100001518005).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The Ethics Committee of Peking University People’s Hospital (2020PHB065-01).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Under the conditions of anonymisation of individual patients, patient-related data will be shared upon request from any qualified researcher. iDs: Qingpei Hao http://orcid.org/0000-0002-2234-976X.
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