A double-blind study on a patient with tardive dyskinesia treated with pallidal deep brain stimulation

Acta Neurol Scand. 2009 Apr;119(4):269-73. doi: 10.1111/j.1600-0404.2008.01115.x. Epub 2008 Oct 25.

Abstract

Background: Tardive dyskinesia (TD) is a neurological disorder typically induced by long-term exposure to neuroleptics. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) may represent a therapeutic alternative for TD, which is often resistant to conservative treatment.

Aims of the study: This report's objective is to present a case of TD successfully treated with DBS, as well as to indicate a putative role of brain perfusion scintigraphy as a helpful tool correlating functional imaging findings with clinical responsiveness to DBS.

Methods/results: A 42-year-old male patient suffering from refractory TD underwent bilateral GPi DBS surgery. Post-operative Burke-Fahn-Mardsen Dystonia Rating Scale (BFMDRS) and Abnormal Involuntary Movement Scale (AIMS) total scores have been reduced by 90.7% and 76.7% respectively on the 6-month follow-up assessment. Brain perfusion scintigraphy, performed post-operatively in the two stimulation states, revealed a decrease in cerebral blood flow, during the 'on-DBS', compared with the 'off-DBS' state.

Conclusions: Clinical improvement of this patient, correspondent to previous studies, suggests that continuous bilateral GPi DBS may provide a promising treatment option for TD. Furthermore, this report could imply, as no previous such comparison study exists, a possible correlation between brain functional imaging findings and the movement disorder's response to DBS.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / physiopathology*
  • Cerebrovascular Circulation
  • Deep Brain Stimulation*
  • Double-Blind Method
  • Dyskinesia, Drug-Induced / physiopathology
  • Dyskinesia, Drug-Induced / therapy*
  • Follow-Up Studies
  • Globus Pallidus*
  • Humans
  • Male
  • Motor Activity
  • Perfusion Imaging
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome
  • Video Recording