Long-term benefit sustained after bilateral pallidal deep brain stimulation in patients with refractory tardive dystonia

Stereotact Funct Neurosurg. 2010;88(5):304-10. doi: 10.1159/000316763. Epub 2010 Jun 24.

Abstract

Background/aims: Tardive dystonia (TD) can be a highly disabling, permanent condition related to the use of dopamine-receptor-blocking medications. Our aim was to evaluate the long-term effect of bilateral pallidal deep brain stimulation (DBS) for TD.

Methods: Five consecutive patients with disabling TD who underwent stereotactic placement of bilateral globus pallidus internus DBS leads were included. All patients had a history of mood disorder or schizophrenia previously treated with neuroleptic medication, with a mean duration of motor symptoms of 10.2 years. Dystonia severity was measured using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement score by a blinded neurologist reviewing pre- and postoperative videotaped examinations.

Results: The mean baseline movement BFMDRS score was 49.7 (range 20-88). Overall, we observed a mean reduction of 62% in the BFMDRS movement score within the first year after surgery. Persistent improvement in dystonia (71%) was seen at the last follow-up ranging from 2 to 8 years after surgery.

Conclusion: Our experience suggests that pallidal DBS can be an effective therapy with long-term benefits for patients with TD.

MeSH terms

  • Adult
  • Deep Brain Stimulation*
  • Dopamine Antagonists / adverse effects*
  • Dyskinesia, Drug-Induced / therapy*
  • Electrodes, Implanted
  • Female
  • Globus Pallidus / surgery*
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / drug therapy
  • Retrospective Studies
  • Schizophrenia / drug therapy
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Dopamine Antagonists