• Valeria Lo Faso, Luigi Schisano, Luigi Gianmaria Remore, Leonardo Tariciotti, Giorgio Fiore, Gloria Valcamonica, Linda Borellini, Filippo Cogiamanian, Antonio D'Ammando, Elena Pirola, Antonella Ampollini, Giovanni Marfia, and Marco Locatelli.
• Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. Electronic address: valeria.lofaso@unimi.it.
• World Neurosurg. 2024 Dec 6: 123438123438.

BackgroundDystonia is common in Parkinson disease patients, affecting about 30% of them. Bilateral subthalamic nucleus deep brain stimulation (DBS) can sometimes lead to dystonia, but this relationship is not well understood. Our aim was to provide a better understanding of dystonia's causes and its connection to DBS.MethodsWe conducted a retrospective analysis of clinical data from 80 Parkinson disease patients who underwent bilateral subthalamic nucleus stimulation, focusing on dystonia before and after surgery and its relation to medication state (on-dystonia/off-dystonia).ResultsAfter DBS, off-dystonia had a higher recovery rate than on-dystonia (43.5% vs. 9.1%). Among patients suffering for on-dystonia, 74.4% had it for the first time after surgery; these patients assumed higher doses of levodopa before DBS.ConclusionsPatients with off-dystonia before surgery tend to improve after DBS. Otherwise, DBS could have the role of "additive boost" in the process of sensitization of striato-pallidal pathways and lead to on-dystonia in particular patients.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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