• Damianos E Sakas, Athanassios Leonardos, Efstathios Boviatsis, Stergios Gatzonis, Ioannis Panourias, Pantelis Stathis, and Lampis C Stavrinou.
• Unit of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, University of Athens Medical School, Athens, Greece; "Petros S. Kokkalis" Hellenic Center for Neurosurgical Research, Athens, Greece.
• World Neurosurg. 2017 Jul 1; 103: 45-56.

ObjectiveTo evaluate bilateral constant-current globus pallidus internus (GPi) deep brain stimulation using an 8-contact lead.MethodsThis prospective, open-label, single-center pilot study of 10 patients assessed the feasibility of delivering bilaterally constant-current GPi deep brain stimulation with a novel 8-channel lead to treat primary dystonia using standard scales as outcome measures.ResultsPatients included 4 men and 6 women with a mean age of 35.8 years ± 9.2 (range, 27-49 years). Mean age of onset was 18.5 years ± 9.1 (range, 8-35 years), and mean disease duration was 17.3 years (range, 7-27 years). All had primary dystonia (8 generalized dystonia, 1 segmental dystonia, 1 focal dystonia). The primary variable was determined as 50% reduction in dystonia symptoms from baseline to the 6-month follow-up, as defined by the Burke-Fahn-Marsden Dystonia Rating Scale. Six patients (60.0%) achieved >50% reduction in Burke-Fahn-Marsden Dystonia Rating Scale score and were classified as responders at the 6-month follow-up. Five of these 6 responders (83.3%) sustained that response through the assessment at the end of the first year. Constant-current stimulation was associated with significant improvement in pain and quality of life in all patients. Nearly 84% of the overall improvement occurred by the end of first month after stimulation onset, documenting an early response to treatment. Axial symptoms responded the best.ConclusionsConstant-current GPi deep brain stimulation proved safe and efficacious for treatment of primary dystonia. Motor scores improved by 54%, mostly within the first month. No phenotype-specific stimulation could be achieved, despite the capability of the new lead to stimulate specific loci within the GPi.Copyright © 2017 Elsevier Inc. All rights reserved.

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