• Sara Meoni, Valérie Fraix, Anna Castrioto, Alim Louis Benabid, Eric Seigneuret, Laurent Vercueil, Pierre Pollak, Paul Krack, Eric Chevrier, Stephan Chabardes, and Elena Moro.
• Division of Neurology, CHU of Grenoble, Grenoble Alpes University, Grenoble, France.
• J. Neurol. Neurosurg. Psychiatr. 2017 Nov 1; 88 (11): 960-967.

BackgroundPallidal deep brain stimulation (globus pallidus internus (GPi) DBS) is the best therapeutic option for disabling isolated idiopathic (IID) and inherited (INH) dystonia. Acquired dystonia (AD) may also benefit from GPi DBS. Efficacy and safety in the long-term remained to be established.ObjectiveTo retrospectively assess long-term clinical outcomes and safety in dystonic patients who underwent GPi DBS.MethodsPatients were videotaped and assessed preoperatively and postoperatively (1-year and at last available follow-up) using the Burke-Fahn-Marsden Dystonia Rating Scale (motor score (BFMDRS-M); disability score (BFMDRS-D)).ResultsSixty-one patients were included (follow-up 7.9±5.9 years; range 1-20.7). In IID and INH (n=37), the BFMDRS-M improved at first (20.4±24.5; p<0.00001) and last (22.2±18.2; p<0.001) follow-ups compared with preoperatively (50.5±28.0). In AD (n=19), the BFMDRS-M ameliorated at 1-year (40.8±26.5; p<0.02) and late follow-ups (44.3±24.3; p<0.04) compared with preoperatively (52.8±24.2). In INH dystonia with other neurological features (n=4) there was no motor benefit. In IID and INH, the BFMDRS-D improved at 1-year (9.5±7.5; p<0.0002) and late follow-ups (10.4±7.8; p<0.016) compared with preoperatively (13.3±6.9). In AD, the BFMDRS-D reduced at 1-year (12.0±8.1; p<0.01) and late follow-ups (12.7 ±6.1; p=0.2) compared with preoperatively (14.35±5.7). Most adverse events were hardware related.ConclusionsGPi DBS is an effective and safe treatment in most patients with dystonia.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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