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The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach

BACKGROUND: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living. METHODS: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8–65) receiving...

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Autores principales: Eggink, Hendriekje, Toonen, Rivka F., van Zijl, Jonathan C., van Egmond, Martje E., Bartels, Anna L., Brandsma, Rick, Contarino, M. Fiorella, Peall, Kathryn J., van Dijk, J. Marc C., Oterdoom, D. L. Marinus, Beudel, Martijn, Tijssen, Marina A. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394190/
https://www.ncbi.nlm.nih.gov/pubmed/32775016
http://dx.doi.org/10.5334/tohm.69
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author Eggink, Hendriekje
Toonen, Rivka F.
van Zijl, Jonathan C.
van Egmond, Martje E.
Bartels, Anna L.
Brandsma, Rick
Contarino, M. Fiorella
Peall, Kathryn J.
van Dijk, J. Marc C.
Oterdoom, D. L. Marinus
Beudel, Martijn
Tijssen, Marina A. J.
author_facet Eggink, Hendriekje
Toonen, Rivka F.
van Zijl, Jonathan C.
van Egmond, Martje E.
Bartels, Anna L.
Brandsma, Rick
Contarino, M. Fiorella
Peall, Kathryn J.
van Dijk, J. Marc C.
Oterdoom, D. L. Marinus
Beudel, Martijn
Tijssen, Marina A. J.
author_sort Eggink, Hendriekje
collection PubMed
description BACKGROUND: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living. METHODS: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8–65) receiving GPi-DBS were recruited. All patients underwent a multidisciplinary evaluation before and 1-year post DBS implantation. The Canadian Occupational Performance Measure (COPM) first identified and then measured changes in functional priorities. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to evaluate dystonia severity. RESULTS: Priorities in daily functioning substantially varied between patients but showed significant improvements on performance and satisfaction after DBS. Clinically significant COPM-score improvements were present in 7/8 motor responders, but also in 4/7 motor non-responders. DISCUSSION: The use of a patient-oriented approach to measure GPi-DBS effectiveness in dystonia provides an unique insight in patients’ priorities and demonstrates that tangible improvements can be achieved irrespective of motor response. HIGHLIGHTS: Functional priorities in life of dystonia patients and their caregivers vary greatly. The effect of DBS on functional priorities did not correlate with motor outcome. Half of the motor ‘non-responder’ patients reported important changes in their priorities. The effect of DBS in dystonia should not be measured by motor outcome alone.
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spelling pubmed-73941902020-08-07 The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach Eggink, Hendriekje Toonen, Rivka F. van Zijl, Jonathan C. van Egmond, Martje E. Bartels, Anna L. Brandsma, Rick Contarino, M. Fiorella Peall, Kathryn J. van Dijk, J. Marc C. Oterdoom, D. L. Marinus Beudel, Martijn Tijssen, Marina A. J. Tremor Other Hyperkinet Mov (N Y) Brief Report BACKGROUND: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living. METHODS: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8–65) receiving GPi-DBS were recruited. All patients underwent a multidisciplinary evaluation before and 1-year post DBS implantation. The Canadian Occupational Performance Measure (COPM) first identified and then measured changes in functional priorities. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to evaluate dystonia severity. RESULTS: Priorities in daily functioning substantially varied between patients but showed significant improvements on performance and satisfaction after DBS. Clinically significant COPM-score improvements were present in 7/8 motor responders, but also in 4/7 motor non-responders. DISCUSSION: The use of a patient-oriented approach to measure GPi-DBS effectiveness in dystonia provides an unique insight in patients’ priorities and demonstrates that tangible improvements can be achieved irrespective of motor response. HIGHLIGHTS: Functional priorities in life of dystonia patients and their caregivers vary greatly. The effect of DBS on functional priorities did not correlate with motor outcome. Half of the motor ‘non-responder’ patients reported important changes in their priorities. The effect of DBS in dystonia should not be measured by motor outcome alone. Ubiquity Press 2020-06-08 /pmc/articles/PMC7394190/ /pubmed/32775016 http://dx.doi.org/10.5334/tohm.69 Text en Copyright: © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Brief Report
Eggink, Hendriekje
Toonen, Rivka F.
van Zijl, Jonathan C.
van Egmond, Martje E.
Bartels, Anna L.
Brandsma, Rick
Contarino, M. Fiorella
Peall, Kathryn J.
van Dijk, J. Marc C.
Oterdoom, D. L. Marinus
Beudel, Martijn
Tijssen, Marina A. J.
The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach
title The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach
title_full The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach
title_fullStr The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach
title_full_unstemmed The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach
title_short The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach
title_sort effectiveness of deep brain stimulation in dystonia: a patient-centered approach
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394190/
https://www.ncbi.nlm.nih.gov/pubmed/32775016
http://dx.doi.org/10.5334/tohm.69
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