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Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation

There is no available data on the journey of dystonia patients once referred to a tertiary center to undergo deep brain stimulation (DBS). We hypothesized that some patients might be incorrectly diagnosed while others might decline the procedure or experience significant benefit with switching to a...

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Autores principales: Gorodetsky, Carolina, Azevedo, Paula, Candeias da Silva, Carolina, Fasano, Alfonso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8402533/
https://www.ncbi.nlm.nih.gov/pubmed/34437382
http://dx.doi.org/10.3390/toxins13080511
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author Gorodetsky, Carolina
Azevedo, Paula
Candeias da Silva, Carolina
Fasano, Alfonso
author_facet Gorodetsky, Carolina
Azevedo, Paula
Candeias da Silva, Carolina
Fasano, Alfonso
author_sort Gorodetsky, Carolina
collection PubMed
description There is no available data on the journey of dystonia patients once referred to a tertiary center to undergo deep brain stimulation (DBS). We hypothesized that some patients might be incorrectly diagnosed while others might decline the procedure or experience significant benefit with switching to a different botulinum neurotoxin (BoNT). This is a single-center, retrospective study of dystonia patients who were referred to the DBS program between January 2014 and December 2018. We collected data on the surgical decision as well as factors influencing this decision. Sixty-seven patients were included (30 males, mean age: 48.3 ± 20.1 years, disease duration: 16.9 ± 15.3 years). Thirty-three (49%) patients underwent DBS. Four (6%) patients were awaiting the procedure while the remaining 30 patients (45%) did not undergo DBS. Reasons for DBS decline were patient refusal (17, 53%), functional dystonia (6, 20%), and successful use of AbobotulinumtoxinA (3, 10%) in patients who had failed other BoNTs. Our study highlights the importance of structured patient education to increase acceptance of DBS, as well as careful patient evaluation, particularly with respect to functional dystonia. Finally, changing BoNT formulation might be beneficial in some patients.
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spelling pubmed-84025332021-08-29 Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation Gorodetsky, Carolina Azevedo, Paula Candeias da Silva, Carolina Fasano, Alfonso Toxins (Basel) Article There is no available data on the journey of dystonia patients once referred to a tertiary center to undergo deep brain stimulation (DBS). We hypothesized that some patients might be incorrectly diagnosed while others might decline the procedure or experience significant benefit with switching to a different botulinum neurotoxin (BoNT). This is a single-center, retrospective study of dystonia patients who were referred to the DBS program between January 2014 and December 2018. We collected data on the surgical decision as well as factors influencing this decision. Sixty-seven patients were included (30 males, mean age: 48.3 ± 20.1 years, disease duration: 16.9 ± 15.3 years). Thirty-three (49%) patients underwent DBS. Four (6%) patients were awaiting the procedure while the remaining 30 patients (45%) did not undergo DBS. Reasons for DBS decline were patient refusal (17, 53%), functional dystonia (6, 20%), and successful use of AbobotulinumtoxinA (3, 10%) in patients who had failed other BoNTs. Our study highlights the importance of structured patient education to increase acceptance of DBS, as well as careful patient evaluation, particularly with respect to functional dystonia. Finally, changing BoNT formulation might be beneficial in some patients. MDPI 2021-07-22 /pmc/articles/PMC8402533/ /pubmed/34437382 http://dx.doi.org/10.3390/toxins13080511 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gorodetsky, Carolina
Azevedo, Paula
Candeias da Silva, Carolina
Fasano, Alfonso
Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation
title Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation
title_full Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation
title_fullStr Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation
title_full_unstemmed Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation
title_short Factors Influencing the Surgical Decision in Dystonia Patients Referred for Deep Brain Stimulation
title_sort factors influencing the surgical decision in dystonia patients referred for deep brain stimulation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8402533/
https://www.ncbi.nlm.nih.gov/pubmed/34437382
http://dx.doi.org/10.3390/toxins13080511
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