La estimulación cerebral profunda en el tratamiento de la distonía cráneocervical (Síndrome de Meige): presentación de cuatro pacientes y revisión bibliográfica de sus efectos terapéuticos.: Publicado originalmente en la revista Neuromodulation 2016; 19: 818-23. Traducción: Dr. Juan Carlos Andreani.

Xiu Wang; Chao Zhang; Yao Wang; Chang Liu; Baotian Zhao; Jian-guo Zhang; Wenhan Hu; Xiaoqiu Shao; Kai Zhang

doi:10.47924/neurotarget2017141

Authors

Xiu Wang Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.
Chao Zhang Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.
Yao Wang Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.
Chang Liu Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.
Baotian Zhao Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.
Jian-guo Zhang Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.
Wenhan Hu Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Instituto Neuroquirúrgico de Beijing, Beijing, China
Xiaoqiu Shao Beijing Key Laboratorio de Neuroestimulación, Beijing, China. Departamento de Neurología del Hospital Beijing Tiantan, Capital Medical University, Beijing, China.
Kai Zhang Departamento de Neurocirugía del Hospital Beijing Tiantan, Capital Medical University, Beijing, China. Beijing Key Laboratorio de Neuroestimulación, Beijing, China.

DOI:

https://doi.org/10.47924/neurotarget2017141

Keywords:

Craniocervical dystonia, deep brain stimulation, Meige Syndrome, Treatment outcome

Abstract

Objectives: The aim of this study was to report on four patients with craniocervical dystonia (CCD) treated with deep brain stimulation (DBS). In addition, we investigated the treatment eficacy and surgical outcome predictors by the review and analysis of previously published studies.
Methods: Four patients with CCD underwent DBS of the globus pallidus internus (Gpi) or subthalamic nucleus (STN). PubMed and MEDLINE searches were performed to obtain detailed information on patients who underwent DBS for CCD. The primary eficacy endpoint was the change in the Burke–Fahn–Marsden Dystonia Rating Scale (movement and disability scores, BFMDRS- M/D) after surgery.
Results: Seventyfive patients were included in the pooled analysis, including 69 patients with Gpi-DBS and 6 patients with STNDBS. The mean follow-up of time was 28.0 months after surgery. The mean BFMDRS-M score was 24.5 ± 11.2 preoperatively and 8.1 ± 5.7 postoperatively at the final follow-up evaluation, with a mean improvement of 66.9% (p < 0.001). The mean BFMDRS-D score was 8.1 ± 4.6 preoperatively and 3.6 ± 2.5 postoperatively, with a mean percentage improvement of 56.0% (p < 0.01). Positive correlations were found between each of the preoperative movement and disability scores and percentage of postoperative improvement (r = 0.247, p = 0.034; r = 0.331, p = 0.034, respectively).
Conclusion: GPi/STN-DBS is an efective treatment for patients with medically refractory CCD, including those with severe preoperative symptoms. The age at CCD onset and the disease duration do not predict improvement in movement scores.

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