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首页> 外文期刊>Journal of neurology >A pooled meta-analysis of GPi and STN deep brain stimulation outcomes for cervical dystonia
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A pooled meta-analysis of GPi and STN deep brain stimulation outcomes for cervical dystonia

机译：宫颈肌瘤的GPI和STN深脑刺激结果的汇集荟萃分析

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Objective To analyze deep brain stimulation (DBS) outcomes in patients with cervical dystonia (CD), the relationships between motor and disability/pain outcomes, and the differences in outcomes between globus pallidus internus (GPi) and subthalamic nucleus (STN) DBS, and to identify potential outcome predictors. Methods A systematic literature search identified individual patient data of CD patients who underwent DBS and whose outcomes were assessed with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Then, we performed a pooled meta-analysis on this cohort. Results A review of 39 papers yielded 208 patients with individual TWSTRS scores and demographic information. At a mean follow-up period of 23.3 months after either GPi or STN DBS, the TWSTRS total (58.8%), severity (53.9%), disability (61.3%), and pain (46.6%) scores significantly improved compared to baseline status (all p = 23.3 months). The TWSTRS outcomes after GPi and STN DBS were comparable, whereas these two targets showed different adverse effect profiles. The rates of responders to DBS according to the TWSTRS total and severity (defined as >= 25% improvement) were both 89%. Regression analyses demonstrated motor benefits associated with disability improvement more than pain relief (R-2 = 0.345 and 0.195, respectively). No clinically meaningful predictors for DBS outcomes were identified. Conclusion DBS improves motor symptoms, disability, and pain in CD patients and may provide sustained benefits over 2 years. GPi and STN appear to be equally effective targets with different adverse effect profiles.
机译：目的分析宫颈肿瘤患者（CD），电动机与残疾/疼痛结果之间的关系，以及Globus pallidus Internus（GPI）和亚粒细胞核（STN）DBS之间结果的差异识别潜在的结果预测因子。方法系统文献搜索确定了多伦多西部痉挛性斜颈评级（TWSTRS）评估DBS的CD患者的个体患者数据。然后，我们对此队列进行了汇集的元分析。结果39篇论文综述产生了208名单个TWSTRS分数和人口统计信息患者。在GPI或STN DBS后23.3个月的平均随访时间，TWSTRS总量（58.8％），严重程度（53.9％），残疾（61.3％）和疼痛（46.6％）与基线状态相比显着改善（所有P = 23.3个月）。 GPI和STN DBS在可比较后的TWSTRS结果，而这两个靶标显示出不同的不良反应谱。根据TWSTRS总和严重程度（定义为> = 25％的改进）的响应者对DB的速率均为89％。回归分析证明了与残疾改善的电动效益超过疼痛缓解（R-2 = 0.345和0.195）。没有确定DBS结果的临床上有意义的预测因子。结论DBS提高了CD患者的运动症状，残疾和疼痛，可能提供超过2年的持续效益。 GPI和STN似乎是具有不同不利影响型材的同等有效目标。

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