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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Good long-term efficacy of pallidal stimulation in cervical dystonia: A prospective, observer-blinded study
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Good long-term efficacy of pallidal stimulation in cervical dystonia: A prospective, observer-blinded study

机译：苍白质刺激对宫颈肌张力障碍的良好长期疗效：一项前瞻性，观察者为盲的研究

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Background and purpose: Deep brain stimulation of the internal globus pallidus (GPi-DBS) is established as an effective treatment of primary generalised dystonia in controlled studies. In cervical dystonia (CD), only one previous study has reported observer-blinded outcome assessment of long-term GPi-DBS, with 1-year follow-up. Methods: In this prospective, single-centre study, eight patients with CD (7 women:1 man, 4 focal:4 segmental) treated with bilateral GPi-DBS for median (range) 30 (12-48) months, were evaluated by the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS; Severity, Disability and Pain scores), the Short-Form Health Survey-36 (SF-36), and the Becks Depression Index in an open design. In addition, a blinded rater assessed the TWSTRS Severity score from videos obtained preoperatively and at the last follow-up. Results: In the blinded evaluation, median (range) TWSTRS Severity score improved from 25 (19-30) to 8 (4-23) (P=0.028), thus a 70% (23-82) score reduction. In the open evaluation, median Severity score improvement at the last follow-up was 73%, representing a significant further improvement from 50% at 6months. The Disability and Pain scores improved by median 91% and 92%, respectively, and the SF-36 subdomain scores improved significantly. A reversible right hemiparesis and aphasia occured in one patient 4days postoperatively, because of reversible oedema around the left electrode. No other serious adverse effects and no permanent morbidity were observed. Conclusions: This single-blinded study shows good long-term efficacy of GPi-DBS in CD patients and supports using this treatment in those who have insufficient response to medical treatment.
机译：背景与目的：在对照研究中，对内苍白球（GPi-DBS）进行深层脑刺激是一种有效的治疗原发性泛肌张力障碍的方法。在子宫颈肌张力障碍（CD）中，只有一项先前的研究报道了对GPi-DBS长期患者进行观察者盲法的结局评估，并进行了1年的随访。方法：在这项前瞻性，单中心研究中，通过双侧GPi-DBS治疗中位（范围）30（12-48）个月的8例CD患者（7名女性：1名男性，4名病灶：4部分）被评估。开放式设计中的多伦多西部痉挛性斜颈评分量表（TWSTRS;严重程度，残疾和疼痛评分），短期健康调查-36（SF-36）和贝克抑郁指数。此外，盲人评估者从术前和最后一次随访中获得的视频评估了TWSTRS严重性评分。结果：在盲法评估中，TWSTRS严重度中位数（范围）从25（19-30）改善为8（4-23）（P = 0.028），因此得分降低了70％（23-82）。在公开评估中，最近一次随访的严重度中位数改善率为73％，较6个月时的50％有了显着改善。残疾和疼痛评分分别提高了91％和92％，并且SF-36亚域评分显着提高。一名患者在术后4天出现了可逆的右半身轻瘫和失语症，原因是左电极周围可逆的水肿。没有观察到其他严重的不良反应，也没有永久性的发病率。结论：这项单盲研究显示GPi-DBS在CD患者中具有良好的长期疗效，并支持对药物治疗反应不足的患者使用该治疗。

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