SweetSpot of antidystonic effect in pallidal neurostimulation: a European multicentre imaging study

摘要: Abstract Objective: We investigated Volumes of Tissue activated (VTA) in dystonia subjects under effective bilateral pallidal DBS. We aimed to disentangle the sweet spot for dystonia suppression within the pallidal region. Background: GPi-DBS is an established therapy for generalized and cervical dystonia. Average improvement of dystonia severity amounts to 50-60%, but outcomes are often variable and clinical studies report up to 25% non-responders. Variability in electrode placement may account for a large proportion of outcome variability. So far no study has been able to identify an" optimal efficacy volume" within the GPi. Methods: 85 subjects with dystonia (41 cervical mean TWSTRS 20.3±3.6 points/44 generalized dystonia, mean BFMDRS 45.8±20.5 points) under chronic bilateral GPi-DBS from 8 European DBS centres were stratified for chronic motor improvement (median reduction of 46.7 (±27.7)% after …