Relevant conflicts of interest/financial disclosures: Anne Koy took part in the EMCT-training sponsored by Medtronic and is supported by the German Research Foundation (DFG).
Effects of deep brain stimulation in dyskinetic cerebral palsy: A meta-analysis
Article first published online: 13 FEB 2013
Copyright © 2013 Movement Disorder Society
Volume 28, Issue 5, pages 647–654, May 2013
How to Cite
Koy, A., Hellmich, M., Pauls, K. A. M., Marks, W., Lin, J.-P., Fricke, O. and Timmermann, L. (2013), Effects of deep brain stimulation in dyskinetic cerebral palsy: A meta-analysis. Mov. Disord., 28: 647–654. doi: 10.1002/mds.25339
Oliver Fricke received financial support from Walter- and Marga-Boll-StiftungPfizer and Turner-Syndrom-Vereinigung Deutschland e.V.. Martin Hellmich, Amande Pauls, Warren Marks do not have financial disclosures and no conflicts of interests. Jean-Pierre Lin has been the recipient of an unrestricted educational grant and also travel support to attend scientific meetings from Medtronic Ltd. Lars Timmermann received payments as a consultant for Medtronic Inc, Boston Scientific, Bayer Healthcare, UCB Schwarz Pharma. L.T. received honoraria as a speaker on symposia sponsored by TEVA Pharma, Lundbeck Pharma, Bracco, Gianni PR, Medas Pharma, UCB Schwarz Pharma, Desitin Pharma, Boehringer Ingelheim, GlaxoSmithKline, Eumecom, Orion Pharma, Medtronic, Boston Scientific, Cephalon, Abott, GE Medical. The institution of L.T., not L.T. personally received funding by the German Research Foundation, the German Ministry of Education and Research, Manfred und Ursula Müller Stiftung, Klüh Stiftung, Hoffnungsbaum e.V., NBIA DISORDERS SOCIETY USA, Köln Fortune, Medtronic, Deutsche Parkinson Vereinigung.
Anne Koy and Martin Hellmich contributed equally to this work.
- Issue published online: 15 MAY 2013
- Article first published online: 13 FEB 2013
- Manuscript Accepted: 3 DEC 2012
- Manuscript Revised: 27 NOV 2012
- Manuscript Received: 21 MAR 2012
- deep brain stimulation;
- dyskinetic cerebral palsy
Secondary dystonia encompasses a heterogeneous group with different etiologies. Cerebral palsy is the most common cause. Pharmacological treatment is often unsatisfactory. There are only limited data on the therapeutic outcomes of deep brain stimulation in dyskinetic cerebral palsy. The published literature regarding deep brain stimulation and secondary dystonia was reviewed in a meta-analysis to reevaluate the effect on cerebral palsy. The Burke-Fahn-Marsden Dystonia Rating Scale movement score was chosen as the primary outcome measure. Outcome over time was evaluated and summarized by mixed-model repeated-measures analysis, paired Student t test, and Pearson's correlation coefficient. Twenty articles comprising 68 patients with cerebral palsy undergoing deep brain stimulation assessed by the Burke-Fahn-Marsden Dystonia Rating Scale were identified. Most articles were case reports reflecting great variability in the score and duration of follow-up. The mean Burke-Fahn-Marsden Dystonia Rating Scale movement score was 64.94 ± 25.40 preoperatively and dropped to 50.5 ± 26.77 postoperatively, with a mean improvement of 23.6% (P < .001) at a median follow-up of 12 months. The mean Burke-Fahn-Marsden Dystonia Rating Scale disability score was 18.54 ± 6.15 preoperatively and 16.83 ± 6.42 postoperatively, with a mean improvement of 9.2% (P < .001). There was a significant negative correlation between severity of dystonia and clinical outcome (P < .05). Deep brain stimulation can be an effective treatment option for dyskinetic cerebral palsy. In view of the heterogeneous data, a prospective study with a large cohort of patients in a standardized setting with a multidisciplinary approach would be helpful in further evaluating the role of deep brain stimulation in cerebral palsy. © 2013 Movement Disorder Society