Funding agencies: This study was funded by the Lüneburg Heritage.
Onset latency of segmental dystonia after deep brain stimulation cessation: A randomized, double-blind crossover trial
Article first published online: 20 DEC 2013
© 2013 International Parkinson and Movement Disorder Society
Volume 29, Issue 7, pages 944–949, June 2014
How to Cite
Levin, J., Singh, A., Feddersen, B., Mehrkens, J.-H. and Bötzel, K. (2014), Onset latency of segmental dystonia after deep brain stimulation cessation: A randomized, double-blind crossover trial. Mov. Disord., 29: 944–949. doi: 10.1002/mds.25780
Relevant conflicts of interest/financial disclosures: K. Bötzel and J. H. Mehrkens reported to have received speaker's honoraria from Medtronic.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 12 JUN 2014
- Article first published online: 20 DEC 2013
- Manuscript Accepted: 28 OCT 2013
- Manuscript Revised: 6 OCT 2013
- Manuscript Received: 7 JAN 2013
- deep brain stimulation;
- globus pallidus;
- segmental dystonia;
- Toronto Western Spasmodic Torticollis Rating Scale
Deep brain stimulation (DBS) of the globus pallidus internus is an effective treatment for cervical dystonia (CD). Interestingly, the onset of initial DBS effects is significantly prolonged compared with that in other diseases, such as Parkinson's disease. The return of symptoms after cessation of DBS could be delayed as well, but this has not been studied systematically.
In patients who were treated for CD using DBS and had a good treatment effect, we compared interruption of DBS with sham-OFF in a randomized, double-blind crossover trial.
We observed that dystonic features appeared within a few minutes at almost full intensity in all patients after the cessation of DBS.
The almost immediate onset of dystonic features in our sample seems to exclude mechanisms with long time constants from the pathophysiology of dystonia. Thus, it is likely that, in these patients, an aberrant pattern of neural activity representing an inappropriate set point value for the position of the head is responsible for dystonia. © 2013 International Parkinson and Movement Disorder Society