Deep-brain Stimulation for Dystonia

Current Indications and Future Orientations

Stéphane Thobois; Teodor Danaila; Gustavo Polo; Emile Simon; Patrick Mertens; Emmanuel Broussolle

Disclosures

Future Neurology. 2014;9(1):77-87. 

In This Article

Conclusion

DBS represents a major therapeutic advance for dystonia. However, dystonia consist of a very heterogeneous group of entities, which do not respond to DBS to the same extent. Recognized 'good' indications are primary generalized and segmental (notably cervical) dystonia, and myoclonus and tardive dystonia. Outcomes are much poorer for secondary dystonia, mainly because of the presence of brain lesions, or the progression of the disease. Therefore, for secondary dystonia, indications of DBS should be discussed carefully and on an individual basis. The classical target of stimulation remains the ventrolateral part of the GPi but other targets, such as the subthalamic nucleus, seem promising. The use of combined targets of stimulation to better improve heterogeneous clinical manifestations could also be interesting in the future but new studies are needed to conclude. A summary of the current indications is presented in Table 5.

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