Keywords
dystonic disorders
surgery for dystonia
deep Brain Stimulation (DBS)
How to Cite
Abstract
The aim of this article is to review the importance of deep brain stimulation (DBS) as
treatment for dystonia, considering the population that should be taken to surgery, the
cerebral structure that should be stimulated and the expected results in improvement of
symptoms and the risks to which the patient is
exposed. For that aim, a search was performed
in Pubmed and Medline databases. Dystonia is
a major medical problem with little prevalence
in the general population, being a disease of
primary and secondary origin, affecting patient
mobility and producing a significant deterioration
in the quality of life. This review pretends is
to evaluate the effectiveness of brain stimulation
in dystonia, if it is more effective depending on
the type, timing for intervention and long-term
improvement.
Tarsy D, Simon D. Dystonia. N EngL J
Med. 2006;355;818-29.
Sironi V. Origin and evolution of deep
brain stimulation. Front Integr Neurosci.
;5:42.
Bragg D, Armata L, Nery F, Breakefield
X, Sharma N. Molecular pathways in
dystonia. Neurobiol Dis. 2011;42(2):136-
Albright L, Barry M, Painter M, Shultz
B. Infusion of intrathecal baclofen for
generalized dystonia in cerebral palsy. J
Neurosurg. 1998;88:73-6.
Uchiyama T, Nakanishi K, Fukawa N.
Neuromodulation usion intrathecal baclofen
therapy for spasticity and dystonia.
Neuro Med Chir. 2012;52:101-15.
Chiken S, Nambu A. Disrupting neuronal
transmission: mechanism of DBS? Front
Integr Neurosci. 2014;8:33.
Francisco G, Saulino M, Yablon S, Turner
M. Intrathecal baclofen therapy: An
update. PM R. 2009;1(9):852-8.
Rahul S, Shah B, Chang S, Min H, Cho
Z, Blaha C, Lee K. Deep brain stimulation:
technology at the cutting edge. J
Clin Neurol. 2010;6:167-82.
Lyons M. Deep brain stimulation: current
and future clinical applications. Mayo
Clin Proc. 2011;86(7):662-72.
Kiss Z, Doig-Beyaert K, Eliasziw M,
Tsui J, Haffenden A, Suchowersky O.
The Canadian multicentre study of deep
brain stimulation for cervical dystonia.
Brain. 2007;130:2879-86.
Isaias L, Alterman R, Tagliati M. Outcome
predictors of pallidal stimulation in
patients with primary dystonia: the role of
disease duration. Brain. 2008;131:1895-
Greene P. Deep-brain stimulation for
generalized dystonia. N Engl J Med.
;352:5-19.
Cheung T, Noecker A, Alterman R, Mc-
Intyre C, Tagliati M. Defining a therapeutic
target for Pallidal Deep Brain
Stimulation for Dystonia. Ann Neurol.
;76:22-30.
Jahanshahi M, Torkamani M, Beigi M,
Wilkinson L, Page D, Madeley L. Palli dal stimulation for primary generalised
dystonia: effect on cognition, mood and
quality of life. J Neurol. 2014;261:164-
Bonilla AJ, Miranda N, Acevedo JC.
Uso de neuroestimuladores en el síndrome
de dolor regional complejo. Dolor.
;1(1):64-78.
Acevedo JC. La corteza motora cerebral:
relación directa con la vía nociceptiva.
Análisis anatómico y fisiológico. Estimulación
de la corteza motora en el tratamiento
del dolor. Dolor. 2007;2(1):47-57.
Acevedo JC. Dolor neuropático de origen
cerebral. anatomía del tálamo: principios
fisiopatológicos. Dolor. 2007;2(2):24-35.
Acevedo JC, Álvarez R. Evolución histórica
del concepto de estimulación
eléctrica de la corteza motora como tratamiento
del dolor neuropático de origen
central (Takashi Tsubokawa). Dolor.
;3(4):57-65.
Acevedo JC, Aristizábal D, Ardila A,
Ávila D. Psiconeurocirugía: antecedentes
históricos y actualidad. Dolor.
;4(1):78-91.
Acevedo JC, Ordóñez G, Camacho JE,
Tshampel A, Burgos R. Procedimientos
neuroquirúrgicos cerebrales guiados
por estereotaxia realizados en el Hospital
Universitario San Ignacio: evolución
a corto y mediano plazo. Univ Méd.
;54(1):27-42.
Rubio-Agusti I, Pareés I, Kojovic M.
Tremulous cervical dystonia is likely to
be familial: clinical characteristics of a
large cohort. Parkinsonism Relat Disord.
;19:634-8.
Nisticò R, Pirritano D, Salsone M. Blink
reflex recovery cycle in patients with
dystonic tremor: a crosssectional study.
Neurology. 2012;78:1363-5.
Tinazzi M, Fasano A, Di Matteo A. Temporal
discrimination in patients with
dystonia and tremor and patients with essential
tremor. Neurology. 2013;80:76-84.
Bradley D, Whelan R, Walsh R. Temporal
discrimination threshold: VBM
evidence for an endophenotype in adult
onset primary torsion dystonia. Brain.
;132:2327-35.
Kimmich O, Bradley D, Whelan R. Sporadic
adult onset primary torsion dystonia
is a genetic disorder by the temporal discrimination
test. Brain. 2011;134:2656-
Kimmich O, Molloy A, Whelan R. Temporal
discrimination, a cervical dystonia
endophenotype: penetrance and functional
correlates. Mov Disord. 2014;29:804-
Liu X, Wang S, Yianni J. The sensory
and motor representation of synchronized
oscillations in the globus pallidus
in patients with primary dystonia. Brain.
;131:1562-73.
Neychev VK, Gross RE, Lehéricy S,
Hess EJ, Jinnah HA. The functional neuroanatomy
of dystonia. Neurobiol Dis.
;42:185-201.
Zoons E, Booij J, Nederveen AJ, Dijk
JM, Tijssen MA. Structural, functional
and molecular imaging of the brain in
primary focal dystonia: a review. Neuroimage.
;56:1011-20.
Teo JT, van de Warrenburg BP, Schneider
SA, Rothwell JC, Bhatia KP. Neurophysiological
evidence for cerebellar dysfunction
in primary focal dystonia. J Neurol
Neurosurg Psychiatry. 2009;80:80-3.
Hoffland BS, Kassavetis P, Bologna M.
Cerebellumdependent associative learning
deficits in primary dystonia are
normalized by rTMS and practice. Eur J
Neurosci. 2013;38:2166-71.
Prudente CN, Pardo CA, Xiao J. Neuropathology
of cervical dystonia. Exp Neurol.
;241:95-104.
Sadnicka A, Hoffland BS, Bhatia KP, van
de Warrenburg BP, Edwards MJ. The cerebellum
in dystonia: help or hindrance?
Clin Neurophysiol. 2012;123:65-70.
Prudente CN, Hess EJ, Jinnah HA. Dystonia
as a network disorder: what is the
role of the cerebellum? Neuroscience.
;260:23-35.
Quartarone A, Hallett M. Emerging concepts
in the physiological basis of dystonia.
Mov Disord. 2013;28:958-67.
Hedera P, Cibulcík F, Davis TL. Pharmacotherapy
of essential tremor. J Cent
Nerv Syst Dis. 2013;5:43-55.
Ilinsky IA, Kultas-Ilinsky K. Motor
thalamic circuits in primates with emphasis
on the area targeted in treatment
of movement disorders. Mov Disord.
;17:S9-S14.
Vidailhet M, Vercueil L, Houeto JL.
Bilateral deepbrain stimulation of the
globus pallidus in primary generalized
dystonia. N Engl J Med. 2005;352:459-67.
Vidailhet M, Vercueil L, Houeto JL. Bilateral,
pallidal, deep-brain stimulation in
primary generalised dystonia: a prospective
-year follow-up study. Lancet Neurol.
;6:223-9.
Kupsch A, Benecke R, Müller J. Pallidal
deep-brain stimulation in primary generalized
or segmental dystonia. N Engl J
Med. 2006;355:1978-90.
Eltahawy HA, Saint-Cyr J, Giladi N, Lang
AE, Lozano AM. Primary dystonia is
more responsive than secondary dystonia
to pallidal interventions: outcome after
pallidotomy or pallidal deep brain stimulation.
Neurosurgery. 2004;54:613-9.
Vidailhet M, Yelnik J, Lagrange C. Bilateral
pallidal deep brain stimulation
for the treatment of patients with dystonia-
choreoathetosis cerebral palsy: a
prospective pilot study. Lancet Neurol.
;8:709-17.
Vidailhet M, Jutras MF, Grabli D, Roze
E. Deep brain stimulation for dystonia.
J Neurol Neurosurg Psychiatry.
;84:1029-42.
Fuller J, Prescott IA, Moro E, Toda H,
Lozano A, Hutchison WD. Pallidal deep
brain stimulation for a case of hemidystonia
secondary to a striatal stroke. Stereotact
Funct Neurosurg. 2013;91:190-7.
Walsh RA, Sidiropoulos C, Lozano AM.
Bilateral pallidal stimulation in cervical
dystonia: blinded evidence of benefit beyond
years. Brain. 2013;136:761-9.
Lefaucheur JP, Fénelon G, Ménard-Lefaucheur
I, Wendling S, Nguyen JP. Lowfrequency
repetitive TMS of premotor
cortex can reduce painful axial spasms
in generalized secondary dystonia: a pilot
study of three patients. Neurophysiol
Clin. 2004;34:141-5.
Charlesworth G, Bhatia KP. Primary and
secondary dystonic syndromes: an update.
Curr Opin Neurol. 2013;26:406-12.
Fung VS, Jinnah HA, Bhatia K, Vidailhet
M. Assessment of patients with isolated
or combined dystonia: an update
on dystonia syndromes. Mov Disord.
;28:889-98.
Fahn S. Classification of movement disorders.
Mov Disord. 2011;26:947-57.
Albanese A, Asmus F, Bhatia KP. EFNS
guidelines on diagnosis and treatment
of primary dystonias. Eur J Neurol.
;18:5-18.
Moghimi N, Jabbari B, Szekely AM. Primary
dystonias and genetic disorders with
dystonia as clinical feature of the disease.
Eur J Paediatr Neurol. 2014;18:79-105.
Charlesworth G, Plagnol V, Holmstro¨m
KM. Mutations in ANO3 cause dominant
craniocervical dystonia: ion channel
implicated in pathogenesis. Am J Hum
Genet. 2012;91:1041-50.
Zech M, Gross N, Jochim A. Rare sequence
variants in ANO3 and GNAL in a
primary torsion dystonia series and controls.
Mov Disord. 2014;29:143-7.
This journal is registered under a Creative Commons Attribution 4.0 International Public License. Thus, this work may be reproduced, distributed, and publicly shared in digital format, as long as the names of the authors and Pontificia Universidad Javeriana are acknowledged. Others are allowed to quote, adapt, transform, auto-archive, republish, and create based on this material, for any purpose (even commercial ones), provided the authorship is duly acknowledged, a link to the original work is provided, and it is specified if changes have been made. Pontificia Universidad Javeriana does not hold the rights of published works and the authors are solely responsible for the contents of their works; they keep the moral, intellectual, privacy, and publicity rights.
Approving the intervention of the work (review, copy-editing, translation, layout) and the following outreach, are granted through an use license and not through an assignment of rights. This means the journal and Pontificia Universidad Javeriana cannot be held responsible for any ethical malpractice by the authors. As a consequence of the protection granted by the use license, the journal is not required to publish recantations or modify information already published, unless the errata stems from the editorial management process. Publishing contents in this journal does not generate royalties for contributors.