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- Title
Parameters for subthalamic deep brain stimulation in patients with dystonia: a systematic review.
- Authors
Wang, Yuhan; Zhang, Chencheng; Sun, Bomin; Li, Dianyou; Wu, Yiwen
- Abstract
Background and objective: Deep brain stimulation (DBS) is used for treating dystonia, commonly targeting the subthalamic nucleus (STN). Optimal stimulation parameters are required to achieve satisfying results. However, recommended parameters for STN-DBS remain to be identified. In this review, we aimed to assess the optimal stimulation parameters by analyzing previously published STN-DBS data of patients with dystonia. Methods: We examined the STN-DBS stimulation parameters used in studies on dystonia selected on the PubMed/Medline database. Results: Of the 86 publications retrieved from the PubMed/Medline database, we included 24, which consisted of data from 94 patients and 160 electrodes. Overall, the following average stimulation parameters were observed: amplitude, 2.59 ± 0.67 V; pulse width, 83.87 ± 34.70 μs; frequency, 142.08 ± 37.81 Hz. The average improvement rate was 64.72 ± 24.74%. The improvement rate and stimulation parameters were linearly dependent. The average improvement rate increased by 3.58% at each 10-Hz increase in frequency. In focal and segmental dystonia, the improvement rate and stimulation parameters were linearly dependent. The improvement rate increased by 6.06% and decreased by 2.14% at each 10-Hz increase in frequency and pulse width, respectively. Seventeen publications (83 patients) mentioned stimulation-related adverse effects, including dyskinesia (17), depression (8), transient dysarthria (5), weight gain (4), transient dysphasia (3), transient paresthesia (2), and sustained hyperkinesia (2). Conclusions: The optimal stimulation parameter for STN-DBS varies across patients. Our findings may be useful for DBS programming based on the specific dystonia subtypes, especially for patients with focal and segmental dystonia.
- Subjects
SUBTHALAMIC nucleus; DEEP brain stimulation; DYSTONIA; FOCAL dystonia; WEIGHT gain
- Publication
Journal of Neurology, 2022, Vol 269, Issue 1, p197
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-020-10372-x