title: Deep brain stimulation in dystonia.
abstract: Renewed interest in stereotaxy for dystonia followed the introduction of deep brain stimulation (DBS) in Parkinson's disease and essential tremor in the 1990s. DBS evolved from ablative surgery, which was applied with varying results in the 1950s in patients with movement disorders such as Parkinson's disease, essential tremor and dystonia. The present review summarizes the current knowledge on clinical aspects of DBS in dystonia (Dec. 2002). Excellent results have been achieved in dystonic patients carrying a mutation in the DYT1 gene with improvements up to 90 %. Similar results may also be obtained in patients with idiopathic generalized dystonia, myoclonus-dystonia syndrome, and tardive dystonia. Substantial improvement has been observed in patients with focal dystonia (for instance cervical dystonia). Patients with secondary dystonia often display a lesser and more variable degree of improvement. Long-term studies are warranted to assess both motor and neuropsychological sequelae of DBS in dystonia. Furthermore, the optimal target for different dystonic disorders remains to be determined, although the globus pallidus internus has currently emerged as the most promising target for dystonia.
authors.affiliation: Dept. of Neurology and Neurosurgery, Augustenburger Platz 1, 13353 Berlin, Germany. andreas.kupsch@charite.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Kupsch
authors.forename: Andrea
authors.initials: A
authors.lastname: Kuehn
authors.forename: Stefanie
authors.initials: S
authors.lastname: Klaffke
authors.forename: Wassilios
authors.initials: W
authors.lastname: Meissner
authors.forename: Daniel
authors.initials: D
authors.lastname: Harnack
authors.forename: Christine
authors.initials: C
authors.lastname: Winter
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Haelbig
authors.forename: Anatol
authors.initials: A
authors.lastname: Kivi
authors.forename: Guy
authors.initials: G
authors.lastname: Arnold
authors.forename: Karl-Max
authors.initials: KM
authors.lastname: Einhäupl
authors.forename: Gerd-Helge
authors.initials: GH
authors.lastname: Schneider
authors.forename: Thomas
authors.initials: T
authors.lastname: Trottenberg
mesh_terms: D004421:Dystonia / Q000145:classification / Q000628:therapy*; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy / Q000379:methods*; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D013788:Thalamus / Q000601:surgery