A double-blind study on a patient with tardive dyskinesia treated with pallidal deep brain stimulation.
BACKGROUND
Tardive dyskinesia (TD) is a neurological disorder typically induced by long-term exposure to neuroleptics. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) may represent a therapeutic alternative for TD, which is often resistant to conservative treatment.


OBJECTIVE
This report's objective is to present a case of TD successfully treated with DBS, as well as to indicate a putative role of brain perfusion scintigraphy as a helpful tool correlating functional imaging findings with clinical responsiveness to DBS.


RESULTS
A 42-year-old male patient suffering from refractory TD underwent bilateral GPi DBS surgery. Post-operative Burke-Fahn-Mardsen Dystonia Rating Scale (BFMDRS) and Abnormal Involuntary Movement Scale (AIMS) total scores have been reduced by 90.7% and 76.7% respectively on the 6-month follow-up assessment. Brain perfusion scintigraphy, performed post-operatively in the two stimulation states, revealed a decrease in cerebral blood flow, during the 'on-DBS', compared with the 'off-DBS' state.


CONCLUSIONS
Clinical improvement of this patient, correspondent to previous studies, suggests that continuous bilateral GPi DBS may provide a promising treatment option for TD. Furthermore, this report could imply, as no previous such comparison study exists, a possible correlation between brain functional imaging findings and the movement disorder's response to DBS.
Kefalopoulou
Z
Z
Department of Neurosurgery, University of Patras, Greece.
Paschali
A
A
Markaki
E
E
Vassilakos
P
P
Ellul
J
J
Constantoyannis
C
C
D000328:Adult; D001921:Brain / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D046690:Deep Brain Stimulation; D004311:Double-Blind Method; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology / Q000628:therapy*; D005500:Follow-Up Studies; D005917:Globus Pallidus; D006801:Humans; D008297:Male; D009043:Motor Activity; D055420:Perfusion Imaging; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014741:Video Recording