Comparison of treatment results between selective peripheral denervation and deep brain stimulation in patients with cervical dystonia.
OBJECTIVE
Cervical dystonia (CD) is the most common form of focal dystonia. The treatment options for CD include medical therapy and surgery. The 3 basic types of CD are tonic, phasic and tremulous. Selective peripheral denervation (SPD) and globus pallidus internus (GPi) deep brain stimulation (DBS) have been developed as therapeutic options for the treatment of CD.


METHODS
Between 1997 and 2009, 24 patients with CD underwent operations: either SPD (n = 16) or DBS (n = 8). The mean follow-up period was 29.5 months (range = 2-59). The mean age at onset of symptoms was 46.6 years (range = 27-65). The patients were evaluated with the subjective scores and the Toronto Western Spasmodic Torticollis Scale scores.


RESULTS
All patients showed gradual improvement after SPD and DBS. No statistically significant differences were seen between the SPD group and the DBS group. However, there was a trend toward greater pain reduction in the DBS group (p = 0.094).


CONCLUSIONS
Both the SPD group and the DBS group showed successful improvement in their Toronto Western Spasmodic Torticollis Scale scores as well as subjective scores. The GPi DBS group showed a remarkable improvement on the pain scale and there was a trend toward greater pain reduction in the DBS group.
Huh
Ryoong
R
Department of Neurosurgery, CHA University, Bundang CHA Hospital, Sungnam, Korea.
Han
In Bo
IB
Chung
MoonYoung
M
Chung
Sangsup
S
D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation; D003714:Denervation; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D014103:Torticollis / Q000628:therapy*; D016896:Treatment Outcome