title: Evaluation of the efficacy of deep brain stimulation in the surgical treatment of cervical dystonia.
abstract: OBJECTIVE
  Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia.
  
  
  METHODS
  Four patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
  
  
  RESULTS
  The 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported.
  
  
  CONCLUSIONS
  Pallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment.
authors.affiliation: Neurosurgery Department, Centro Hospitalar de S. João, University of Porto, Porto, Portugal. Electronic address: trigo.francisca@gmail.com.
authors.forename: Francisca
authors.initials: F
authors.lastname: Calheiros-Trigo
authors.affiliation: Neurosurgery Department, Centro Hospitalar de S. João, University of Porto, Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Linhares
mesh_terms: D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use; D046690:Deep Brain Stimulation; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D020127:Recovery of Function; D012720:Severity of Illness Index; D014103:Torticollis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D001905:Botulinum Toxins
keywords: Botulinum toxins; Cervical dystonia; Deep brain stimulation; Distonía cervical; Distonía focal idiopática; Estimulación cerebral profunda; Focal idiopathic dystonia; Globo pálido; Globus pallidus; Movement disorder; Toxinas botulínicas; Trastornos del movimiento