title: Deep Brain Stimulation for Craniocervical Dystonia (Meige Syndrome): A Report of Four Patients and a Literature-Based Analysis of Its Treatment Effects.
abstract: OBJECTIVE
  The aim of this study was to report on four patients with craniocervical dystonia (CCD) treated with deep brain stimulation (DBS). In addition, we investigated the treatment efficacy and surgical outcome predictors by the review and analysis of previously published studies.
  
  
  METHODS
  Four patients with CCD underwent DBS of the globus pallidus internus (Gpi) or subthalamus nucleus (STN). PubMed and MEDLINE searches were performed to obtain detailed information on patients who underwent DBS for CCD. The primary efficacy endpoint was the change in the Burke-Fahn-Marsden Dystonia Rating Scale (movement and disability scores, BFMDRS-M/D) after surgery.
  
  
  RESULTS
  Seventy-five patients were included in the pooled analysis, including 69 patients with Gpi-DBS and 6 patients with STN-DBS. The mean follow-up of time was 28.0 months after surgery. The mean BFMDRS-M score was 24.5 ± 11.2 preoperatively and 8.1 ± 5.7 postoperatively at the final follow-up evaluation, with a mean improvement of 66.9% (p < 0.001). The mean BFMDRS-D score was 8.1 ± 4.6 preoperatively and 3.6 ± 2.5 postoperatively, with a mean percentage improvement of 56.0% (p < 0.01). Positive correlations were found between each of the preoperative movement and disability scores and percentage of postoperative improvement (r = 0.247, p = 0.034; r = 0.331, p = 0.034, respectively).
  
  
  CONCLUSIONS
  GPi/STN-DBS is an effective treatment for patients with medically refractory CCD, including those with severe preoperative symptoms. The age at CCD onset and the disease duration do not predict improvement in movement scores.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Xiu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Baotian
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Zhang
authors.affiliation: Beijing Key Laboratory of Neurostimulation, Beijing, China.|Beijing Neurosurgical Institute, Beijing, China.
authors.forename: Wenhan
authors.initials: W
authors.lastname: Hu
authors.affiliation: Beijing Key Laboratory of Neurostimulation, Beijing, China.|Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaoqiu
authors.initials: X
authors.lastname: Shao
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Neurostimulation, Beijing, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D019465:Craniofacial Abnormalities / Q000628:therapy*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005917:Globus Pallidus / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010009:Osteochondrodysplasias / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
keywords: Craniocervical dystonia; Meige syndrome; deep brain stimulation; treatment outcome