Deep brain stimulation for dystonia: a novel perspective on the value of genetic testing.
The dystonias are a group of disorders characterized by excessive muscle contractions leading to abnormal movements and postures. There are many different clinical manifestations and underlying causes. Deep brain stimulation (DBS) provides an effect treatment, but outcomes can vary considerably among the different subtypes of dystonia. Several variables are thought to contribute to this variation including age of onset and duration of dystonia, specific characteristics of the dystonic movements, location of stimulation and stimulator settings, and others. The potential contributions of genetic factors have received little attention. In this review, we summarize evidence that some of the variation in DBS outcomes for dystonia is due to genetic factors. The evidence suggests that more methodical genetic testing may provide useful information in the assessment of potential surgical candidates, and in advancing our understanding of the biological mechanisms that influence DBS outcomes.
Departments of Neurology, Human Genetics and Pediatrics, Emory University, Suite 6300 Woodruff Memorial Building, 101 Woodruff Circle, Atlanta, GA, 30322, USA. hjinnah@emory.edu.
H A
HA
Jinnah
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Ron
R
Alterman
Department of Neurology and Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Christine
C
Klein
Department of Neurosurgery, Medical School Hannover, MHH, Hannover, Germany.
Joachim K
JK
Krauss
Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France.
Elena
E
Moro
Département des Maladies du Système Nerveux, Hôpital de la Salpêtrière, Paris, France.
Marie
M
Vidailhet
Neuromodulation Global Research, Medtronic Inc., Fridley, MN, USA.
Robert
R
Raike
D046690:Deep Brain Stimulation; D020821:Dystonic Disorders / Q000235:genetics* / Q000628:therapy*; D005820:Genetic Testing / Q000379:methods; D006801:Humans
Deep brain stimulation; Dystonia; Genetics; Neuromodulation