The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach

Hendriekje Eggink; Rivka F Toonen; Jonathan C van Zijl; Martje E van Egmond; Anna L Bartels; Rick Brandsma; M Fiorella Contarino; Kathryn J Peall; J Marc C van Dijk; D L Marinus Oterdoom; Martijn Beudel; Marina A J Tijssen

doi:10.5334/tohm.69

The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach

Hendriekje Eggink^*, Rivka F Toonen, Jonathan C van Zijl, Martje E van Egmond, Anna L Bartels, Rick Brandsma, M Fiorella Contarino, Kathryn J Peall, J Marc C van Dijk, D L Marinus Oterdoom, Martijn Beudel, Marina A J Tijssen

^*Corresponding author for this work

Biology-Related, Artificial, and Interventional Neuroscience (BRAIN)

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living.

Methods: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8-65) receiving GPi-DBS were recruited. All patients underwent a multidisciplinary evaluation before and 1-year post DBS implantation. The Canadian Occupational Performance Measure (COPM) first identified and then measured changes in functional priorities. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to evaluate dystonia severity.

Results: Priorities in daily functioning substantially varied between patients but showed significant improvements on performance and satisfaction after DBS. Clinically significant COPM-score improvements were present in 7/8 motor responders, but also in 4/7 motor non-responders.

Discussion: The use of a patient-oriented approach to measure GPi-DBS effectiveness in dystonia provides an unique insight in patients' priorities and demonstrates that tangible improvements can be achieved irrespective of motor response.

Highlights: Functional priorities in life of dystonia patients and their caregivers vary greatlyThe effect of DBS on functional priorities did not correlate with motor outcomeHalf of the motor 'non-responder' patients reported important changes in their prioritiesThe effect of DBS in dystonia should not be measured by motor outcome alone.

Original language	English
Pages (from-to)	2
Number of pages	1
Journal	Tremor and other hyperkinetic movements (New York, N.Y.)
Volume	10
DOIs	https://doi.org/10.5334/tohm.69
Publication status	Published - 8-Jun-2020

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Eggink, H., Toonen, R. F., van Zijl, J. C., van Egmond, M. E., Bartels, A. L., Brandsma, R., Contarino, M. F., Peall, K. J., van Dijk, J. M. C., Oterdoom, D. L. M., Beudel, M., & Tijssen, M. A. J. (2020). The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach. Tremor and other hyperkinetic movements (New York, N.Y.), 10, 2. https://doi.org/10.5334/tohm.69

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abstract = "Background: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living.Methods: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8-65) receiving GPi-DBS were recruited. All patients underwent a multidisciplinary evaluation before and 1-year post DBS implantation. The Canadian Occupational Performance Measure (COPM) first identified and then measured changes in functional priorities. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to evaluate dystonia severity.Results: Priorities in daily functioning substantially varied between patients but showed significant improvements on performance and satisfaction after DBS. Clinically significant COPM-score improvements were present in 7/8 motor responders, but also in 4/7 motor non-responders.Discussion: The use of a patient-oriented approach to measure GPi-DBS effectiveness in dystonia provides an unique insight in patients' priorities and demonstrates that tangible improvements can be achieved irrespective of motor response.Highlights: Functional priorities in life of dystonia patients and their caregivers vary greatlyThe effect of DBS on functional priorities did not correlate with motor outcomeHalf of the motor 'non-responder' patients reported important changes in their prioritiesThe effect of DBS in dystonia should not be measured by motor outcome alone.",

author = "Hendriekje Eggink and Toonen, {Rivka F} and {van Zijl}, {Jonathan C} and {van Egmond}, {Martje E} and Bartels, {Anna L} and Rick Brandsma and Contarino, {M Fiorella} and Peall, {Kathryn J} and {van Dijk}, {J Marc C} and Oterdoom, {D L Marinus} and Martijn Beudel and Tijssen, {Marina A J}",

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year = "2020",

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doi = "10.5334/tohm.69",

language = "English",

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journal = "Tremor and other hyperkinetic movements (New York, N.Y.)",

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T1 - The Effectiveness of Deep Brain Stimulation in Dystonia

T2 - A Patient-Centered Approach

AU - Eggink, Hendriekje

AU - Toonen, Rivka F

AU - van Zijl, Jonathan C

AU - van Egmond, Martje E

AU - Bartels, Anna L

AU - Brandsma, Rick

AU - Contarino, M Fiorella

AU - Peall, Kathryn J

AU - van Dijk, J Marc C

AU - Oterdoom, D L Marinus

AU - Beudel, Martijn

AU - Tijssen, Marina A J

PY - 2020/6/8

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N2 - Background: To systematically evaluate the effectiveness of deep brain stimulation of the globus pallidus internus (GPi-DBS) in dystonia on pre-operatively set functional priorities in daily living.Methods: Fifteen pediatric and adult dystonia patients (8 male; median age 32y, range 8-65) receiving GPi-DBS were recruited. All patients underwent a multidisciplinary evaluation before and 1-year post DBS implantation. The Canadian Occupational Performance Measure (COPM) first identified and then measured changes in functional priorities. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to evaluate dystonia severity.Results: Priorities in daily functioning substantially varied between patients but showed significant improvements on performance and satisfaction after DBS. Clinically significant COPM-score improvements were present in 7/8 motor responders, but also in 4/7 motor non-responders.Discussion: The use of a patient-oriented approach to measure GPi-DBS effectiveness in dystonia provides an unique insight in patients' priorities and demonstrates that tangible improvements can be achieved irrespective of motor response.Highlights: Functional priorities in life of dystonia patients and their caregivers vary greatlyThe effect of DBS on functional priorities did not correlate with motor outcomeHalf of the motor 'non-responder' patients reported important changes in their prioritiesThe effect of DBS in dystonia should not be measured by motor outcome alone.

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DO - 10.5334/tohm.69

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JO - Tremor and other hyperkinetic movements (New York, N.Y.)

JF - Tremor and other hyperkinetic movements (New York, N.Y.)

ER -

The Effectiveness of Deep Brain Stimulation in Dystonia: A Patient-Centered Approach

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