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Ann Rehabil Med. 2014 Apr;38(2):209-17. doi: 10.5535/arm.2014.38.2.209. Epub 2014 Apr 29.

Two-year outcomes of deep brain stimulation in adults with cerebral palsy.

Author information

1
Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
2
Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
3
Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. ; Graduate School Program of Nano Science and Technology, Yonsei University, Seoul, Korea. ; Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, Korea.

Abstract

OBJECTIVE:

To investigate the effect of deep brain stimulation (DBS) on reducing dystonia and disability in adults with cerebral palsy (CP) and to compare the therapeutic outcomes between primary dystonia patients and CP patients over two years after bilateral pallidal DBS.

METHODS:

Five patients with primary dystonia and seven CP patients with dystonia were recruited. All subjects received DBS surgery in both globus pallidus. Burke-Fahn-Marsden dystonia rating scale consisting of dystonia movement score and disability score and subjective satisfaction scale were assessed after 1 month and every 6 months over two years following DBS treatment.

RESULTS:

On the dystonia movement scale, both groups of primary dystonia patients and CP patients showed a significant decrease over time following DBS. On the disability scale, patients with primary dystonia showed a significant decrease over time, whereas the disability score of CP patients did not change over the two years. Comparing the dystonia movement and disability scores of CP patients at each assessment, patients with primary dystonia showed a significant reduction after 6 months. Comparing the satisfaction scores of CP patients after DBS, patients with primary dystonia showed significantly higher subjective satisfaction.

CONCLUSION:

Whereas dystonia can be significantly reduced in patients with primary dystonia, CP patients showed a modest improvement on the dystonia movement scale, but not on the disability scale. Therefore, DBS may be considered with caution as a treatment modality of CP patients with dystonia.

KEYWORDS:

Cerebral palsy; Deep brain stimulation; Dystonia; Dystonia rating scale

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