Should We Consider Deep Brain Stimulation for Cervical Dystonia?

Patients who had otherwise treatment-resistant dystonia responded well in a randomized, sham-controlled trial.

A growing number of cases of cervical dystonia resistant to medications and botulinum toxin are presenting to clinicians for advanced management. This study was a randomized, sham-controlled, manufacturer-funded trial of bilateral globus pallidus deep brain stimulation (DBS) in this population (an investigational use not specifically approved by the FDA). Participants had to have at least a 3-year disease duration and a Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score of ≥15 and be free of significant medical or psychiatric comorbidities. The 62 patients were randomized 1:1 to active or sham stimulation. Patients were unaware of their treatment assignment, and outcomes were blindly compared at 3 months. After 3 mon…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)