Prospective evaluation of Globus pallidus internus deep brain stimulation in Huntington's disease

Parkinsonism & Related Disorders
S ZittelA Münchau

Abstract

Pharmacological treatment of chorea in Huntington's disease (HD) is often limited by poor efficacy or side effects. Pallidal deep brain stimulation (DBS) has been considered in these patients but experience is so far limited. We prospectively evaluated the effects of bilateral DBS of the Globus pallidus internus (GPi) over one year in six severely affected HD patients with treatment refractory chorea in an advanced stage of the disease. Primary endpoint of the study was improvement in chorea. Additionally, we evaluated the effects of GPi DBS on the motor part of the Unified Huntington's Disease Rating Scale (UHDRS), bradykinesia, dystonia, functional impairment, psychiatric and cognitive symptoms. Side effects were systematically assessed. The chorea subscore was significantly reduced postoperatively (-47% six months, -40% twelve months postoperatively). The UHDRS total motor score was significantly reduced at six months postoperatively (- 17%) but the effect was not sustained twelve months after the operation (- 5%). Pallidal DBS did not improve other motor symptoms or functional impairment. There was no effect on psychiatric symptoms or cognition. A number of side effects were noted, especially spasticity in three of the pati...Continue Reading

Citations

Jun 12, 2019·Expert Review of Neurotherapeutics·Hassaan Bashir
Sep 5, 2020·Journal of Neurology·Emily SanreyGaetan Poulen
Jul 11, 2020·Journal of Neurology·Ana Luísa de Almeida MarcelinoAndrea A Kühn
Sep 27, 2018·Current Treatment Options in Neurology·Erin Feinstein, Ruth Walker
Feb 9, 2021·Expert Opinion on Pharmacotherapy·Jessie S Gibson, Daniel O Claassen
Apr 29, 2020·Journal of Neuroscience Methods·A MacerolloJ Osman-Farah
Aug 21, 2021·Practical Neurology·Thomas B StokerRoger A Barker
Sep 3, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Roberta BonomoRoberto Eleopra

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