Clinical outcome of deep brain stimulation for dystonia: constant-current or constant-voltage stimulation? A non-randomized study

Eur J Neurol. 2015 Jun;22(6):919-26. doi: 10.1111/ene.12515. Epub 2014 Jul 10.

Abstract

Background and purpose: Bilateral globus pallidus deep brain stimulation (GPi-DBS) represents an effective and relatively safe therapy for different forms of refractory dystonia. The aim of this study was to assess, retrospectively, the effect of two different stimulation settings during GPi-DBS in 22 patients affected by primary generalized or multi-segmental dystonia.

Methods: Thirteen patients were stimulated using a voltage-controlled setting whilst in the other nine patients a current-controlled setting was used. Clinical features were evaluated for each patient at baseline, 6 months and 12 months after surgery by means of the Burke-Fahn-Marsden Dystonia Rating Scale.

Results: Globus pallidus deep brain stimulation was effective in all patients. However, comparing constant-current and constant-voltage stimulation, a better outcome was found in the current-controlled group during the last 6 months of follow-up.

Conclusions: Current-controlled stimulation is effective during GPi-DBS for primary dystonia and it could be a better choice than voltage-controlled stimulation over long-term follow-up.

Keywords: constant-current stimulation; constant-voltage stimulation; deep brain stimulation; dystonia; impedance.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Deep Brain Stimulation / methods*
  • Dystonic Disorders / therapy*
  • Electric Impedance
  • Female
  • Follow-Up Studies
  • Globus Pallidus / physiology*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult