Outcomes Following Deep Brain Stimulation for Cervical Dystonia: a Single Centre Experience

Introduction: Deep Brain Stimulation (DBS) for Cervical Dystonia (CD) is a well-stablished treatment for this condition.

Objective: This is a review of outcomes following implantation of Deep brain stimulation for CD in a single Centre.

Methods: The Toronto Western Spasmodic Torticollis Rating Scale – TWSTR, EQ-5D and HADS anxiety and depression were recorded pre-implantation and again up to 3-year post-implant. The prospectively collected data was analyzed to assess outcomes.

Results: 33 patients with CD had deep brain stimulators inserted from 2009 to 2017 with a mean age of 55 years (28–71). The chosen target for these patients was the GPI location. Follow up data were available for 20 patients at 3y follow-up. The mean EQ-5D score pre-DBS was 0.50 and post was 0.59 at 3y follow-up. The mean HADS A and D pre-DBS was 9.47 and 7.23 respectively and at 3y follow-up was 6.53 and 5.15 respectively. The TWSTR score showed a mean value of 51.28 pre-DBS and post of 30.18. 90% of the patients had an improvement on TWSTR that was on average of approximately 37.5%. 2 systems were explanted due to infection. No mortality associated with the procedure. All patients had postop imaging with no evidence of intracranial haematoma.

Conclusion: This is a series in a single Centre showing that deep brain stimulation for Cervical Dystonia is a safe and established method of treatment. The results show that the most significant effects are in severity and disability after DBS. The overall quality of life has been shown to improve post-DBS implantation significantly.