caa a22 4500 445809949 CHVBK 20180317145208.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00415-011-5961-9 doi (NATIONALLICENCE)springer-10.1007/s00415-011-5961-9 Factors predicting protracted improvement after pallidal DBS for primary dystonia: the role of age and disease duration [Elektronische Daten] [Ioannis Isaias, Jens Volkmann, Andreas Kupsch, Jean-Marc Burgunder, Jill Ostrem, Ron Alterman, Hubertus Mehdorn, Thomas Schönecker, Joachim Krauss, Philip Starr, Rene Reese, Andrea Kühn, W. Schüpbach, Michele Tagliati] In many patients, optimal results after pallidal deep brain stimulation (DBS) for primary dystonia may appear over several months, possibly beyond 1year after implant. In order to elucidate the factors predicting such protracted clinical effect, we retrospectively reviewed the clinical records of 44 patients with primary dystonia and bilateral pallidal DBS implants. Patients with fixed skeletal deformities, as well as those with a history of prior ablative procedures, were excluded. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) scores at baseline, 1 and 3years after DBS were used to evaluate clinical outcome. All subjects showed a significant improvement after DBS implants (mean BFMDRS improvement of 74.9% at 1year and 82.6% at 3years). Disease duration (DD, median 15years, range 2-42) and age at surgery (AS, median 31years, range 10-59) showed a significant negative correlation with DBS outcome at 1 and 3years. A partition analysis, using DD and AS, clustered subjects into three groups: (1) younger subjects with shorter DD (n=19, AS<27, DD≤17); (2) older subjects with shorter DD (n=8, DD≤17, AS≥27); (3) older subjects with longer DD (n=17, DD>17, AS≥27). Younger patients with short DD benefitted more and faster than older patients, who however continued to improve 10% on average 1year after DBS implants. Our data suggest that subjects with short DD may expect to achieve a better general outcome than those with longer DD and that AS may influence the time necessary to achieve maximal clinical response. Springer-Verlag, 2011 Deep brain stimulation nationallicence Globus pallidus nationallicence Dystonia nationallicence Outcome predictors nationallicence DBS : Deep brain stimulation nationallicence GPi : Globus pallidus internus nationallicence BFMDRS : Burke-Fahn-Marsden Dystonia Rating Scale nationallicence AS : Age at surgery (in years) nationallicence DD : Disease duration (in years) nationallicence SS : Speech and swallowing nationallicence SY : Subjects with disease duration ≤17years and age at surgery <27years nationallicence SO : Subjects with disease duration ≤17years and age at surgery ≥27years nationallicence LO : Subjects with disease duration >17years and age at surgery ≥27years nationallicence Isaias Ioannis Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA aut Volkmann Jens Department of Neurology, Christian-Albrechts-University, Kiel, Germany aut Kupsch Andreas Department of Neurology, Charité-University Medicine, Berlin, Germany aut Burgunder Jean-Marc Movement Disorder Center, Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland aut Ostrem Jill Department of Neurology, University of California, San Francisco, CA, USA aut Alterman Ron Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA aut Mehdorn Hubertus Department of Neurosurgery, Christian-Albrechts-University, Kiel, Germany aut Schönecker Thomas Department of Neurology, Charité-University Medicine, Berlin, Germany aut Krauss Joachim Department of Neurosurgery, Medical School Hannover, Hannover, Germany aut Starr Philip Department of Neurosurgery, University of California, San Francisco, CA, USA aut Reese Rene Department of Neurology, Christian-Albrechts-University, Kiel, Germany aut Kühn Andrea Department of Neurology, Charité-University Medicine, Berlin, Germany aut Schüpbach W. Movement Disorder Center, Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland aut Tagliati Michele Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA aut Journal of Neurology Springer-Verlag 258/8(2011-08-01), 1469-1476 0340-5354 258:8<1469 2011 258 415 https://doi.org/10.1007/s00415-011-5961-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-5961-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Isaias Ioannis Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA aut NATIONALLICENCE 700 1- Volkmann Jens Department of Neurology, Christian-Albrechts-University, Kiel, Germany aut NATIONALLICENCE 700 1- Kupsch Andreas Department of Neurology, Charité-University Medicine, Berlin, Germany aut NATIONALLICENCE 700 1- Burgunder Jean-Marc Movement Disorder Center, Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland aut NATIONALLICENCE 700 1- Ostrem Jill Department of Neurology, University of California, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Alterman Ron Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA aut NATIONALLICENCE 700 1- Mehdorn Hubertus Department of Neurosurgery, Christian-Albrechts-University, Kiel, Germany aut NATIONALLICENCE 700 1- Schönecker Thomas Department of Neurology, Charité-University Medicine, Berlin, Germany aut NATIONALLICENCE 700 1- Krauss Joachim Department of Neurosurgery, Medical School Hannover, Hannover, Germany aut NATIONALLICENCE 700 1- Starr Philip Department of Neurosurgery, University of California, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Reese Rene Department of Neurology, Christian-Albrechts-University, Kiel, Germany aut NATIONALLICENCE 700 1- Kühn Andrea Department of Neurology, Charité-University Medicine, Berlin, Germany aut NATIONALLICENCE 700 1- Schüpbach W. Movement Disorder Center, Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland aut NATIONALLICENCE 700 1- Tagliati Michele Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/8(2011-08-01), 1469-1476 0340-5354 258:8<1469 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer