PMID- 34899219
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211215
IS  - 1662-5161 (Print)
IS  - 1662-5161 (Electronic)
IS  - 1662-5161 (Linking)
VI  - 15
DP  - 2021
TI  - Deep Brain Stimulation Treating Dystonia: A Systematic Review of Targets, Body 
      Distributions and Etiology Classifications.
PG  - 757579
LID - 10.3389/fnhum.2021.757579 [doi]
LID - 757579
AB  - Background: Deep brain stimulation (DBS) is a typical intervention treating 
      drug-refractory dystonia. Currently, the selection of the better target, the GPi 
      or STN, is debatable. The outcomes of DBS treating dystonia classified by body 
      distribution and etiology is also a popular question. Objective: To 
      comprehensively compare the efficacy, quality of life, mood, and adverse effects 
      (AEs) of GPi-DBS vs. STN-DBS in dystonia as well as in specific types of dystonia 
      classified by body distribution and etiology. Methods: PubMed, Embase, the 
      Cochrane Library, and Google Scholar were searched to identify studies of GPi-DBS 
      and STN-DBS in populations with dystonia. The efficacy, quality of life, mood, 
      and adverse effects were quantitatively compared. Meta-regression analyses were 
      also performed. This analysis has been registered in PROSPERO under the number 
      CRD42020146145. Results: Thirty five studies were included in the main analysis, 
      in which 319 patients underwent GPI-DBS and 113 patients underwent STN-DBS. The 
      average follow-up duration was 12.48 months (range, 3-49 months). The GPI and STN 
      groups were equivalent in terms of efficacy, quality of life, mood, and 
      occurrence of AEs. The focal group demonstrated significantly better disability 
      symptom improvement (P = 0.012) than the segmental and generalized groups but 
      showed less SF-36 enhancement than the segmental group (P < 0.001). The primary 
      groups exhibited significantly better movement and disability symptom 
      improvements than the secondary non-hereditary group (P < 0.005), which 
      demonstrated only disability symptom improvement compared with the secondary 
      hereditary group (P < 0.005). The primary hereditary and idiopathic groups had a 
      significantly lower frequency of AEs than the secondary non-hereditary group (P < 
      0.005). The correlation between disability symptom improvement and movement 
      symptom improvement was also significant (P < 0.05). Conclusion: GPi-DBS and 
      STN-DBS were both safe and resulted in excellent improvement in efficacy and 
      quality of life in patients with dystonia. Compared with patients with segmental 
      dystonia, patients with focal dystonia demonstrated better improvement in 
      dystonia symptoms but less enhancement of quality of life. Those with primary 
      dystonia had a better response to DBS in terms of efficacy than those with 
      secondary dystonia. Patients who exhibit a significant improvement in movement 
      symptoms might also exhibit excellent improvement in disability symptoms.
CI  - Copyright (c) 2021 Fan, Zheng, Yin, Zhang and Lu.
FAU - Fan, Houyou
AU  - Fan H
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Zheng, Zijian
AU  - Zheng Z
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Yin, Zixiao
AU  - Yin Z
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Zhang, Jianguo
AU  - Zhang J
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Lu, Guohui
AU  - Lu G
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20211126
PL  - Switzerland
TA  - Front Hum Neurosci
JT  - Frontiers in human neuroscience
JID - 101477954
PMC - PMC8663760
OTO - NOTNLM
OT  - GPi (globus pallidus internus)
OT  - STN (subthalamic nucleus)
OT  - body distribution
OT  - deep brain stimulation
OT  - dystonia
OT  - etiology
OT  - systematic review
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/12/14 06:00
MHDA- 2021/12/14 06:01
PMCR- 2021/01/01
CRDT- 2021/12/13 17:53
PHST- 2021/08/12 00:00 [received]
PHST- 2021/10/27 00:00 [accepted]
PHST- 2021/12/13 17:53 [entrez]
PHST- 2021/12/14 06:00 [pubmed]
PHST- 2021/12/14 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fnhum.2021.757579 [doi]
PST - epublish
SO  - Front Hum Neurosci. 2021 Nov 26;15:757579. doi: 10.3389/fnhum.2021.757579. 
      eCollection 2021.