Sadnicka A1, Kimmich O2, Pisarek O1, Ruge D1, Galea J1, Kassavetis P1, Parees I1, Saifee TA1, Molloy A2, Bradley D1, O’Riordan S2, Zrinzo L1, Hariz M1, Bhatia KP1, Limousin P1, Foltynie T1, Rothwell JC1, Hutchinson M2, Edwards MJ1
Mov Disord. 2013 Nov;28(13):1874-7. doi: 10.1002/mds.25581. Epub 2013 Jul 12.
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ABSTRACT:
BACKGROUND:
We investigated whether clinical improvement observed after deep brain stimulation (DBS) of the globus pallidus internus (GPi) in cervical dystonia (CD) is paralleled by the normalisation of temporal discrimination thresholds (TDTs), a marker of abnormal sensory processing in CD.
METHODS:
TDT was tested in 11 patients with CD after they received DBS and was compared with TDT scores from 24 patients with CD and a group of 61 controls.
RESULTS:
A clear clinical response to GPi-DBS was demonstrated (total Toronto Western Spasmodic Torticollis Rating Scale scores fell from 50 to 18; P < 0.001). In contrast, TDT remained abnormal in the CD-DBS group (P < 0.001) and was not significantly different from the abnormal TDT range observed in CD.
CONCLUSIONS:
Underlying sensory abnormalities in temporal discrimination observed in dystonia do not seem to be corrected by successful GPi-DBS. This adds further data to the ongoing debate regarding which pathophysiological abnormalities observed in dystonia are likely to be causal in the genesis of the disease rather than epiphenomena observed secondary to abnormal motor activity.
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Copyright © 2013 International Parkinson and Movement Disorder Society..