The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis
Objective. To compare the efficacy in patients with different genotypes, identify the potential predictive factors, and summarize the complications of globus pallidus deep brain stimulation (GPi-DBS) treating early-onset dystonia. Methods. Three electronic databases (PubMed, Embase, and Cochrane dat...
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Wiley
2021-01-01
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| Series: | Neural Plasticity |
| Online Access: | http://dx.doi.org/10.1155/2021/9924639 |
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| author | Wenxiu Chen Houyou Fan Guohui Lu |
| author_facet | Wenxiu Chen Houyou Fan Guohui Lu |
| author_sort | Wenxiu Chen |
| collection | DOAJ |
| description | Objective. To compare the efficacy in patients with different genotypes, identify the potential predictive factors, and summarize the complications of globus pallidus deep brain stimulation (GPi-DBS) treating early-onset dystonia. Methods. Three electronic databases (PubMed, Embase, and Cochrane databases) were searched with no publication data restriction. The primary outcomes were the improvements in Burke–Fahn–Marsden Dystonia Rating Scale motor (BFMDRS-M) and disability (BFMDRS-D) score. Pearson’s correlation coefficients and a metaregression analysis were used to identify the potential predictive factors. This article was registered in Prospero (CRD42020188527). Results. Fifty-four studies (231 patients) were included. Patients showed significant improvement rate in BFMDRS-M (60.6%, p<0.001) and BFMDRS-D (57.5%, p<0.001) scores after treatment with GPi-DBS. BFMDRS-M score improved greater in the DYT-1-positive (p=0.001) and DYT-11-positive (p=0.008) patients compared to DYT-6-positive patients. BFMDRS-D score improved greater in the DYT-11 (+) compared to DYT-6 (+) patients (p=0.010). The relative change of BFMDRS-M (p=0.002) and BFMDRS-D (p=0.010) scores was negatively correlated with preoperative BFMDRS-M score. In the metaregression analysis, the best predictive model showed that preoperative BFMDRS-M, disease duration (p=0.047), and the age at symptom onset (p=0.027) were important. Conclusion. Patients with early-onset dystonia have a significant effect after GPi-DBS treatment, and DYT-1 (+) and DYT-11 (+) patients are better candidates for GPi-DBS. Lower preoperative score, later age of onset, and an earlier age at surgery probably predict better clinical outcomes. |
| format | Article |
| id | doaj-art-0a95042e176141988519975efa52f400 |
| institution | Kabale University |
| issn | 2090-5904 1687-5443 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neural Plasticity |
| spelling | doaj-art-0a95042e176141988519975efa52f4002025-02-03T06:46:16ZengWileyNeural Plasticity2090-59041687-54432021-01-01202110.1155/2021/99246399924639The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient AnalysisWenxiu Chen0Houyou Fan1Guohui Lu2Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaObjective. To compare the efficacy in patients with different genotypes, identify the potential predictive factors, and summarize the complications of globus pallidus deep brain stimulation (GPi-DBS) treating early-onset dystonia. Methods. Three electronic databases (PubMed, Embase, and Cochrane databases) were searched with no publication data restriction. The primary outcomes were the improvements in Burke–Fahn–Marsden Dystonia Rating Scale motor (BFMDRS-M) and disability (BFMDRS-D) score. Pearson’s correlation coefficients and a metaregression analysis were used to identify the potential predictive factors. This article was registered in Prospero (CRD42020188527). Results. Fifty-four studies (231 patients) were included. Patients showed significant improvement rate in BFMDRS-M (60.6%, p<0.001) and BFMDRS-D (57.5%, p<0.001) scores after treatment with GPi-DBS. BFMDRS-M score improved greater in the DYT-1-positive (p=0.001) and DYT-11-positive (p=0.008) patients compared to DYT-6-positive patients. BFMDRS-D score improved greater in the DYT-11 (+) compared to DYT-6 (+) patients (p=0.010). The relative change of BFMDRS-M (p=0.002) and BFMDRS-D (p=0.010) scores was negatively correlated with preoperative BFMDRS-M score. In the metaregression analysis, the best predictive model showed that preoperative BFMDRS-M, disease duration (p=0.047), and the age at symptom onset (p=0.027) were important. Conclusion. Patients with early-onset dystonia have a significant effect after GPi-DBS treatment, and DYT-1 (+) and DYT-11 (+) patients are better candidates for GPi-DBS. Lower preoperative score, later age of onset, and an earlier age at surgery probably predict better clinical outcomes.http://dx.doi.org/10.1155/2021/9924639 |
| spellingShingle | Wenxiu Chen Houyou Fan Guohui Lu The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis Neural Plasticity |
| title | The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis |
| title_full | The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis |
| title_fullStr | The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis |
| title_full_unstemmed | The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis |
| title_short | The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis |
| title_sort | efficacy and predictors of using gpi dbs to treat early onset dystonia an individual patient analysis |
| url | http://dx.doi.org/10.1155/2021/9924639 |
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