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Meta-Regression Analysis of the Long-Term Effects of Pallidal and Subthalamic Deep Brain Stimulation for the Treatment of Isolated Dystonia.
World Neurosurg. 2019 Sep; 129:e409-e416.WN

Abstract

OBJECTIVE

The globus pallidus internus (GPi) and subthalamic nucleus (STN) are therapeutic targets for deep brain stimulation (DBS) in the treatment of isolated dystonia. We conducted a meta-regression analysis on long-term studies of bilateral DBS in the GPi and STN to compare the relative effects of the 2 approaches.

METHODS

We systematically searched the PubMed, Embase, and Cochrane Controlled Register of Trials databases to identify studies reporting the treatment outcomes of GPi DBS and STN DBS for isolated dystonia. The primary outcome measure was the change in the Burke-Fahn-Marsden dystonia rating scale movement score between the baseline and follow-up evaluations. We performed a regression analysis using a random effects model.

RESULTS

A total of 42 follow-up evaluations (30 for GPi and 12 for STN) nested in 19 studies (16 of GPi and 3 of STN) were included in our analysis. The results from univariate regression analysis suggested that shorter disease duration and STN stimulation were associated with a greater standardized change in the Burke-Fahn-Marsden dystonia rating scale movement score. On combining the factors into 1 model, only the disease duration remained significant. The regression analysis results of the GPi and STN subgroups revealed more persistent improvement after STN stimulation.

CONCLUSIONS

A shorter disease duration correlated positively with better DBS outcomes. The STN appeared to be an optimized stimulation target for the treatment of isolated dystonia, although randomized controlled trials are needed to compare the treatment efficacy of GPi DBS and STN DBS.

Authors+Show Affiliations

Department of Neurology, Xinyang Central Hospital, Xinyang, China. Electronic address: WuYS-neuro@outlook.com.Department of Neurology, Xinyang Central Hospital, Xinyang, China; Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.Department of Neurology, Xinyang Central Hospital, Xinyang, China; Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Cardiology, Nanyang Central hospital, Nanyang, China.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

31146039

Citation

Wu, Yi-Song, et al. "Meta-Regression Analysis of the Long-Term Effects of Pallidal and Subthalamic Deep Brain Stimulation for the Treatment of Isolated Dystonia." World Neurosurgery, vol. 129, 2019, pp. e409-e416.
Wu YS, Ni LH, Fan RM, et al. Meta-Regression Analysis of the Long-Term Effects of Pallidal and Subthalamic Deep Brain Stimulation for the Treatment of Isolated Dystonia. World Neurosurg. 2019;129:e409-e416.
Wu, Y. S., Ni, L. H., Fan, R. M., & Yao, M. Y. (2019). Meta-Regression Analysis of the Long-Term Effects of Pallidal and Subthalamic Deep Brain Stimulation for the Treatment of Isolated Dystonia. World Neurosurgery, 129, e409-e416. https://doi.org/10.1016/j.wneu.2019.05.165
Wu YS, et al. Meta-Regression Analysis of the Long-Term Effects of Pallidal and Subthalamic Deep Brain Stimulation for the Treatment of Isolated Dystonia. World Neurosurg. 2019;129:e409-e416. PubMed PMID: 31146039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-Regression Analysis of the Long-Term Effects of Pallidal and Subthalamic Deep Brain Stimulation for the Treatment of Isolated Dystonia. AU - Wu,Yi-Song, AU - Ni,Lin-Hui, AU - Fan,Ru-Meng, AU - Yao,Ming-Yang, Y1 - 2019/05/27/ PY - 2019/03/08/received PY - 2019/05/18/revised PY - 2019/05/20/accepted PY - 2019/5/31/pubmed PY - 2020/1/25/medline PY - 2019/5/31/entrez KW - Deep brain stimulation KW - Globus pallidus internus KW - Isolated dystonia KW - Long-term effect KW - Meta-regression KW - Subthalamic nucleus SP - e409 EP - e416 JF - World neurosurgery JO - World Neurosurg VL - 129 N2 - OBJECTIVE: The globus pallidus internus (GPi) and subthalamic nucleus (STN) are therapeutic targets for deep brain stimulation (DBS) in the treatment of isolated dystonia. We conducted a meta-regression analysis on long-term studies of bilateral DBS in the GPi and STN to compare the relative effects of the 2 approaches. METHODS: We systematically searched the PubMed, Embase, and Cochrane Controlled Register of Trials databases to identify studies reporting the treatment outcomes of GPi DBS and STN DBS for isolated dystonia. The primary outcome measure was the change in the Burke-Fahn-Marsden dystonia rating scale movement score between the baseline and follow-up evaluations. We performed a regression analysis using a random effects model. RESULTS: A total of 42 follow-up evaluations (30 for GPi and 12 for STN) nested in 19 studies (16 of GPi and 3 of STN) were included in our analysis. The results from univariate regression analysis suggested that shorter disease duration and STN stimulation were associated with a greater standardized change in the Burke-Fahn-Marsden dystonia rating scale movement score. On combining the factors into 1 model, only the disease duration remained significant. The regression analysis results of the GPi and STN subgroups revealed more persistent improvement after STN stimulation. CONCLUSIONS: A shorter disease duration correlated positively with better DBS outcomes. The STN appeared to be an optimized stimulation target for the treatment of isolated dystonia, although randomized controlled trials are needed to compare the treatment efficacy of GPi DBS and STN DBS. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31146039/Meta_Regression_Analysis_of_the_Long_Term_Effects_of_Pallidal_and_Subthalamic_Deep_Brain_Stimulation_for_the_Treatment_of_Isolated_Dystonia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)31442-1 DB - PRIME DP - Unbound Medicine ER -