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Deep brain stimulation for Meige syndrome: a meta-analysis with individual patient data.
J Neurol 2019JN

Abstract

BACKGROUND

Deep brain stimulation (DBS) is an effective intervention for Meige syndrome, a type of dystonia characterized by blepharospasm, facial, and oromandibular dystonia. This individual patient-level data meta-analysis was to identify the potential outcome predictors, compare the stimulation targets and summarize the efficacy of DBS for Meige syndrome.

METHODS

Three electronic databases (PubMed, Web of Science and Embase) were searched with no publication data restriction to identify studies regarding DBS for Meige syndrome. The primary outcome was the improvement in BFMDRS-M score. Pearson's correlation coefficients and a stepwise multivariate regression analysis were used to identify the potential prognostic factors.

RESULTS

Twenty-three studies (115 patients, 94 with pallidal stimulation and 21 with subthalamic stimulation) were eligible. Patients showed significant improvement in Burke-Fahn-Marsden Dystonia Rating Scale movement (BFMDRS-M) (21.5 ± 11.0 vs 8.6 ± 6.9, P < 0.001) and disability (BFMDRS-D) (6.4 ± 5.1 vs 2.9 ± 2.4, P < 0.001) scores at the last follow-up visit (31.9 ± 30.7 months), compared with scores at baseline. Preoperative BFMDRS-M and BFMDRS-D scores were positively correlated with the relative changes in BFMDRS-M score at the last follow-up visit. On the stepwise multivariate regression, only the preoperative BFMDRS remained significant in the best predictive model.

CONCLUSIONS

Based on the existing evidence, pallidal/subthalamic stimulation is an effective therapy for even the refractory Meige syndrome. Higher preoperative scores probably indicate larger improvement. Stimulation targets or other clinical factors do not constitute the outcome predictive factors.

Authors+Show Affiliations

School of Medicine, Nankai University, 94 Weijin Road, Naikai District, Tianjin, 300071, China. Department of Neurosurgery, The First Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.School of Medicine, Nankai University, 94 Weijin Road, Naikai District, Tianjin, 300071, China. Department of Neurosurgery, The First Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.Department of Neurosurgery, The First Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.School of Medicine, Nankai University, 94 Weijin Road, Naikai District, Tianjin, 300071, China. xinguang_yu301@126.com. Department of Neurosurgery, The First Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. xinguang_yu301@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31302747

Citation

Wang, Xin, et al. "Deep Brain Stimulation for Meige Syndrome: a Meta-analysis With Individual Patient Data." Journal of Neurology, 2019.
Wang X, Zhang Z, Mao Z, et al. Deep brain stimulation for Meige syndrome: a meta-analysis with individual patient data. J Neurol. 2019.
Wang, X., Zhang, Z., Mao, Z., & Yu, X. (2019). Deep brain stimulation for Meige syndrome: a meta-analysis with individual patient data. Journal of Neurology, doi:10.1007/s00415-019-09462-2.
Wang X, et al. Deep Brain Stimulation for Meige Syndrome: a Meta-analysis With Individual Patient Data. J Neurol. 2019 Jul 13; PubMed PMID: 31302747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep brain stimulation for Meige syndrome: a meta-analysis with individual patient data. AU - Wang,Xin, AU - Zhang,Zhibin, AU - Mao,Zhiqi, AU - Yu,Xinguang, Y1 - 2019/07/13/ PY - 2019/06/17/received PY - 2019/07/08/accepted PY - 2019/07/02/revised PY - 2019/7/15/entrez KW - Deep brain stimulation KW - Globus pallidus internus KW - Individual patient data KW - Meige syndrome KW - Meta-analysis KW - Predictive factors KW - Subthalamic nucleus JF - Journal of neurology JO - J. Neurol. N2 - BACKGROUND: Deep brain stimulation (DBS) is an effective intervention for Meige syndrome, a type of dystonia characterized by blepharospasm, facial, and oromandibular dystonia. This individual patient-level data meta-analysis was to identify the potential outcome predictors, compare the stimulation targets and summarize the efficacy of DBS for Meige syndrome. METHODS: Three electronic databases (PubMed, Web of Science and Embase) were searched with no publication data restriction to identify studies regarding DBS for Meige syndrome. The primary outcome was the improvement in BFMDRS-M score. Pearson's correlation coefficients and a stepwise multivariate regression analysis were used to identify the potential prognostic factors. RESULTS: Twenty-three studies (115 patients, 94 with pallidal stimulation and 21 with subthalamic stimulation) were eligible. Patients showed significant improvement in Burke-Fahn-Marsden Dystonia Rating Scale movement (BFMDRS-M) (21.5 ± 11.0 vs 8.6 ± 6.9, P < 0.001) and disability (BFMDRS-D) (6.4 ± 5.1 vs 2.9 ± 2.4, P < 0.001) scores at the last follow-up visit (31.9 ± 30.7 months), compared with scores at baseline. Preoperative BFMDRS-M and BFMDRS-D scores were positively correlated with the relative changes in BFMDRS-M score at the last follow-up visit. On the stepwise multivariate regression, only the preoperative BFMDRS remained significant in the best predictive model. CONCLUSIONS: Based on the existing evidence, pallidal/subthalamic stimulation is an effective therapy for even the refractory Meige syndrome. Higher preoperative scores probably indicate larger improvement. Stimulation targets or other clinical factors do not constitute the outcome predictive factors. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/31302747/Deep_brain_stimulation_for_Meige_syndrome:_a_meta-analysis_with_individual_patient_data L2 - https://dx.doi.org/10.1007/s00415-019-09462-2 DB - PRIME DP - Unbound Medicine ER -