A three-year follow-up study of globus pallidus internus deep brain stimulation for spasmodic torticollis.

Objective To investigate long-term efficacy and safety of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) for spasmodic torticollis (ST), and to evaluate its impact on patients' quality of life, emotional state, and cognitive function. Methods A retrospective analysis was conduct...

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Publicado en:Chinese Journal of Contemporary Neurology & Neurosurgery Vol. 26; no. 5; pp. 492 - 501
Autores principales: LIU, Jing-xuan, LU, Guang-han, QIU, Chang, DONG, Wen-wen, YAN, Jun, ZHANG, Wen-bin
Formato: research tables/charts Journal Article
Publicado: Chinese Journal of Contemporary Neurology & Neurosurgery May2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2026
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      pub: Chinese Journal of Contemporary Neurology & Neurosurgery
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        10.3969/j.issn.1672-6731.2026.05.006
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        atl: A three-year follow-up study of globus pallidus internus deep brain stimulation for spasmodic torticollis.
      aug:
        au:
          LIU, Jing-xuan
          LU, Guang-han
          QIU, Chang
          DONG, Wen-wen
          YAN, Jun
          ZHANG, Wen-bin
        affil: Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
      sug:
        subj:
          Torticollis Surgery
          Deep Brain Stimulation Methods
          Treatment Outcomes
          Treatment Outcomes Evaluation
          Patient Safety Evaluation
          Quality of Life Evaluation
          Mental Health Evaluation
          Cognition
          Basal Ganglia
          Human
          Retrospective Design
          Record Review
          Preoperative Period
          Postoperative Period
          Scales
          Motor Activity
          Pain Measurement
          Neuropsychological Tests
          Pretest-Posttest Design
          Anxiety
          Depression
          Severity of Illness
          Descriptive Statistics
          Dystonic Disorders
          Hamilton Rating Scale for Depression
          Psychological Tests
          Questionnaires
      ab: Objective To investigate long-term efficacy and safety of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) for spasmodic torticollis (ST), and to evaluate its impact on patients' quality of life, emotional state, and cognitive function. Methods A retrospective analysis was conducted on the clinical data of 41 patients with spasmodic torticollis who underwent bilateral GPi-DBS in The Affiliated Brain Hospital of Nanjing Medical University from September 2016 to July 2022. Follow-up assessments were performed preoperatively and at 3, 6, 12, 24 and 36 months postoperatively. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to assess motor function and pain. The Craniocervical Dystonia Questionnaire-24 (CDQ-24) was used to assess quality of life. The Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and Mini-Mental State Examination (MMSE) were used to assess neuropsychiatric and cognitive functions. Results There were significant differences before and after surgery in the total TWSTRS score (P = 0.000) and its subscale scores for severity (P = 0.000), disability (P = 0.000) and pain (P = 0.000), as well as CDQ-24 (P = 0.000), HAMA (P = 0.000), HAMD (P = 0.000) and MMSE (P = 0.001) scores. Compared with preoperative baselines, the total TWSTRS score (P = 0.000, for all), subscale scores for severity (P = 0.000, for all), disability (P = 0.000, for all) and pain (P = 0.001, 0.001, 0.001, 0.004, 0.001), along with CDQ -24 (P = 0.000, for all), HAMA (P = 0.000, for all), HAMD (P = 0.000, for all) significantly decreased at 3, 6, 12, 24 and 36 months postoperatively. Meanwhile, although MMSE score exhibited statistical fluctuations during the follow -up period (P = 0.007, 0.000, 0.007, 0.011, 0.026), they all remained within the normal range without clear clinical significance. Compared with those at 3 months postoperatively, the total TWSTRS score (P = 0.000, for all), subscale scores for severity (P = 0.000, for all), disability (P = 0.000, for all) and pain (P = 0.018, 0.018, 0.014, 0.007), as well as CDQ-24 (P = 0.000, for all), HAMA (P = 0.000, for all), and HAMD (P = 0.000, 0.001, 0.000, 0.000) scores further decreased at 6, 12, 24 and 36 months postoperatively. Compared with those at 6 months postoperatively, the total TWSTRS score (P = 0.000, for all) and subscale scores for severity (P = 0.000, for all) and disability (P = 0.000, for all) further decreased at 12, 24 and 36 months postoperatively; additionally, CDQ-24 (P = 0.004, 0.018) and HAMA (P = 0.004, 0.017) scores showed further decreased at 12 and 36 months postoperatively. At the 36-month postoperative follow-up, the total TWSTRS score showed an average improvement of 63.18% compared with preoperative baseline, with subscale scores for severity, disability and pain improving by 65.82%, 62.09% and 51.72%, respectively; meanwhile, CDQ-24, HAMA and HAMD scores improved by 51.54%, 45.38% and 32.70%, respectively. Conclusions Bilateral GPi-DBS demonstrates significant and sustained long-term efficacy in the treatment of spasmodic torticollis. It effectively improves motor symptoms, alleviates pain, and enhances quality of life without impairing cognitive function, demonstrating a favorable safety profile.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: Chinese
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