AUTHOR=Listik Clarice , Cury Rubens Gisbert , Casagrande Sara Carvalho Barbosa , Listik Eduardo , Arnaut Debora , Santiago Natally , Da Silva Valquiria Aparecida , Galhardoni Ricardo , Machado Júlia de Lima Arantes , Almeida Jessica Campelo de , Barbosa Egberto Reis , Teixeira Manoel Jacobsen , De Andrade Daniel Ciampi 

TITLE=Improvement of Non-motor Symptoms and Quality of Life After Deep Brain Stimulation for Refractory Dystonia: A 1-Year Follow-Up

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.717239

DOI=10.3389/fneur.2021.717239

ISSN=1664-2295

ABSTRACT=<p><bold>Introduction:</bold> Deep brain stimulation (DBS) is a treatment option for refractory dystonia's motor symptoms, while its non-motor symptoms (NMS) have been less systematically assessed. We aimed to describe the effects of DBS on NMS in refractory generalized inherited/idiopathic dystonia prospectively.</p><p><bold>Methods:</bold> We evaluated patients before and 1 year after DBS surgery and applied the following scales: Burke–Fahn–Marsden Rating Scale (BFMRS), NMS Scale for Parkinson's Disease (NMSS-PD), Parkinson's Disease Questionnaire-8, short-form Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI), and short-form McGill Pain Questionnaire (MPQ).</p><p><bold>Results:</bold> Eleven patients (38.35 ± 11.30 years) underwent surgery, all with generalized dystonia. Motor BFMRS subscore was 64.36 ± 22.94 at baseline and 33.55 ± 17.44 1 year after DBS surgery (47.9% improvement, <italic>p</italic> = 0.003). NMSS-PD had a significant change 12 months after DBS, from 70.91 ± 59.07 to 37.18 ± 55.05 (47.5% improvement, <italic>p</italic> = 0.013). NMS changes were mainly driven by changes in the gastrointestinal (<italic>p</italic> = 0.041) and miscellaneous domains (<italic>p</italic> = 0.012). Seven patients reported chronic pain before DBS and four after it. BPI's severity and interference scores were 4.61 ± 2.84 and 4.12 ± 2.67, respectively, before surgery, and 2.79 ± 2.31 (0.00–6.25) and 1.12 ± 1.32 (0.00–3.00) after, reflecting a significant improvement (<italic>p</italic> = 0.043 and <italic>p</italic> = 0.028, respectively). NPSI score was 15.29 ± 13.94 before, while it was reduced to 2.29 ± 2.98 afterward (<italic>p</italic> = 0.028). MPQ's total score was 9.00 ± 3.32 before DBS, achieving 2.71 ± 2.93 after (<italic>p</italic> = 0.028).</p><p><bold>Conclusions:</bold> DBS improves NMS in generalized inherited/idiopathic dystonia, including chronic pain.</p>