Quality of life outcomes after deep brain stimulation in dystonia: A systematic review |
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| Affiliation: | 1. Department of Neurology, University of Luebeck, Luebeck, Germany;2. Department of Psychology II, University of Luebeck, Luebeck, Germany;3. Institute of Neurogenetics, University of Luebeck, Luebeck, Germany;4. University of Santo Tomas, Neurology and Psychiatry, Manila, Philippines;5. Metropolitan Medical Center, Manila, Philippines;6. Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines;7. Institute for Neurosciences, St. Luke''s Medical Center, Quezon City and Global City, Philippines;8. Makati Medical Center, Department of Neurosciences Makati, Philippines;1. Gardner Family Center for Parkinson''s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA;2. Edmond J. Safra Program in Parkinson''s Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada;3. Krembil Research Institute, Toronto, Ontario, Canada;1. Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA;2. Department of Neurology, Baylor College of Medicine, Houston, Texas, USA;1. Department of Neurosurgery, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany;2. Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany;3. Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany;4. Department of Neuroradiology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany;5. XDP Study Group, Philippine Children''s Medical Center, Quezon City, Philippines;6. Department of Neurology and Psychiatry, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines;7. Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines;8. Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany;1. Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea;2. Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Severance Intrathecal Pump Clinic, Yonsei University College of Medicine, Seoul, Korea;3. Department and Research Institute of Rehabilitation Medicine, Severance Intrathecal Pump Clinic, Yonsei University College of Medicine, Seoul, Korea;1. Complex Motor Disorders Service, Evelina London Children''s Hospital, St Thomas'' Hospital, Guy''s and St Thomas'' NHS Foundation Trust, London, UK;2. Department of Audiology, St Thomas'' Hospital, Guy''s and St Thomas'' NHS Foundation Trust, London, UK;3. Department of Neurosurgery, Kings'' College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK |
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| Abstract: | Dystonia is an incurable movement disorder which can cause not only physical but also mental problems, leading to impaired health-related quality of life (HRQoL). For patients with dystonia refractory to medical treatment, deep brain stimulation (DBS) is a well-established surgical treatment. The objective of this systematic review is to provide a better understanding of HRQoL outcomes after DBS for dystonia. A search of the literature was conducted using Medline (PubMed), Embase, and Cochrane Library databases in May 2019. HRQoL outcomes after DBS along with motor outcomes were reported in a total of 36 articles involving 610 patients: 21 articles on inherited or idiopathic isolated dystonia, 5 on tardive dystonia, 3 on cerebral palsy, 2 on myoclonus-dystonia, 1 on X-linked dystonia-parkinsonism, and 3 on mixed cohorts of different dystonia subtypes. DBS improved motor symptoms in various subtypes of dystonia. Most studies on patients with inherited or idiopathic isolated dystonia showed significant improvement in physical QoL, whereas gains in mental QoL were less robust and likely related to the complexity of associated neuropsychiatric problems. HRQoL outcomes beyond 5 years remain scarce. Although the studies on patients with other subtypes of dystonia also demonstrated improvement in HRQoL after DBS, the interpretation is difficult because of a limited number of articles with small cohorts. Most articles employed generic measures (e.g. Short Form Health Survey-36) and this highlights the critical need to develop and to utilize sensitive and disease-specific HRQoL measures. Finally, long-term HRQoL outcomes and predictors of HRQoL should also be clarified. |
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| Keywords: | Dystonia Deep brain stimulation Quality of life |
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