Department of Neurology, Ludwig-Maximilians University Munich, Munich, Germany.
Mov Disord. 2014 Jun;29(7):944-9. doi: 10.1002/mds.25780. Epub 2013 Dec 20.
Deep brain stimulation (DBS) of the globus pallidus internus is an effective treatment for cervical dystonia (CD). Interestingly, the onset of initial DBS effects is significantly prolonged compared with that in other diseases, such as Parkinson's disease. The return of symptoms after cessation of DBS could be delayed as well, but this has not been studied systematically.
In patients who were treated for CD using DBS and had a good treatment effect, we compared interruption of DBS with sham-OFF in a randomized, double-blind crossover trial.
We observed that dystonic features appeared within a few minutes at almost full intensity in all patients after the cessation of DBS.
The almost immediate onset of dystonic features in our sample seems to exclude mechanisms with long time constants from the pathophysiology of dystonia. Thus, it is likely that, in these patients, an aberrant pattern of neural activity representing an inappropriate set point value for the position of the head is responsible for dystonia.
深部脑刺激（DBS）内侧苍白球是治疗颈肌张力障碍（CD）的有效方法。有趣的是，与其他疾病（如帕金森病）相比，DBS 初始效果的出现明显延长。停止 DBS 后症状的恢复也可能会延迟，但这尚未得到系统研究。
在使用 DBS 治疗 CD 且治疗效果良好的患者中，我们在一项随机、双盲交叉试验中比较了 DBS 中断与假手术-OFF。
我们观察到，在 DBS 停止后，所有患者的肌张力障碍特征几乎在几分钟内以几乎全强度出现。
我们样本中肌张力障碍特征的几乎即刻出现似乎排除了从肌张力障碍的病理生理学中具有长时间常数的机制。因此，在这些患者中，代表头部位置不当设定点值的异常神经活动模式可能是导致肌张力障碍的原因。
