School of Medicine, Nankai University, Tianjin, China; Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Clin Neurol Neurosurg. 2020 May;192:105720. doi: 10.1016/j.clineuro.2020.105720. Epub 2020 Feb 4.
Primary cervical dystonia (CD) is characterized by abnormal contractions of neck muscles. Globus pallidus internus deep brain stimulation (GPi-DBS) is recognized as an effective therapy for patients with refractory CD, but the prognostic factors need further research. Our study investigated the predictive factors of clinical outcomes in CD patients who underwent GPi-DBS.
Patients (n = 23) who underwent GPi-DBS at Chinese PLA General Hospital from March 2012 to April 2018 were included in our analysis. Their scores of Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Tsui were acquired at baseline and at the last follow-up visit. Percent improvement in these scores were compared between the categorical variables. Correlations between outcomes and continuous demographic and clinical variables were calculated.
Patients showed significant improvement in TWSTRS total (55.71 %), severity (48.75 %), disability (57.05 %), pain (63.67 %) scores and total Tsui score (46.07 %, all P ﹤0.001). Follow-up duration was positively correlated with percent improvement in TWSTRS total (rho = 0.594, P = 0.003), severity (rho = 0.581, P = 0.004) and disability (rho = 0.470, P = 0.023) scores. No significant differences in the outcomes were found between any pair of the categorical variables.
Follow-up duration was the only independent factor correlated to the outcomes of GPi-DBS for CD patients. However, follow-up duration is an indefinite factor prior to surgery, thus further studies are needed before the final conclusions of prognostic factors are established.
原发性颈肌张力障碍（CD）的特征是颈部肌肉异常收缩。苍白球内侧部（GPi）深部脑刺激（DBS）已被认为是治疗难治性 CD 的有效方法，但预后因素仍需进一步研究。本研究旨在探讨接受 GPi-DBS 的 CD 患者的临床结局的预测因素。
回顾性分析 2012 年 3 月至 2018 年 4 月在中国人民解放军总医院接受 GPi-DBS 的 23 例 CD 患者的临床资料。收集患者术前及末次随访时的多伦多西部痉挛性斜颈评定量表（TWSTRS）和 Tsui 评分，比较不同分类变量之间评分的改善百分比。计算临床结局与连续的人口统计学和临床变量之间的相关性。
患者 TWSTRS 总分（55.71%）、严重程度（48.75%）、残疾（57.05%）、疼痛（63.67%）评分和 Tsui 总分（46.07%）均有显著改善（均 P﹤0.001）。随访时间与 TWSTRS 总分（rho=0.594，P=0.003）、严重程度（rho=0.581，P=0.004）和残疾（rho=0.470，P=0.023）评分的改善百分比呈正相关。各分类变量之间的结局无显著差异。
随访时间是与 CD 患者 GPi-DBS 结局相关的唯一独立因素。然而，随访时间是手术前的一个不确定因素，因此，在确定预后因素的最终结论之前，还需要进一步的研究。
