Movement Disorders Center of Arizona, Scottsdale, Arizona, US.
Barrow Neurological Institute, Phoenix, Arizona, US.
Tremor Other Hyperkinet Mov (N Y). 2020 Dec 31;10:60. doi: 10.5334/tohm.575.
To date, there are only six published reports of adductor spasmodic dysphonia (SD) responding to awake thalamic deep brain stimulation (DBS).
We retrospectively reviewed cases of Essential Tremor (ET) with SD that were seen in our center from 2012 to 2020. We further identified those that have undergone thalamic DBS, and had a blinded laryngologist rate first the audio voice recordings before and after DBS using the Unified Spasmodic Dysphonia Rating Scale (USDRS), and the video recordings last to rate the related movements and facial grimacing.
We identified three cases of adductor SD with ET that had undergone bilateral ventralis intermedius (VIM) DBS under general anesthesia. All patients noted improvement of their limb and voice tremor, as well as their SD post-DBS. Although improvement of tremor was observed even with initial programming in all three, improvement of SD was noted only upon reaching higher amplitudes or wider pulse widths. Blinded voice assessments showed improvement of USDRS scores post-DBS compared to pre-DBS, and with stimulator on compared to stimulator off.
We report the first three cases of SD responding favorably to bilateral VIM asleep DBS and summarize the nine cases so far of SD who have undergone thalamic DBS.
迄今为止，仅有 6 篇关于内收肌痉挛性发音障碍 (SD) 对清醒丘脑深部脑刺激 (DBS) 有反应的文献报道。
我们回顾了 2012 年至 2020 年期间在我们中心就诊的特发性震颤 (ET) 合并 SD 的病例。我们进一步确定了那些接受过丘脑 DBS 的患者，并让一位盲法喉镜师使用统一痉挛性发音障碍评分量表 (USDRS) 对 DBS 前后的音频语音录音进行评分，并对相关运动和面部痉挛进行视频录音评分。
我们发现了 3 例 ET 合并内收肌 SD 患者，他们在全身麻醉下接受了双侧腹侧中间核 (VIM) DBS。所有患者均注意到他们的肢体和声音震颤以及 SD 在 DBS 后的改善。尽管在所有 3 例患者中，初始编程时都观察到了震颤的改善，但仅在达到更高的振幅或更宽的脉冲宽度时才注意到 SD 的改善。盲法语音评估显示，与 DBS 前相比，DBS 后 USDRS 评分有所改善，与刺激器关闭相比，刺激器开启时评分也有所改善。
我们报告了首例 3 例对双侧 VIM 睡眠 DBS 反应良好的 SD，并总结了迄今为止对 9 例接受丘脑 DBS 的 SD 患者的报道。
