Deep brain stimulation for dystonia: outcomes from a Brazilian cohort

TL;DR

This study evaluates the effectiveness of deep brain stimulation for dystonia in Brazil, showing significant and lasting motor improvements.

Contribution

The study provides the first detailed analysis of DBS outcomes for dystonia in a Brazilian cohort, demonstrating its effectiveness in a developing country context.

Findings

DBS led to significant motor improvement in dystonia patients in Brazil, with BFMDRS scores decreasing from 63.0 to 36.7 at one year.

Improvements were sustained over time, with scores remaining lower at the last assessment (43.6).

DBS targeting the globus pallidus internus was the most common approach (73.3%).

Abstract

Deep brain stimulation (DBS) is a treatment for dystonia, with most trials conducted in developed countries. Data from developing countries like Brazil are limited.

To evaluate the landscape of DBS for dystonia in Brazil, assessing motor outcomes compared with the existing literature.

A retrospective multicenter cohort study was conducted via medical record review. Demographics and motor outcomes were collected and analyzed using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) from patients across four of Brazil's five macro-regions.

The cohort included 60 patients (44.3% female), with DBS primarily targeting the globus pallidus internus (73.3%) or subthalamic nucleus (18.3%). The BFMDRS motor scores decreased from 63.0 ± 26.2 (n = 24) at baseline to 36.7 ± 24.6 at 1-year post-DBS (n = 22,
p
 = 0.0018) and 43.6 ± 35.0 at the last assessment (n = 13,
p
 = 0.0327).

The use of DBS yielded significant, sustained motor improvements, consistent with developed countries, highlighting its feasibility and effectiveness in Brazil within diverse healthcare settings.

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