Sustained quality-of-life improvements over 10 years after subthalamic nucleus deep brain stimulation for isolated dystonia.

BACKGROUND

Bilateral deep brain stimulation (DBS) of subthalamic nucleus (STN) has demonstrated efficacy for ameliorating medication-refractory isolated dystonia. Nonetheless, the paucity of evidence regarding its long-term impact on quality-of-life (QoL) necessitates further investigation.

OBJECTIVES

This study aimed to elucidate the longitudinal effects of chronic STN stimulation on QoL in patients suffering from isolated dystonia.

METHODS

We enrolled 54 subjects diagnosed with isolated dystonia who underwent STN-DBS and maintained post-operative status for over 5 years. The 36-item Short Form General Health Survey (SF-36) assessed QoL, while the Montreal Cognitive Assessment (MoCA) evaluated cognitive functioning.

RESULTS

The average follow-up since implantation extended to 10.9 years. The data analysis revealed a significant enhancement in QoL following STN-DBS treatment, as Physical Component Summary (PCS), Mental Component Summary (MCS), and Global scores demonstrated substantial improvement from pre-DBS to post-DBS (p < 0.0001). The disease classifications yielded differential results; patients with generalized dystonia exhibited superior improvements in PCS (p = 0.0053) and Global scores (p = 0.0120) compared to other types. Patients aged < 36 at the time of implantation experienced greater improvements in PCS (p = 0.0109) and global scores (p = 0.0057) than older counterparts. Cognitive function, as per the MoCA scale, showed no significant difference between pre- and post-operative scores (p = 0.08).

CONCLUSIONS

STN-DBS appears to confer enduring improvements to the QoL in dystonia patients, persisting an average of 10 years or more post-surgery. These findings underscore the long-term efficacy of STN-DBS for isolated dystonia and highlight the influence of patient age and disease classification on outcomes.