Low-Frequency Deep Brain Stimulation for Dystonia: Lower is Not Always Better

• Published in: Tremor and other hyperkinetic movements (New York, N.Y.) Vol. 2; p. 2
• Main Authors: Velez-Lago, Frances M, Oyama, Genko, Foote, Kelly D, Hwynn, Nelson, Zeilman, Pamela, Jacobson, Charles, Wu, Samuel, Okun, Michael S
• Format: Journal Article
• Language: English
• Published: United States Ubiquity Press 01.01.2012; Columbia University Libraries/Information Services
• Subjects: Age; Deep brain stimulation; Dystonia; Females; Larynx; Patients; Surgery; complications; Deep brain stimulation; rate; dystonia; outcome; voltage
• ISSN: 2160-8288; 2160-8288
• DOI: 10.5334/TOHM.84

It has been observed that low-frequency stimulation (LFS) may be effective for dystonia, and the use of LFS may alleviate the need for frequent battery changes in a subset of patients. The aim of this study was to analyze LFS as a strategy to treat deep brain stimulation (DBS) patients with various dystonias. Subjects had to receive a minimum of 6 months of clinical follow-up at the University of Florida, and were required to have a minimum of 3 months on a LFS trial. Twenty-seven dystonia DBS patients were retrospectively analyzed from the UF-INFORM database. Thirteen subjects met inclusion criteria. Of the 13 subjects, all had bilateral internal pallidum (GPi) DBS, and five (38.5%) remained with at least one side on LFS settings at their last follow up (average follow up 24 months, range 6-46 months). Within the first 6 months, six (46%) subjects remained on LFS and seven (54%) were changed to high-frequency stimulation (HFS). Those who remained on LFS settings at 6 months were characterized by shorter disease durations than those on HFS settings. There were no significant differences in dystonia severity (Unified Dystonia Rating Scale and Burke-Fahn-Marsden Dystonia Rating Scale) at baseline between the two settings. The estimated battery life for LFS (79.9±30.5) was significantly longer than for HFS settings (32.2±13.1, p<0.001). LFS was ultimately chosen for 38.5% of all subjects. Although this study failed to yield solid predictive features, subjects on LFS tended to have shorter disease durations.