Video 1
Symptoms before and after surgery. Comparison of patient’s symptoms before surgery, at 1-month follow-up (deep brain stimulation [DBS]-on), and at 36-month follow-up (DBS-on), recorded with patient’s arms suspended.
Figure 1
Occlusive changes at bilateral distal internal carotid arteries (ICA), beginning portions of middle cerebral artery (MCA), and anterior cerebral arteries (ACA) (blue arrows). An abnormal vascular network at the base of the brain (“puff of smoke” sign) (red arrow).
Figure 2
a–d (a and b: axial view; c and d: coronal view): Brain magnetic resonance imaging before stereotactic surgery revealing abnormal signal intensities in the right thalamus (red arrows). e–g: Stereotactic targeting images. Electrode location is marked with a blue line, and ventral intermediate nucleus/ventral oral nucleus radiofrequency lesion is marked with a red line.
Video 2
Right hand’s function tests during operation. Patient’s performances of writing test and rapid succession movement before and after thalamotomy.
Table 1
The dystonia severity evaluated by the Burke–Fahn–Marsden Dystonia Rating Scale at baseline and follow-up visit.
| BFMDRS | General response (%BFMDRS change) | ||
|---|---|---|---|
| Motor score | Disability score | ||
| Baseline | 23 | 9 | / |
| 1-week follow-up (DBS-on) | 19 | 6 | –21.88% |
| 1-month follow-up (DBS-on) | 14 | 6 | –37.50% |
| 1-month follow-up (DBS-off) | 16 | / | / |
| 3-month follow-up (DBS-on) | 12 | 5 | –46.88% |
| 9-month follow-up (DBS-on) | 12 | 4 | –50.00% |
| 36-month follow-up (DBS-on) | 11 | 4 | –53.13% |
| 36-month follow-up (DBS-off) | 16 | / | / |
[i] BFMDRS, Burke–Fahn–Marsden Dystonia Rating Scale.
Dystonia severity was evaluated using the Burke–Fahn–Marsden Dystonia Rating Scale at baseline and follow-up visit (1 week, 1 month, 3 months, 9 months, and 36 months). At 1-month and 36-month follow-up visit, the symptoms were recorded and assessed at DBS-off status additionally.
Video 3
Gait’s change with DBS off. Patient’s gait was recorded at deep brain stimulation (DBS)-on state (1-month follow-up) and when the stimulator was turned off 24 hours later. With DBS off, the patient experienced slight left leg weakness and gait instability.