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

Frances M. Velez-Lago; Genko Oyama; Kelly D. Foote; Nelson Hwynn; Pamela Zeilman; Charles Jacobson; Samuel Wu; Michael S. Okun

doi:10.5334/tohm.84

Figures & Tables

Table 1.

Demographics of patients who had minimum of 3 months of low-frequency stimulation

Subject #	Gender	Age Symptom Onset	Age at First Surgery	DYT-1 Status	Fixed Skeletal Deformities	Dystonia Type (1^o vs. 2^o)	Distribution	Baseline UDRS	Baseline BFM–DRS M
1	F	29	35	N/A	YES	1	Cervical + larynx	7	N/A
2	M	8	31	pos	NO	1	Gen	44	31
3	M	birth	34	N/A	NO	2 (CP)	Gen	69	64.5
4	M	39	43	N/A	NO	2 (TD)	Gen	82	72
5	M	48	62	N/A	NO	1	Cervical	12	8
6	F	51	73	N/A	NO	1	Cervical	8	8
7	M	15	35	neg	NO	1	Gen	N/A	N/A
8	M	62	67	N/A	NO	1	Craniofacial	29	N/A
9	M	6	8	pos	NO	1	Gen	71	N/A
10	F	29	60	N/A	YES	1	Cervical	12	6
11	M	27	34	N/A	NO	1	Cervical	8	8
12	M	5	11	pos	NO	1	Gen	55	116
13	M	13	33	neg	NO	1	Gen	63	66.5

UDRS, Unified Dystonia Rating Scale; N/A, not available; pos, positive; neg, negative; Gen, generalized dystonia; CP, cerebral palsy; TD, tardive dystonia; BFM–DRS M, Burke–Fahn–Marsden Dystonia Rating Scale Motor subscore.

Table 2.

Programming settings at baseline and at the last follow-up for the deep brain simulation (DBS) leads.

Contacts	Amp	PW	Freq	Contacts	Amp	PW	Freq	Months1	Contacts	Amp	PW	Freq
1	R	1-	2.2	180	60	1-	3	180	135	28	1-	2.3	180	135	46
L	1-	2.2	180	60	1-	3.1	180	135	28	1-	2.3	180	60	89
2	R	5-	2.8	180	60	5-	1.7	180	135	42	5-	1.8	180	135	393
L	2-	3.3	180	60	2-	2.4	180	135	41	2-	2.5	180	135	393
32	R	1-	2.1	210	60	2-	2	450	185	13	1-/2-	3.0	120	5	>1203
L	2-	2.1	210	60	1-/2+	2	450	185	13	1-/2-	2.0	120	5	>1203
4	R	6-	3.0	180	60	5-/6-	2.1	180	60	35	5-/6-	3.1	180	185	213
L	1-	3.0	180	60	1-/2+	3	450	185	9	1-/2+	3.0	450	185	213
5	R	2-	2.2	150	60	1-/2+	3	150	135	6	1-/2+	3.0	150	135	45
L	2-	2.2	150	60	1-/2+	2.6	150	135	7	1-/2+	2.6	150	135	54
6	R	1-/2+	2.0	180	60	1-/2+	2.3	210	185	12	1-/2+	3.0	330	185	20
L	2-	2.3	180	60	1-	2.5	210	185	12	0-/1+	3.5	330	185	16
7	R	1-	2.5	180	60	0-/1+	2.2	150	135	27	1-	3.0	180	60	72
L	1-	2.5	180	60	0-/2+	3	150	135	27	1-	3.1	180	60	70
8	R	5-	3.5	180	60	5-/6-	3.2	60	10	6	5-/6-	3.2	60	10	>1203
L	1-	3.4	180	60	1-/2+	3.2	60	10	6	1-/2-	3.2	60	10	>1203
9	R	2-	2.6	180	60	2-	3.2	180	60	46	1-/2-	3.6	180	90	40
L	1-	2.8	180	60	1-	3	180	60	46	1-/2-	3.6	180	60	68
10	R	1-	2.0	180	60	1-/2-/3+	2.3	450	135	39	1-/2-/3+	3.3	330	145	25
L	0-/1-	2.0	180	60	1-/2-/3+	4.5	450	135	38	1-	3.1	330	185	17
11	R	2-	2.5	180	60	2-	3.2	180	60	24	2-	3.5	180	60	58
L	2-	2.5	180	60	2-	3.2	180	60	24	2-	3.5	180	60	52
12	R	2-	2.1	150	60	2-	2.8	180	60	25	0-/2+	2.3	210	80	44
L	1-	2.0	150	60	1-	2.8	180	60	25	1-/2-	2.3	180	80	66
13	R	2-	2.2	180	60	2-	3.2	180	80	23	2-	3.0	210	160	30
L	2-	2.2	180	60	2-	3.2	180	80	23	2-	3.5	180	100	46

DBS contacts are monopolar unless noted with a positive contact which indicates bipolar configuration.

1 Months after placement of DBS lead at their last follow up.

2 Subject 3 had failure of DBS and all hardware was removed 13 months post DBS, at last follow up devices were turned off. EBL: estimated battery life using programming parameters at last clinical follow up.

3 Kinetra IPGs, otherwise subjects had Soletra IPGs.

Abbreviations: Amp, amplitude of stimulation in volts; PW, pulse width; Freq, frequency of stimulation.

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

Figures & Tables

Table 1.

Table 2.

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