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.