Objective: Dystonia is a rare neurologic disorder that affects patients' quality of life. Globus pallidus internus (GPi) deep brain stimulation (DBS) is an effective treatment for dystonia. The application of microelectrode recording (MER) under general anaesthesia for treating dystonia during GPi DBS has seldom been reported. This study aimed to investigate the clinical outcomes of MER-guided GPi DBS for dystonia patients under general anaesthesia.
Methods: A total of 20 dystonia patients who underwent single-track MER-guided GPi DBS were included in this study. All patients were evaluated before surgery and at the most recent follow-up after DBS surgery. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was utilized to assess dystonia severity. The median duration of follow-up was 17.10 ± 10.02 months.
Results: The patients' mean age at disease onset was 41.20 ± 14.86 years, and the mean disease duration before surgery was 6.06 ± 7.46 years. The general anaesthesia single-track MER trajectory presented left-sided and right-sided GPi lengths of 6.73 ± 1.60 mm and 6.76 ± 1.41 mm, respectively. Patients' BFMDRS movement scores decreased from baseline score 24.13 ± 14.07 into 9.30 ± 8.33 (p < 0.01), with 63.09 ± 14.02% improvement. The BFMDRS disability scores decreased from baseline score 8.50 ± 4.70 into 3.50 ± 2.50 (p < 0.01), with 60.08 ± 14.12% remission after GPi-DBS. The MMSE score showed no difference between preoperative 27.0 ± 1.68 and postoperative 26.46 ± 1.56 (p = 0.4). One patient had incision infection after 6 months of DBS. No other severe postoperative side effects were observed in this study.
Conclusions: This study showed that MER-guided GPi DBS under general anaesthesia can relieve the movement and disability of dystonia patients, with no cognitive function change.
Keywords: Deep brain stimulation (DBS); Dystonia; General anaesthesia; Globus pallidus internus (GPi); Microelectrode recording (MER).
© 2025. The Author(s).