Abstract | BACKGROUND: METHODS: In a controlled double-blind phase six patients (four chorea-dominant, two Westphal-variant) with predominant movement disorder were randomly assigned to either the sequence of 6-week internal- or 6-week external-pallidal stimulation, or vice versa, followed by further 3 months chronic pallidal stimulation at the target with best effect-side-effect ratio. Primary endpoints were changes in the Unified Huntington's Disease Rating Scale motor-score, chorea subscore, and total motor-score 4 (blinded-video ratings), comparing internal- versus external-pallidal stimulation, and 6 months versus baseline. Secondary endpoints assessed scores on dystonia, hypokinesia, cognition, mood, functionality/disability, and quality-of-life. RESULTS: Intention-to-treat analysis of all patients (n = 3 in each treatment sequence): Both targets were equal in terms of efficacy. Chorea subscores decreased significantly over 6 months (-5.3 (60.2%), p = 0.037). Effects on dystonia were not significant over the group due to it consisting of three responders (>50% improvement) and three non-responders. Westphal patients did not improve. Cognition was stable. Mood and some functionality/disability and quality-of-life scores improved significantly. Eight adverse events and two additional serious adverse events - mostly internal-pallidal stimulation-related - resolved without sequalae. No procedure-related complications occurred. CONCLUSION:
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Authors | Lars Wojtecki, Stefan J Groiss, Stefano Ferrea, Saskia Elben, Christian J Hartmann, Stephen B Dunnett, Anne Rosser, Carsten Saft, Martin Südmeyer, Christian Ohmann, Alfons Schnitzler, Jan Vesper, Surgical Approaches Working Group of the European Huntington's Disease Network (EHDN) |
Journal | Frontiers in neurology
(Front Neurol)
Vol. 6
Pg. 177
( 2015)
ISSN: 1664-2295 [Print] Switzerland |
PMID | 26347707
(Publication Type: Journal Article)
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