Are brain pacemakers effective for dystonia?

Deep Brain Electrical Stimulation (DBS) is a procedure in which a pulse generator (IPG) implanted in the body delivers weak electrical impulses to stimulate the relevant neural nuclei in the brain that control movement, inhibiting the abnormal brain nerve signals that cause the symptoms of Parkinson’s Disease, thus eliminating the symptoms of Parkinson’s Disease and restoring the patient’s ability to move freely and take care of him/herself. It has been recognized as the mainstay of surgical treatment for movement disorders (e.g. Parkinson’s, dystonia). Deep Brain Stimulation (DBS) neuromodulation technology has been accepted by more and more doctors and patients because it is less invasive, more stable, and more reversible in the treatment of many functional neurosurgical diseases. Dystonia is a general term that specifically describes a movement disorder syndrome characterized by abnormal dystonic movements and postures caused by uncoordinated or excessive contraction of the active and antagonist muscles. Depending on where the dystonia occurs, it is limited, segmental, paraplegic, and generalized. Most of the dystonia is characterized by abnormal and bizarre postures due to repetitive twisting of all or a part of the trunk. Common manifestations include repeated and continuous blinking, inability to open the eyes after closing them (what we call blepharospasm); repeated involuntary twisting of the neck resulting in a crooked neck (spasmodic cervical tilt); involuntary twisting of the limbs or the body (torsion spasm) and so on, and some patients may also have speech labored, slurred speech, limb trembling and other manifestations. Abnormal twisting and posture of the limbs will bring great psychological and physiological pain to the patients, and some patients with the development of the disease will gradually appear the loss of daily movement ability, functional blindness and other manifestations. Therefore, it is necessary to seek medical treatment in time when encountering these situations. Deep Brain Stimulation (DBS) has become the main surgical intervention method for drug-refractory torsion dystonia (torsion spasm), which will be ideal for the treatment of dystonia, and can effectively improve the patient’s symptoms, with the advantages of reversibility of the stimulation effect, which can be adjusted according to the need, and relatively good safety. The efficacy of DBS in the treatment of dystonia, especially generalized dystonia and cervical dystonia, is now widely recognized. Overall, patients with primary dystonia responded well, while those with secondary dystonia responded relatively poorly. Clinical studies have confirmed that DBS is an effective treatment for drug-refractory dystonia, with significant improvement in functional scores as well as ability to perform daily living scores while relieving motor symptoms.