Abstract Details

Title Prospective, Multicenter, International Registry of Deep Brain Stimulation for Dystonia: Sub-analysis of Cervical Dystonia Patients

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-018

Objective The study objective is to assess/report real-world outcomes of patients with idiopathic, inherited, or acquired dystonia implanted with Multiple Independent Current Control (MICC)-based directional Deep Brain Stimulation (DBS) systems.

Background

In patients with cervical (focal) versus generalized dystonia, optimal DBS target sites (within pallidothalamic loop) are thought to diverge and be specific for particular connections. DBS devices equipped with capabilities such as directionality and Multiple Independent Current Control (MICC) may enable improved outcomes.

Design/Methods This is a sub-analysis of patients with focal (cervical) dystonia only or cervical dystonia in context of segmental or generalized dystonia derived from a prospective, multicenter, international dystonia registry (NCT02686125). All patients receive an MICC-based, directional DBS system (Boston Scientific). Patients are followed up to 3-years (post-implant). The following assessments collected to evaluate dystonia symptoms include: Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), quality-of-life, overall satisfaction, and adverse events.

Results A total of 50-patients (mean age 56.1-years, 62% females) with focal (cervical) dystonia only, and 95-patients (mean 43.6-years, 58% females) with cervical dystonia in context of segmental or generalized dystonia have been evaluated to date. In cervical only cohort, a 20-point improvement in overall TWSTRS score was noted at 6-months (n=35) and sustained up to 1-year (23.1-point improvement, n=30). In those with cervical dystonia in context of segmental or generalized dystonia, an 8.3- and 7.8-point improvement in overall TWSTRS scores was noted at 6- (n=62) and 12-months (n=48), respectively. Both evaluated groups reported the following level of improvement versus Baseline (Global-Impression-of-Change) at 12-months follow-up: 84% with cervical only and 82% of patients with cervical and other involved regions.

Conclusions

This registry represents the first comprehensive, large-scale collection of real-world outcomes associated with dystonia patients implanted with directional, MICC-based DBS systems. Preliminary results demonstrate significant improvement in cervical dystonia patients (alone or in context of segmental or generalized dystonia) following DBS.

Authors/Disclosures
Alberto Albanese, MD (Universita Cattolica Sacro Cuore) PRESENTER	Dr. Albanese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ipsen pharma. Dr. Albanese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merz pharms. Dr. Albanese has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers Publishing Group. Dr. Albanese has a non-compensated relationship as a President with International Association on Parkinsonism and Related Disorders that is relevant to AAN interests or activities.
Alfons Schnitzler (Heinrich Heine University, Neurology)	No disclosure on file
Andrea Kuehn	Andrea Kuehn has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medtronic. Andrea Kuehn has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific.
David Arkadir	No disclosure on file
David Ledingham	No disclosure on file
David Pedrosa (University Hospital Giessen and Marburg)	David Pedrosa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. David Pedrosa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bial. David Pedrosa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific Corp.. David Pedrosa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. David Pedrosa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Desitin. David Pedrosa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. The institution of David Pedrosa has received research support from Boston Scientific Corp..
Edward Newman	No disclosure on file
Ignacio Regidor	No disclosure on file
Jens Volkmann (Universitätsklinikum Würzburg)	No disclosure on file
Marcin Rudas	No disclosure on file
Maria Fiorella Contarino	The institution of Maria Fiorella Contarino has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. The institution of Maria Fiorella Contarino has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Inbrain. The institution of Maria Fiorella Contarino has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BostonScientific. Maria Fiorella Contarino has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for ECMT. An immediate family member of Maria Fiorella Contarino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Maria Fiorella Contarino has received research support from Boston Scientific. The institution of Maria Fiorella Contarino has received research support from Parkinsonvereniging. The institution of Maria Fiorella Contarino has received research support from Stichting ParkinsonFonds. The institution of Maria Fiorella Contarino has received research support from European Innovation Council. The institution of an immediate family member of Maria Fiorella Contarino has received research support from Stichting ParkinsonFonds. The institution of an immediate family member of Maria Fiorella Contarino has received research support from Alzheimer nederland.
Mariachiara Sensi	No disclosure on file
Michael Barbe	No disclosure on file
Monika Poetter-Nerger	No disclosure on file
Norbert Kovacs	Norbert Kovacs has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Norbert Kovacs has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Norbert Kovacs has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie.
Ralph Lehrke	No disclosure on file
Ryoong Huh	No disclosure on file
Steffen Paschen	The institution of Steffen Paschen has received research support from Deutsche Forschungsgemeinschaft. The institution of Steffen Paschen has received research support from Parkinsonfonds. The institution of Steffen Paschen has received research support from UCB .
Tomasz Mandat	No disclosure on file
Tommaso Tufo	No disclosure on file
Veerle Visser-Vandewalle	Veerle Visser-Vandewalle has nothing to disclose.
Volker Coenen	Volker Coenen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceregate. Volker Coenen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Inbrain. Volker Coenen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Cortec. Volker Coenen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PRECISIS. Volker Coenen has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific. Volker Coenen has stock in Ceregate. The institution of Volker Coenen has received research support from Boston Scientific.
Yen F. Tai, MD (Hammersmith Hosp)	The institution of Dr. Tai has received research support from Medical Research Council UK. The institution of Dr. Tai has received research support from Moulton Charitable Foundation.
Lilly Chen (Boston Scientific)	Lilly Chen has received personal compensation for serving as an employee of Boston Scientific .
Edward Goldberg (Boston Scientific)	No disclosure on file
Joachim Krauss	No disclosure on file

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