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In some dystonia cases, deep brain therapy benefits may linger after device turned off
Date:2/12/2013

ed for 48 hours.

Findings from the 10-patient study correlate well with these two cases, Tagliati said.

"It appears that several factors age, duration of disease, length of time the patient has received DBS treatment and stimulation parameters determine which patients may retain symptom relief after prolonged DBS interruption. Our two patients were young, 20 years old. They both began DBS therapy a relatively short time after disease onset; one at four years and the other at seven years. One had received continuous stimulation for five years and the other for 18 months before stimulation was interrupted," Tagliati said.

"We can't say for certain why these factors make the difference," he added, "But we theorize that a younger brain with shorter exposure to the negative effects of dystonia may be more responsive to therapy and have greater 'plasticity' to adapt back to normal. Both of our patients received DBS therapy at a lower energy than most patients experience, suggesting the possibility that low-frequency stimulation over an extended time may help retrain the brain's low-frequency electrical activity."

Both instances of device shut-off were accidental and were discovered during doctor visits after mild symptoms returned. The patient who had undergone five years of DBS therapy had only one stimulator turned off for about three months; the one stimulating the left side of his brain remained active. In the other patient, the left device had been off for about seven months and the right one for two months, Tagliati said.

Tagliati was senior author of a 2011 Journal of Neurology article on a study showing that for patients suffering from dystonia, deep brain therapy tends to get better, quicker results when started earlier rather than later.

"We knew from earlier work that younger patients with shorter disease duration had better clinical outcomes in the short term. In our 2011 article, we reported that they
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Contact: Sandy Van
sandy@prpacific.com
808-526-1708
Cedars-Sinai Medical Center
Source:Eurekalert

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