1010 Prospective, Multicenter, International Study of Deep Brain Stimulation for Dystonia: Analysis of Cervical Dystonia Patients

INTRODUCTION: In patients with cervical (focal) versus generalized dystonia, optimal Deep Brain Stimulation (DBS) target sites (within pallidothalamic loop) are thought to diverge and be specific for particular connections. 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 study (NCT02686125). Participants receive an MICC-based, directional DBS system (Boston Scientific). Patients are followed up to 3-years (post-implant). Study assessments collect the following: 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 the cervical-only cohort, a 20-point improvement in overall TWSTRS score (baseline: 42.4) 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-point and 7.8-point improvement in overall TWSTRS scores (baseline: 35.1) was noted at 6- (n=62) and 12-months (n=48), respectively. The percentage of those who reported significant improvement as compared with Baseline (Global Impression of Change) at 12-months follow-up was the following: 91% of patients with cervical only and 82% of patients with cervical and other involved regions. Additional results, per on-going data collection and analysis, is planned for presentation. CONCLUSIONS: This study represents one of the largest comprehensive collection of real-world outcomes associated with dystonia patients implanted with a directional, MICC-based DBS system. Preliminary results demonstrate significant improvement in patients with cervical dystonia (alone or in context of segmental or generalized dystonia) following DBS.