{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T16:18:55Z","timestamp":1776442735105,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008723","name":"Suomen L\u00e4\u00e4ketieteen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008723","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Deep brain stimulation of the globus pallidus interna (GPi\u2010DBS) is a highly efficacious treatment for cervical dystonia. Typically, the treatment response is delayed, appearing and increasing even months after implantation. However, it is not known how fast the symptoms reappear and whether there is a long\u2010term therapeutic effect after the stimulation is discontinued.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To study symptom reappearance after switching GPi\u2010DBS off in cervical dystonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twelve patients with bilateral GPi\u2010DBS were included in the study. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was evaluated during the study with DBS stimulation on, after switching the stimulation off and 2\u2009days after the stimulation was switched off. Presurgical symptom severity and best postsurgical response were extracted from the hospital records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the time of the investigation, GPi\u2010DBS was associated with 67 (SD 39)% symptom improvement of presurgical symptoms severity (<jats:italic>P<\/jats:italic> =\u20090.001). Symptom improvement decreased to 27 (53)% (<jats:italic>P<\/jats:italic> =\u20090.046) (n = 12) acutely after switching the stimulation off and was further reduced to 4 (56)% 2\u2009days after discontinuation (<jats:italic>P<\/jats:italic> =\u20090.01) (n = 11), reaching the presurgical level (<jats:italic>P<\/jats:italic> =\u20090.42). In descriptive analyses, older age was associated with faster worsening of symptoms (<jats:italic>P<\/jats:italic> &lt;\u20090.05). Presurgical symptoms severity, stimulation parameters or magnitude of treatment response did not predict symptom worsening. All but one patient tolerated 2\u2009days DBS switched off.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results provide novel information about the time frame and severity of symptom worsening after discontinuing GPi\u2010DBS in cervical dystonia. Symptoms partially reappear immediately after discontinuing GPi\u2010DBS and full presurgical symptom severity is reached within 2\u2009days.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13162","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T06:37:18Z","timestamp":1612593438000},"page":"406-411","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Reappearance of Symptoms after <scp>GPi\u2010DBS<\/scp> Discontinuation in Cervical Dystonia"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3497-5706","authenticated-orcid":false,"given":"Emma A.","family":"Honkanen","sequence":"first","affiliation":[{"name":"Clinical Neurosciences University of Turku  Turku Finland"},{"name":"Division of Clinical Neurosciences Turku University Hospital  Turku Finland"},{"name":"Department of Neurology Satasairaala Central Hospital  Pori Finland"},{"name":"Turku PET 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Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin M.","family":"Reich","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital and Julius Maximilian University  W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juho","family":"Joutsa","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences University of Turku  Turku Finland"},{"name":"Division of Clinical Neurosciences Turku University Hospital  Turku Finland"},{"name":"Turku PET Centre Turku University Hospital  Turku Finland"},{"name":"Turku Brain and Mind Center University of Turku  Turku 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