{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:24:49Z","timestamp":1787750689834,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) is an established therapy for dystonia; however, the long\u2010term trajectory of adjunctive treatment burden, including oral medications and botulinum toxin (BoNT) injections, and the likelihood of achieving medication\u2010free status remain poorly understood, despite important implications for adverse effects, injection burden, and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Determine long\u2010term changes in adjunctive medication burden and the durability of medication\u2010free status among dystonia patients undergoing DBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively examined the proportion of dystonia patients requiring oral medications and BoNT therapy after DBS, tracking postoperative changes at 6\u2009months, 1, 3, 5, and 10\u2009years. Factors influencing overall medication burden were evaluated, and the proportion of patients achieving treatment\u2010free status was determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 100 patients in this cohort (56% generalized dystonia), baseline use of oral medications and BoNT was 85% and 43%, respectively. The proportion requiring oral medications and BoNT declined to ~60% and\u2009~\u200920\u201325% as DBS benefits emerged, with reductions maintained throughout follow\u2010up. Among those continuing BoNT, dosing remained largely unchanged. The overall medication burden score, calculated by combining oral medications and BoNT, was significantly reduced at all follow\u2010up intervals, with body distribution influencing the magnitude of reduction. Around one\u2010third of patients did not require any medications at 10\u2010year follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DBS leads to sustained reductions in adjunctive oral medications and BoNT use. At 10\u2010year follow\u2010up, around 20% of dystonia patients continued to require BoNT injections, but 30% were completely medication\u2010free. These data highlight evolving long\u2010term benefits and inform patient expectations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70799","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:16:15Z","timestamp":1787750175000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How Do Oral Medications, Botulinum Toxin Use, and Treatment Burden Change after Deep Brain Stimulation for Dystonia?"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9408-7893","authenticated-orcid":false,"given":"Hikaru","family":"Kamo","sequence":"first","affiliation":[{"name":"Department of Neurology, Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"},{"name":"Department of Neurology Juntendo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Leone","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohini","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase","family":"Antilla","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Gerzenshtein","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunmozhimaran","family":"Elavarasi","sequence":"additional","affiliation":[{"name":"Department of Neurology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Wagle Shukla","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25475"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2023.107251"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.02.035"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.14802\/jmd.25164"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/neurolint13030037"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.04.024"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09745-z"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-12022-4"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012405.pub2"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins16060282"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v14.i5.624"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/wco.0000000000001072"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.757579"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10377"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3233\/jpd-212769"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxae208"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt009"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.05.010"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.30130"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2009.20"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.927573"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.70370"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2016.02.003"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-025-08404-3"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2014.09.004"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09765-9"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000008875"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.14021"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70799","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70799","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:16:17Z","timestamp":1787750177000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":28,"alternative-id":["10.1002\/mdc3.70799"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70799","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"assertion":[{"value":"2026-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"mdc3.70799"}}