{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:52:13Z","timestamp":1786125133954,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND IMPORTANCE<\/jats:title>\n                    <jats:p>Primary generalized dystonia (PGD) is a genetic form of dystonia that frequently displays pharmacological resistance and progresses quickly after onset. Deep brain stimulation (DBS) has been used successfully to treat refractory dystonia, specifically globus pallidus interna (GPi) DBS for DYT1-positive PGD patients. Long-term follow-up of the safety and efficacy falls short of the longevity seen in other diseases treated with DBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE PRESENTATION<\/jats:title>\n                    <jats:p>A male patient presented for neurosurgical evaluation with scapular winging, hand contractures, and violent truncal spasms, which forced him to be bedridden. After failing conservative therapy, the 18-yr-old patient was implanted with bilateral GPi-DBS. DBS parameter adjustments were made primarily within the first 3 yr after implantation, with nominal changes thereafter. Initial settings were contact of 3 + 0\u2212, amplitude of 4.9 V, frequency of 185 Hz, and pulse width of 270 \u03bcsec on the left and 3 + 0\u2212, 2.8 V, 185 Hz, and 120 \u03bcsec on the right. Current settings are 3 + 2 + 1\u2212, 5.2 V, 130 Hz, 330 \u03bcsec on the left and 3 + 0\u2212, 3.5 V, 185 Hz, and 180 \u03bcsec on the right and have been relatively unchanged in the past 4 yr. Unified dystonia rating scale scores reveal a significant decrease in dystonic symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>While prior reports have shown that GPi-DBS is effective for dystonia, this is the first with 15 yr of long-term follow-up showing disease stabilization, suggesting that stimulation is efficacious and can potentially prevent disease progression. This report reaffirms previous reports that recommend early surgical intervention before the onset of permanent musculoskeletal deficits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opx137","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T01:18:49Z","timestamp":1496711929000},"page":"E53-E57","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Disease Stabilization of DYT1-Positive Primary Generalized Dystonia With Deep Brain Stimulation of the Globus Pallidus Interna: A 15-Year Follow-up"],"prefix":"10.1227","volume":"14","author":[{"given":"Derrick A","family":"Dupre","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Nangunoori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sravanthi","family":"Koduri","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Angle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Cantella","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Whiting","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,5]]},"reference":[{"key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"E16","DOI":"10.3171\/2010.6.FOCUS10112","article-title":"Stimulation of the globus pallidus internus in a patient with DYT1-positive primary generalized dystonia: a 10-year follow-up","volume":"29","author":"Alcindor","year":"2010","journal-title":"Neurosurg Focus"},{"key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/ene.12515","article-title":"Clinical outcome of deep brain stimulation for dystonia: constant-current or constant-voltage stimulation? 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