{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:34:18Z","timestamp":1773398058334,"version":"3.50.1"},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Primary dystonia is a disabling movement disorder often refractory to medical therapies. While bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) is established for motor symptom control, broader functional outcomes are less well characterized. To evaluate motor and real-world functional improvements following bilateral GPi DBS in patients with primary dystonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective observational study was conducted on 20 patients (mean age 34.7 years) with medically refractory primary dystonia. All underwent stereotactically guided bilateral GPi DBS. Functional outcomes assessed included skeletal deformity, facial twitching severity, wheelchair dependence, self-feeding ability, and bladder control. Evaluations were conducted at baseline and 6 months postoperatively. McNemar\u2019s test and the Wilcoxon signed-rank test were used for statistical analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Significant improvements were observed across all domains. Skeletal deformity rates decreased from 95% preoperatively to 10% postoperatively (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Facial twitching improved significantly (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.005). Wheelchair dependence dropped from 50% to 5% (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.007). Self-feeding ability increased from 30% to 95% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and bladder control improved from 10% to 95% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). No serious adverse events related to surgery or stimulation were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Bilateral GPi DBS in primary dystonia significantly improves motor symptoms and critical functional domains such as mobility, independence in self-care, and bladder control. These findings support the broader benefits of DBS, emphasizing its role in enhancing quality of life. Further studies with larger samples and longer follow-up are needed to confirm these outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_432_2025","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:02:40Z","timestamp":1773392560000},"page":"141","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional recovery after bilateral globus pallidus internus deep brain stimulation in primary dystonia: A prospective clinical evaluation"],"prefix":"10.25259","volume":"17","author":[{"given":"Moneer K.","family":"Faraj","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"10.25259\/SNI_432_2025\/ref-1","doi-asserted-by":"crossref","first-page":"358","DOI":"10.4236\/wjns.2015.55035","article-title":"Clinical patterns of primary dystonias among hospitalized patients in Baghdad and Kut in Iraq","volume":"5","author":"Al Ameer","year":"2015","journal-title":"World J Neurosci"},{"key":"10.25259\/SNI_432_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1093\/brain\/awh213","article-title":"Globus pallidus internus stimulation in primary generalized dystonia: A H215O PET study","volume":"127","author":"Detante","year":"2004","journal-title":"Brain"},{"key":"10.25259\/SNI_432_2025\/ref-3","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1001\/archneur.64.9.1281","article-title":"Acute deep-brain stimulation of the internal and external globus pallidus in primary dystonia: Functional mapping of the pallidum","volume":"64","author":"Houeto","year":"2007","journal-title":"Arch Neurol"},{"key":"10.25259\/SNI_432_2025\/ref-4","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/S1474-4422(06)70574-9","article-title":"Treatment of dystonia","volume":"5","author":"Jankovic","year":"2006","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_432_2025\/ref-5","doi-asserted-by":"crossref","first-page":"e211","DOI":"10.1016\/j.wneu.2018.11.137","article-title":"Comparison of short-term stimulation of the globus pallidus interna and subthalamic nucleus for treatment of primary dystonia","volume":"123","author":"Liu","year":"2019","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_432_2025\/ref-6","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1111\/ene.13255","article-title":"Efficacy of pallidal stimulation in isolated dystonia: A systematic review and meta-analysis","volume":"24","author":"Moro","year":"2017","journal-title":"Eur J Neurol"},{"key":"10.25259\/SNI_432_2025\/ref-7","doi-asserted-by":"crossref","first-page":"508","DOI":"10.3174\/ajnr.A6429","article-title":"Functional and structural connectivity patterns associated with clinical outcomes in deep brain stimulation of the globus pallidus internus for generalized dystonia","volume":"41","author":"Okromelidze","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_432_2025\/ref-8","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1016\/S1474-4422(11)70232-0","article-title":"Primary dystonia and dystonia-plus syndromes: Clinical characteristics, diagnosis, and pathogenesis","volume":"10","author":"Phukan","year":"2011","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_432_2025\/ref-9","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/978-3-319-97897-0_53","article-title":"Treatment of dystonia: Deep brain stimulation","volume-title":"Therapy of Movement Disorders: A Case-based Approach","author":"Pourfar","year":"2019"},{"key":"10.25259\/SNI_432_2025\/ref-10","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.wneu.2017.03.091","article-title":"Constant-current deep brain stimulation of the globus pallidus internus in the treatment of primary dystonia by a novel 8-contact (Octrode) lead","volume":"103","author":"Sakas","year":"2017","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_432_2025\/ref-11","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1002\/mds.25244","article-title":"The prevalence of primary dystonia: A systematic review and meta-analysis","volume":"27","author":"Steeves","year":"2012","journal-title":"Mov Disord"},{"key":"10.25259\/SNI_432_2025\/ref-12","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1056\/NEJMoa042187","article-title":"Bilateral deep-brain stimulation of the globus pallidus in primary generalized dystonia","volume":"352","author":"Vidailhet","year":"2005","journal-title":"N Engl J Med"},{"key":"10.25259\/SNI_432_2025\/ref-13","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational 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