Skip to main content
Top
Published in: Journal of Neurology 12/2015

01-12-2015 | Original Communication

Long-term effect on dystonia after pallidal deep brain stimulation (DBS) in three members of a family with a THAP1 mutation

Authors: P. Krause, N. Brüggemann, S. Völzmann, A. Horn, A. Kupsch, G.-H. Schneider, K. Lohmann, A. Kühn

Published in: Journal of Neurology | Issue 12/2015

Login to get access

Abstract

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an established treatment in patients with severe dystonia. However, factors predicting outcome are largely unknown and motor improvement in DYT6 patients after DBS has been reported to be poorer as compared to, e.g., DYT1 patients. Here, we report the course of clinical improvement for up to 11 years of pallidal DBS in three male patients belonging to the same family with early-onset generalized or segmental dystonia due to a heterozygous THAP1 gene mutation (DYT6). All patients showed an initial effective response to pallidal DBS with a mean of 56.9 ± 11.7 % improvement in the Burke–Fahn–Marsden Dystonia motor and 45.5 ± 22.4 % in the disability score at 1-year follow-up. The long-term outcome of pallidal DBS was favorable in two patients (39, 67 % motor improvement, respectively). Our findings demonstrate that motor improvement is variable and may depend on disease severity, disease duration, and clinical presentation. Overall, our observation supports pallidal DBS as an important treatment option in patients with DYT6 dystonia.
Appendix
Available only for authorised users
Literature
2.
go back to reference Ozelius LJ, Hewett JW, Page CE et al (1997) The early-onset torsion dystonia gene (DYT1) encodes an ATP-binding protein. Nat Genet 17:40–48CrossRefPubMed Ozelius LJ, Hewett JW, Page CE et al (1997) The early-onset torsion dystonia gene (DYT1) encodes an ATP-binding protein. Nat Genet 17:40–48CrossRefPubMed
3.
go back to reference Fuchs T, Gavarini S, Saunders-Pullman R et al (2009) Mutations in the THAP1 gene are responsible for DYT6 primary torsion dystonia. Nat Genet 41:286–288CrossRefPubMed Fuchs T, Gavarini S, Saunders-Pullman R et al (2009) Mutations in the THAP1 gene are responsible for DYT6 primary torsion dystonia. Nat Genet 41:286–288CrossRefPubMed
4.
go back to reference Bonetti M, Barzaghi C, Brancati F et al (2009) Mutation screening of the DYT6/THAP1 gene in Italy. Mov Disord Off J Mov Disord Soc 24:2424–2427CrossRef Bonetti M, Barzaghi C, Brancati F et al (2009) Mutation screening of the DYT6/THAP1 gene in Italy. Mov Disord Off J Mov Disord Soc 24:2424–2427CrossRef
5.
go back to reference Bressman SBRD, Fuchs T, Heiman G, Ozelius LJ, Saunders-Pullman R (2009) Mutations in THAP1 (DYT6) in early-onset dystonia: a genetic screening study. Lancet Neurol 8:441–446PubMedCentralCrossRefPubMed Bressman SBRD, Fuchs T, Heiman G, Ozelius LJ, Saunders-Pullman R (2009) Mutations in THAP1 (DYT6) in early-onset dystonia: a genetic screening study. Lancet Neurol 8:441–446PubMedCentralCrossRefPubMed
6.
go back to reference Djarmati A, Schneider SA, Lohmann K et al (2009) Mutations in THAP1 (DYT6) and generalised dystonia with prominent spasmodic dysphonia: a genetic screening study. Lancet Neurol 8:447–452CrossRefPubMed Djarmati A, Schneider SA, Lohmann K et al (2009) Mutations in THAP1 (DYT6) and generalised dystonia with prominent spasmodic dysphonia: a genetic screening study. Lancet Neurol 8:447–452CrossRefPubMed
7.
go back to reference Kupsch A, Benecke R, Muller J et al (2006) Pallidal deep-brain stimulation in primary generalized or segmental dystonia. New Engl J Med 355:1978–1990CrossRefPubMed Kupsch A, Benecke R, Muller J et al (2006) Pallidal deep-brain stimulation in primary generalized or segmental dystonia. New Engl J Med 355:1978–1990CrossRefPubMed
8.
go back to reference Mueller J, Skogseid IM, Benecke R et al (2008) Pallidal deep brain stimulation improves quality of life in segmental and generalized dystonia: results from a prospective, randomized sham-controlled trial. Mov Disord Off J Mov Dis Soc 23:131–134CrossRef Mueller J, Skogseid IM, Benecke R et al (2008) Pallidal deep brain stimulation improves quality of life in segmental and generalized dystonia: results from a prospective, randomized sham-controlled trial. Mov Disord Off J Mov Dis Soc 23:131–134CrossRef
9.
go back to reference Vidailhet M, Vercueil L, Houeto J-L et al (2007) Bilateral, pallidal, deep-brain stimulation in primary generalised dystonia: a prospective 3 year follow-up study. Lancet Neurol 6:223–229CrossRefPubMed Vidailhet M, Vercueil L, Houeto J-L et al (2007) Bilateral, pallidal, deep-brain stimulation in primary generalised dystonia: a prospective 3 year follow-up study. Lancet Neurol 6:223–229CrossRefPubMed
10.
go back to reference Volkmann J, Wolters A, Kupsch A et al (2012) Pallidal deep brain stimulation in patients with primary generalised or segmental dystonia: 5-year follow-up of a randomised trial. Lancet Neurol 11:1029–1038CrossRefPubMed Volkmann J, Wolters A, Kupsch A et al (2012) Pallidal deep brain stimulation in patients with primary generalised or segmental dystonia: 5-year follow-up of a randomised trial. Lancet Neurol 11:1029–1038CrossRefPubMed
11.
go back to reference Coubes P, Cif L, El Fertit H et al (2004) Electrical stimulation of the globus pallidus internus in patients with primary generalized dystonia: long-term results. J Neurosurg 101:189–194CrossRefPubMed Coubes P, Cif L, El Fertit H et al (2004) Electrical stimulation of the globus pallidus internus in patients with primary generalized dystonia: long-term results. J Neurosurg 101:189–194CrossRefPubMed
12.
go back to reference Isaias IU, Alterman RL, Tagliati M (2008) Outcome predictors of pallidal stimulation in patients with primary dystonia: the role of disease duration. Brain J Neurol 131:1895–1902CrossRef Isaias IU, Alterman RL, Tagliati M (2008) Outcome predictors of pallidal stimulation in patients with primary dystonia: the role of disease duration. Brain J Neurol 131:1895–1902CrossRef
13.
go back to reference Markun LC, Starr PA, Air EL, Marks WJ Jr, Volz MM, Ostrem JL (2012) Shorter disease duration correlates with improved long-term deep brain stimulation outcomes in young-onset DYT1 dystonia. Neurosurgery 71:325–330CrossRefPubMed Markun LC, Starr PA, Air EL, Marks WJ Jr, Volz MM, Ostrem JL (2012) Shorter disease duration correlates with improved long-term deep brain stimulation outcomes in young-onset DYT1 dystonia. Neurosurgery 71:325–330CrossRefPubMed
14.
go back to reference Andrews C, Aviles-Olmos I, Hariz M, Foltynie T (2010) Which patients with dystonia benefit from deep brain stimulation? A metaregression of individual patient outcomes. J Neurol Neurosurg Psychiatry 81:1383–1389CrossRefPubMed Andrews C, Aviles-Olmos I, Hariz M, Foltynie T (2010) Which patients with dystonia benefit from deep brain stimulation? A metaregression of individual patient outcomes. J Neurol Neurosurg Psychiatry 81:1383–1389CrossRefPubMed
15.
go back to reference Borggraefe I, Mehrkens JH, Telegravciska M, Berweck S, Botzel K, Heinen F (2010) Bilateral pallidal stimulation in children and adolescents with primary generalized dystonia—report of six patients and literature-based analysis of predictive outcomes variables. Brain Dev 32:223–228CrossRefPubMed Borggraefe I, Mehrkens JH, Telegravciska M, Berweck S, Botzel K, Heinen F (2010) Bilateral pallidal stimulation in children and adolescents with primary generalized dystonia—report of six patients and literature-based analysis of predictive outcomes variables. Brain Dev 32:223–228CrossRefPubMed
16.
go back to reference Tagliati M, Shils J, Sun C, Alterman R (2004) Deep brain stimulation for dystonia. Expert Rev Med Devices 1:33–41CrossRefPubMed Tagliati M, Shils J, Sun C, Alterman R (2004) Deep brain stimulation for dystonia. Expert Rev Med Devices 1:33–41CrossRefPubMed
17.
go back to reference Groen JL, Ritz K, Contarino MF et al (2010) DYT6 dystonia: mutation screening, phenotype, and response to deep brain stimulation. Mov Disord 25:2420–2427CrossRefPubMed Groen JL, Ritz K, Contarino MF et al (2010) DYT6 dystonia: mutation screening, phenotype, and response to deep brain stimulation. Mov Disord 25:2420–2427CrossRefPubMed
18.
go back to reference Panov F, Tagliati M, Ozelius LJ et al (2012) Pallidal deep brain stimulation for DYT6 dystonia. J Neurol Neurosurg Psychiatry 83:182–187CrossRefPubMed Panov F, Tagliati M, Ozelius LJ et al (2012) Pallidal deep brain stimulation for DYT6 dystonia. J Neurol Neurosurg Psychiatry 83:182–187CrossRefPubMed
19.
go back to reference Zittel S, Moll CK, Bruggemann N et al (2010) Clinical neuroimaging and electrophysiological assessment of three DYT6 dystonia families. Mov Off J Mov Disord Soc 25:2405–2412CrossRef Zittel S, Moll CK, Bruggemann N et al (2010) Clinical neuroimaging and electrophysiological assessment of three DYT6 dystonia families. Mov Off J Mov Disord Soc 25:2405–2412CrossRef
20.
go back to reference Jech RBM, Křepelová A, Urgošík D, Havránková P, Růžička E (2011) DYT 6—a novel THAP1 mutation with excellent effect on pallidal DBS. Mov Off J Mov Disord Soc 26:924–925CrossRef Jech RBM, Křepelová A, Urgošík D, Havránková P, Růžička E (2011) DYT 6—a novel THAP1 mutation with excellent effect on pallidal DBS. Mov Off J Mov Disord Soc 26:924–925CrossRef
21.
go back to reference França S, Linhares P, Rosas MJ, Volkmann J (2014) Pallidal deep brain stimulation in DYT6: significant long-term improvement of dystonia and disability. Mov Disord Clin Pract 1(2):118–120CrossRef França S, Linhares P, Rosas MJ, Volkmann J (2014) Pallidal deep brain stimulation in DYT6: significant long-term improvement of dystonia and disability. Mov Disord Clin Pract 1(2):118–120CrossRef
22.
go back to reference Bruggemann N, Kuhn A, Schneider SA et al (2015) Short- and long-term outcome of chronic pallidal neurostimulation in monogenic isolated dystonia. Neurology 84:895–903CrossRefPubMed Bruggemann N, Kuhn A, Schneider SA et al (2015) Short- and long-term outcome of chronic pallidal neurostimulation in monogenic isolated dystonia. Neurology 84:895–903CrossRefPubMed
23.
24.
go back to reference Silberstein P, Kuhn AA, Kupsch A et al (2003) Patterning of globus pallidus local field potentials differs between Parkinson’s disease and dystonia. Brain J Neurol 126:2597–2608CrossRef Silberstein P, Kuhn AA, Kupsch A et al (2003) Patterning of globus pallidus local field potentials differs between Parkinson’s disease and dystonia. Brain J Neurol 126:2597–2608CrossRef
25.
go back to reference Cif L, Vasques X, Gonzalez V et al (2010) Long-term follow-up of DYT1 dystonia patients treated by deep brain stimulation: an open-label study. Mov Off J Mov Disord Soc 25:289–299CrossRef Cif L, Vasques X, Gonzalez V et al (2010) Long-term follow-up of DYT1 dystonia patients treated by deep brain stimulation: an open-label study. Mov Off J Mov Disord Soc 25:289–299CrossRef
26.
go back to reference Vidailhet M, Vercueil L, Houeto JL et al (2005) Bilateral deep-brain stimulation of the globus pallidus in primary generalized dystonia. New Engl J Med 352:459–467CrossRefPubMed Vidailhet M, Vercueil L, Houeto JL et al (2005) Bilateral deep-brain stimulation of the globus pallidus in primary generalized dystonia. New Engl J Med 352:459–467CrossRefPubMed
27.
go back to reference Grips E, Blahak C, Capelle HH et al (2007) Patterns of reoccurrence of segmental dystonia after discontinuation of deep brain stimulation. J Neurol Neurosurg Psychiatry 78:318–320PubMedCentralCrossRefPubMed Grips E, Blahak C, Capelle HH et al (2007) Patterns of reoccurrence of segmental dystonia after discontinuation of deep brain stimulation. J Neurol Neurosurg Psychiatry 78:318–320PubMedCentralCrossRefPubMed
28.
go back to reference Vidailhet M, Jutras MF, Grabli D, Roze E (2013) Deep brain stimulation for dystonia. J Neurol Neurosurg Psychiatry 84:1029–1042CrossRefPubMed Vidailhet M, Jutras MF, Grabli D, Roze E (2013) Deep brain stimulation for dystonia. J Neurol Neurosurg Psychiatry 84:1029–1042CrossRefPubMed
29.
go back to reference Barow E, Neumann WJ, Brucke C et al (2014) Deep brain stimulation suppresses pallidal low frequency activity in patients with phasic dystonic movements. Brain J Neurol 137:3012–3024CrossRef Barow E, Neumann WJ, Brucke C et al (2014) Deep brain stimulation suppresses pallidal low frequency activity in patients with phasic dystonic movements. Brain J Neurol 137:3012–3024CrossRef
30.
go back to reference Ruge D, Cif L, Limousin P et al (2011) Shaping reversibility? Long-term deep brain stimulation in dystonia: the relationship between effects on electrophysiology and clinical symptoms. Brain J Neurol 134:2106–2115CrossRef Ruge D, Cif L, Limousin P et al (2011) Shaping reversibility? Long-term deep brain stimulation in dystonia: the relationship between effects on electrophysiology and clinical symptoms. Brain J Neurol 134:2106–2115CrossRef
Metadata
Title
Long-term effect on dystonia after pallidal deep brain stimulation (DBS) in three members of a family with a THAP1 mutation
Authors
P. Krause
N. Brüggemann
S. Völzmann
A. Horn
A. Kupsch
G.-H. Schneider
K. Lohmann
A. Kühn
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 12/2015
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-015-7908-z

Other articles of this Issue 12/2015

Journal of Neurology 12/2015 Go to the issue