BACKGROUND The effectiveness of pallidal deep brain stimulation (GPi DBS) for cervical dystonia has been extensively described, but controversies exist about which prognostic factor is clinically useful. We previously reported that classification of tonic- or phasic-type cervical dystonia is useful for predicting clinical prognosis; however, the approach used by physicians to distinguish between the two types remains subjective. OBJECTIVE The aim of this study was to develop a prognostic factor of GPi DBS for cervical dystonia. METHODS By identifying distributions of range of motion scores between phasic- and tonic-type cervical dystonia, a new prognostic factor group was developed based on whether the patients could voluntarily move their head to the opposite side against dystonic motions. The prognosis for GPi DBS in the two groups was analyzed according to the time sequence. RESULTS Patients who were able to move their head past the midline had a better long-term prognosis after GPi DBS than did those who could not. In the early post-operative phase, there were no significant differences in the clinical outcomes between the two groups. CONCLUSION A range of voluntary neck motility with respect to the midline is an objective factor that is useful in predicting the prognosis of patients with cervical dystonia. This result renders needs for future study addressing neuroplastic changes in the brain network caused by GPi DBS.

中文翻译：

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自愿性颈部运动的范围可预测苍白的DBS对宫颈肌张力障碍的预后。

背景技术已经广泛描述了苍白的深部脑刺激（GPi DBS）对宫颈肌张力障碍的有效性，但是关于哪种预后因素在临床上有用存在争议。我们先前曾报道，对强直性或阶段性宫颈肌张力障碍的分类可用于预测临床预后。但是，医生用来区分两种类型的方法仍然是主观的。目的本研究的目的是开发GPi DBS对宫颈肌张力障碍的预后因素。方法通过确定阶段性和强直性子宫颈肌张力障碍之间运动评分范围的分布，根据患者是否可以自愿将头部移向对侧，以适应肌张力障碍运动，建立了一个新的预后因素组。根据时间顺序分析两组GPi DBS的预后。结果GPi DBS术后能够将头移过中线的患者的长期预后要好于不能进行中线治疗的患者。在术后早期，两组之间的临床结局没有显着差异。结论相对于中线的自愿性颈部运动范围是一个客观因素，可用于预测宫颈肌张力障碍患者的预后。该结果提出了对未来研究的需求，以解决由GPi DBS引起的大脑网络中神经再生的变化。两组之间的临床结局无显着差异。结论相对于中线的自愿性颈部运动范围是一个客观因素，可用于预测宫颈肌张力障碍患者的预后。该结果提出了对未来研究的需求，以解决由GPi DBS引起的大脑网络中神经再生的变化。两组之间的临床结局无显着差异。结论相对于中线的自愿性颈部运动范围是一个客观因素，可用于预测宫颈肌张力障碍患者的预后。该结果提出了针对未来研究的需求，以解决由GPi DBS引起的大脑网络中神经再生的变化。