Dystonia and DBS: The Jury Arrives

Even before the deep brain stimulation (DBS) era, stereotactic functional neurosurgery such as thalamotomy and pallidotomy had been used for control of medically intractable dystonia (Cooper, 1976; Lozano et al., 1997). However, unreliability and variability in the results and furthermore, needs for bilateral surgery in most patients with generalized dystonia and the occurrence of unacceptable adverse effects including dysarthria and cognitive impairment have greatly limited their use. In this regard, DBS, which provides a more stable response with fewer side effects, has revolutionized the treatment of dystonia. The first report of DBS for dystonia was by Mundinger in 1977 (Mundinger, 1997). Since then, over the past few decades, bilateral globus pallidus internus (GPi) DBS has emerged as the best therapeutic option for medication-refractory dystonia (Lang, 2011).