ArticleTremor and other hyperkinetic movements (New York, N.Y.)2014
Brittle Dyskinesia Following STN but not GPi Deep Brain Stimulation.
Article in Tremor and other hyperkinetic movements (New York, N.Y.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 29 citations in OpenAlex.
- Adaptive deep brain stimulation for Parkinson's disease using motor cortex sensing.Journal of neural engineering · 2018Trial
- Case Report: Effective management of a Meige syndrome patient with subthalamic stimulation-induced dyskinesia through timed stimulation programming of different contacts.Frontiers in human neuroscience · 2026Article
- A Convergent Pathway for Stimulation-Induced Dyskinesia Following Deep Brain Stimulation.Movement disorders : official journal of the Movement Disorder Society · 2025Article
- A case report: combined posterior subthalamic area and globus pallidus internus deep brain stimulation in Parkinson's disease.Frontiers in human neuroscience · 2025Article
- Elimination of STN stimulation-induced dyskinesias with VIM-DBS.Movement disorders clinical practice · 2024Article
- Fundamentals of deep brain stimulation for Parkinson's disease in clinical practice: part 2.Arquivos de neuro-psiquiatria · 2024Review
- Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson's disease: a multicenter, retrospective study of efficacy and safety.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Identification and Management of Persistent Stimulation-Induced Dyskinesia Associated with STN DBS: The See-Saw Dilemma.Tremor and other hyperkinetic movements (New York, N.Y.) · 2023Article
- Globus Pallidus Internus (GPi) Deep Brain Stimulation for Parkinson's Disease: Expert Review and Commentary.Neurology and therapy · 2021Article
- Opportunities of connectomic neuromodulation.NeuroImage · 2020Review
- Rescue Levodopa/Carbidopa Intestinal Gel for Secondary Deep Brain Stimulation Failure.Journal of movement disorders · 2020Article
- Dorsal GPi/GPe Stimulation Induced Dyskinesia in a Patient with Parkinson's Disease.Tremor and other hyperkinetic movements (New York, N.Y.) · 2019Article
- Deep Brain Stimulation Emergencies: How the New Technologies Could Modify the Current Scenario.Current neurology and neuroscience reports · 2017Review
- Biomarkers and Stimulation Algorithms for Adaptive Brain Stimulation.Frontiers in neuroscience · 2017Review
- Comparison of Globus Pallidus Interna and Subthalamic Nucleus in Deep Brain Stimulation for Parkinson Disease: An Institutional Experience and Review.Parkinson's disease · 2017Review
- Levodopa-induced Dyskinesia: Clinical Features, Pathophysiology, and Medical Management.Annals of Indian Academy of NeurologyArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim was to describe the prevalence and characteristics of difficult to manage dyskinesia associated with subthalamic nucleus (STN) deep brain stimulation (DBS). A small subset of STN DBS patients experience troublesome dyskinesia despite optimal programming and medication adjustments. This group of patients has been referred to by some practitioners as brittle STN DBS-induced dyskinesia, drawing on comparisons with brittle diabetics experiencing severe blood sugar regulation issues and on a single description by McLellan in 1982. We sought to describe, and also to investigate how often the "brittle" phenomenon occurs in a relatively large DBS practice.
methodsAn Institutional Review Board-approved patient database was reviewed, and all STN and globus pallidus internus (GPi) DBS patients who had surgery at the University of Florida from July 2002 to July 2012 were extracted for analysis.
resultsThere were 179 total STN DBS patients and, of those, four STN DBS (2.2%) cases were identified as having dyskinesia that could not be managed without the induction of an "off state," or by the precipitation of a severe dyskinesia despite vigorous stimulation and medication adjustments. Of 75 GPi DBS cases reviewed, none (0%) was identified as having brittle dyskinesia. One STN DBS patient was successfully rescued by bilateral GPi DBS. DISCUSSION: Understanding the potential risk factors for postoperative troublesome and brittle dyskinesia may have an impact on the initial surgical target selection (STN vs. GPI) in DBS therapy. Rescue GPi DBS therapy may be a viable treatment option, though more cases will be required to verify this observation.
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