Evidence map›Paper›PMID 30419402›Full record

SynthesisWorld neurosurgery2019

Deep Brain Stimulation Versus Peripheral Denervation for Cervical Dystonia: A Systematic Review and Meta-Analysis.

Krishnan Ravindran, Nishant Ganesh Kumar, Dario J Englot, Thomas J Wilson, Scott L Zuckerman

Open access · greenAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Krishnan RavindranDepartment of Neurosurgery, Vanderbilt University Medical Center School, Nashville, Tennessee, USA.
Nishant Ganesh KumarDepartment of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, Michigan.
Dario J EnglotDepartment of Neurosurgery, Vanderbilt University Medical Center School, Nashville, Tennessee, USA.
Thomas J WilsonDepartment of Neurosurgery, Stanford University, Stanford, California, USA.
Scott L ZuckermanDepartment of Neurosurgery, Vanderbilt University Medical Center School, Nashville, Tennessee, USA. Electronic address: scott.zuckerman@vumc.org.
Vanderbilt University Medical Center · USStanford University · USUniversity of Michigan–Ann Arbor · US

Funding

MULTIMODAL MAPPING OF SUBCORTICAL AND CORTICAL FUNCTIONAL NETWORK DISTURBANCES IN FOCAL EPILEPSYR00NS097618 · NINDS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ENGLOT, DARIO J · 2017 to 2019
$743k
NINDS NIH HHS R00 NS097618
6 · The paper itself

Abstract

backgroundCervical dystonia is a disabling medical condition that drastically decreases quality of life. Surgical treatment consists of peripheral nerve denervation procedures with or without myectomies or deep brain stimulation (DBS). The current objective was to compare the efficacy of peripheral denervation versus DBS in improving the severity of cervical dystonia through a systematic review and meta-analysis.

methodsA search of PubMed, MEDLINE, EMBASE, and Web of Science electronic databases was conducted in accordance with PRISMA guidelines. Preoperative and postoperative Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total scores were used to generate standardized mean differences and 95% confidence intervals (CIs), which were combined in a random-effects model. Both mean percentage and absolute reduction in TWSTRS scores were calculated. Absolute reduction was used for forest plots.

resultsEighteen studies met the inclusion criteria, comprising 870 patients with 180 (21%) undergoing DBS and 690 (79%) undergoing peripheral denervation procedures. The mean follow-up time was 31.5 months (range, 12-38 months). In assessing the efficacy of each intervention, forest plots revealed significant absolute reduction in total postoperative TWSTRS scores for both peripheral denervation (standardized mean difference 1.54; 95% CI 1.42-1.66) and DBS (standardized mean difference 2.07; 95% CI 1.43-2.71). On subgroup analysis, DBS therapy was significantly associated with improvement in postoperative TWSTRS severity (standardized mean difference 2.08; 95% CI 1.66-2.50) and disability (standardized mean difference 2.12; 95% CI 1.57-2.68) but not pain (standardized mean difference 1.18; 95% CI 0.80-1.55).

conclusionsBoth peripheral denervation and DBS are associated with a significant reduction in absolute TWSTRS total score, with no significant difference in the magnitude of reduction observed between the 2 treatments. Further comparative data are needed to better evaluate the long-term results of both interventions.

Indexed as

Deep Brain StimulationDenervationHumansTorticollisCervical dystoniaDeep brain stimulationSelective peripheral degeneration

Identifiers

PMID30419402
PMCPMC6363862
OpenAlexW2899808515

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.