ArticleEuropean journal of neurology2025
Comparison of different surgical strategies for cervical dystonia: Evidence from Bayesian network analysis.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Comparison of different surgical strategies for cervical dystonia: Evidence from Bayesian network analysis.European journal of neurology · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
background and purposeSeveral surgical techniques have been used to treat cervical dystonia (CD), however, to date, the optimal surgical technique for CD remains controversial. We therefore conducted the first network meta-analysis to compare different surgical strategies for CD to inform clinical practice.
methodsElectronic databases were searched for surgical strategies for treating CD. The primary outcome was improvement in total Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score. Subgroup analysis was performed to compare short-term (< 1 year) and long-term (≥ 1 year) outcomes. Safety outcomes included surgery-related adverse events (AEs).
resultsA total of 55 trials with 2032 patients employing five surgical strategies were identified, including globus pallidus internus (GPi)/subthalamic nucleus (STN)-deep brain stimulation (DBS), selective peripheral denervation (SPD), microvascular decompression (MVD) and pallidotomy. All strategies led to significant improvement in total TWSTRS score (mean improvement range 18.65-28.22). GPi-DBS showed significantly greater enhancement than SPD for the whole dataset (mean difference [MD] 7.03, 95% credible interval [Crl] 1.53-12.56), while both GPi-DBS (MD 8.05, 95% Crl 2.35-13.80) and STN-DBS (MD 10.71, 95% Crl 2.22-19.20) exhibited more long-term improvement than SPD. Regarding safety outcomes, GPi/STN-DBS and MVD were associated with fewer surgery-related AEs than SPD (ln odds ratio range -1.68 to -1.41).
conclusionWe conclude that DBS should be the preferred surgical option for CD, and the STN is a promising alternative target choice due to its comparable efficacy with the GPi. However, more direct evidence is still required.
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