AUTHOR=Eleopra Roberto , Rinaldo Sara , Devigili Grazia , Mondani Massimo , D'Auria Stanislao , Golfrè Andreasi Nico , Skrap Miran , Lettieri Christian 

TITLE=Globus Pallidus Internus Deep Brain Stimulation Using Frame-Based vs. Frameless Stereotaxy in Dystonia: A Single-Center Experience

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.643757

DOI=10.3389/fneur.2021.643757

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> Bilateral globus pallidus internus deep brain stimulation (GPi-DBS) is an established and effective therapy for primary refractory dystonia. However, the comparison of frameless <italic>vs</italic>. frame-based DBS surgery technique is still controversial. This retrospective study aims to compare the clinical outcome of two GPi-DBS surgical techniques for patients affected by primary generalized or multi-segmental dystonia.</p><p><bold>Methods:</bold> For lead's stereotaxic placement, 10 patients underwent frame-based surgery and the other 10 subjects DBS surgery with a frameless technique. Clinical features were evaluated at baseline and 6 and 12 months after surgery by means of the Burke–Fahn–Marsden Dystonia Rating Scale.</p><p><bold>Results:</bold> Frame-based GPi-DBS and frameless stereotaxic group revealed a comparable clinical outcome with no surgical complications.</p><p><bold>Conclusions:</bold> Frameless technique is safe and well-tolerated by patients and showed similar effectiveness of the frame-based stereotaxic surgery during GPi-DBS for primary dystonia. Notably, it could be a valid alternative solution because of the great advantage in improving the patient's discomfort during awake surgery.</p>