PMC8128503_01
PMC8128503_02
Bilateral GPi-DBS in an adolescent DYT6 dystonia patient. (A) Image-guided frameless stereotaxic surgery was performed to implant DBS leads into GPi in the 12-year-old boy under general anesthesia. (B) Axial, (C) coronal and (D) sagittal images of O-arm (left panel, arrowheads), and fusion images with pre-operative MRI (right panel, arrows) indicating the location of DBS electrodes in bilateral GPi.
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The surgery was performed under general anesthesia (Figure 1A). Bilateral DBS electrodes were implanted and confirmed on intraoperative computed tomography O-arm images (Medtronic) immediately after fusion with the preoperatively planned trajectory (Figure 1B-D).
The clinical improvement of the DYT6 dystonia patient after effective bilateral pallidal stimulation. (A) The BFMDRS score changes at baseline and 3-, 6-, and 12-months after GPi-DBS. (B) Significant improvement in severe scoliosis of the patient and findings of spine x-rays pre-operatively and at 6-months after GPi-DBS. (C) Photos showing his daily physical activity nearly normal state after successful treatment of scoliosis and dystonia at 12 months after GPi-DBS.
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There was a 91% improvement in the score from baseline (pre-operation) to 12 months after DBS (Figure 2A). The patient's scoliosis improved significantly within first 6 months after the surgery, with the Cobb angle decreasing from 45  preoperatively to 20  at the 12-month follow-up (Figure 2B). At 12 months after DBS, the patient returned to a relatively normal life at home and at school, and was able to performed many physical activities, such as running, jumping, and cycling with the improvement of his scoliosis (Figure 2C).