Objective:

Background:

Deep brain stimulation (DBS) surgery targeting the bilateral globus pallidus internus (GPi) has been shown to significantly improve dystonia symptoms, with most studies focusing on generalized and cervical dystonia. However, there is limited longitudinal data on the effects of DBS in patients with blepharospasm or Meige syndrome, and little is known about its long-term impact on mood, anxiety, and apathy in these individuals.

Design/Methods:

In an IRB approved protocol, we extracted longitudinal data collected in patients with blepharospasm with or without Meige syndrome using Unified Dystonia Rating Scale (UDRS) for motor outcomes, Beck Depression Inventory for mood, Beck Anxiety Inventory for anxiety, and Apathy scale for apathy. Data was gathered prior to surgery and at follow-up intervals of 1-2 years and 6-9 years post-surgery.

Results:

We analyzed data on 19 blepharospasm patients (6 males and 13 females; mean age 57±9 years). 13/19 patients had Meige syndrome. Compared to baseline scores, motor symptoms improved by 47.3% (p=0.007) at short-term follow-up (1-2 years) and 54.3% (p=0.005) at long-term follow-up (6-9 years). In the analysis of itemized data that was available, eyes and face items of the UDRS combined (rated 0-8) showed a < 4-point drop (n=8), and ≥ 4-point drop (n=6) at short-term and < 4-point drop (n=5), and ≥ 4-point drop (n=8) at long-term follow-up. There was no significant change in depression, anxiety, and apathy scores through the length of follow-up.

Conclusions:

Bilateral DBS targeting the GPi in patients with blepharospasm and Meige syndrome demonstrates long-term improvements in motor outcomes. A relatively small cohort may not have captured the change in mood, anxiety, and apathy. These findings are essential for patient counseling and setting realistic expectations.