780 Deep Brain Stimulation for Generalized Dystonia and Spasmodic Torticollis
Bibliographic record
Abstract
INTRODUCTION: Dystonia seems to be distinct from the other tremulous disorders in that improvement after deep brain stimulation (DBS) frequently appears in a delayed and progressive manner. The rate of this improvement and the point at which no further progress can be expected are currently unknown. METHODS: We studied 12 consecutive patients with generalized dystonia (n = 6) and spasmodic torticollis (n = 6) who underwent bilateral globus pallidus internus (GPi) DBS. Standard rating scales were used to quantify their neurological improvement. The results were analyzed by applying the Wilcoxon signed-rank test to compare rating scales within each group (preoperatively and at the most recent follow-up visit). In addition, a univariate analysis was performed for each subgroup to evaluate the rate of change in patient rating scales over time. RESULTS: Both groups experienced a statistically significant improvement in their rating scores at both 1 and 2 years after surgery. Mean follow-up was 29.9 months (range, 24–48 months). At 2-year follow-up, the spasmodic torticollis group exhibited a 59% improvement in their total Toronto Western Spasmodic Torticollis Rating Scale rating score, and the generalized dystonia group attained a 46% improvement in their overall Burke-Fahn-Marsden Dystonia Rating Scale evaluation. The total neurological rating scores for each group of patients improved gradually before reaching a plateau. Ninety-five percent of the final improvement was attained by 6.4 months in the generalized dystonia group and by 6.6 months in those with spasmodic torticollis. There was no significant improvement at 1 year after surgery. Postoperative complications occurred in three patients and comprised electrode displacement, lead fracture, and status dystonicus. CONCLUSION: These findings add further support to GPi DBS as an effective treatment for generalized dystonia and spasmodic torticollis and furnish important information as to the expected rate and magnitude of improvement and the point at which no further gains can be reasonably anticipated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".