Journal of Movement Disorders

Original Article

Optimal Stimulation Sites and Long-term Efficacy of Pallidal Deep Brain Stimulation for Tardive Dystonia: TAKU NONAKA, SHIRO HORISAWA, KILSOO KIM, MASATO MURAKAMI, MASAHIKO NISHITANI, TAKAKAZU KAWAMATA, TAKAOMI TAIRA; Received June 24, 2025 Accepted October 24, 2025 Published online October 28, 2025; DOI: https://doi.org/10.14802/jmd.25164 [Accepted]

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Abstract PDF: Background
Globus pallidus internus deep brain stimulation (GPi-DBS) is an established treatment for dystonia, but its specific efficacy for tardive dystonia (TD) remains less documented.
Objectives
To evaluate the long-term clinical outcomes of GPi-DBS and identify optimal stimulation sites in patients with medically refractory TD.
Methods
We retrospectively analyzed 26 patients with TD who underwent bilateral GPi-DBS. Clinical outcomes were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Optimal stimulation sites were identified using voxel-wise Sweetspot analysis.
Results
At an average follow-up of 42 months (range 12–84 months), the mean improvement in the BFMDRS score was 76.7%. Optimal stimulation sites were located in the posteroventral region of the GPi. Two patients experienced sustained symptom remission after DBS cessation. Complications included device-related infection (n=2), dysarthria (n=4), and gait imbalance (n=1); no severe permanent complications occurred.
Conclusion
GPi-DBS is effective and safe for medically refractory tardive dystonia, providing significant long-term symptom relief. Optimal stimulation sites were located in the posteroventral GPi, consistent with those reported for other dystonia types.

Brief communication

Efficacy and Safety of Zolpidem for Musician’s Dystonia: Shiro Horisawa, Kilsoo Kim, Masato Murakami, Masahiko Nishitani, Takakazu Kawamata, Takaomi Taira; J Mov Disord. 2024;17(4):425-429. Published online July 1, 2024; DOI: https://doi.org/10.14802/jmd.24121

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Objective
The efficacy and safety of zolpidem for treating musician’s dystonia are not well understood. We aimed to retrospectively investigate the efficacy and safety of zolpidem for treating musician’s dystonia.
Methods
We retrospectively reviewed medical records between January 2021 and December 2023 to identify patients with musician’s dystonia who had been prescribed zolpidem. Tubiana’s Musician’s Dystonia Rating Scale (range, 1–5; lower scores indicating greater severity) was used to evaluate musician’s dystonia.
Results
Fifteen patients were included in this study. The mean effective dose of zolpidem was 5.3 ± 2.0 mg. The mean effective duration of zolpidem was 4.3 ± 1.2 h. With zolpidem administration, Tubiana’s musician’s dystonia rating scale score significantly improved from 2.2 ± 1.0 to 4.3 ± 0.8 (48.9% improvement, p < 0.001). Two patients (13.3%) discontinued the drug owing to unsatisfactory results or sleepiness.
Conclusion
The results of this study suggest that zolpidem may be an alternative treatment option for musician’s dystonia.

Citations

Citations to this article as recorded by

Deep Phenotyping of Musicians’ Upper Limb Dystonia
Steven J. Frucht
Tremor and Other Hyperkinetic Movements.2025; 15: 31. CrossRef
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Cureus.2025;[Epub] CrossRef
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Letter to the editor

Thalamic Deep Brain Stimulation for SPG56-Related Focal Hand Dystonia: Momo Uchida, Shiro Horisawa, Kenkou Azuma, Hiroyuki Akagawa, Shinichi Tokushige, Takakazu Kawamata, Takaomi Taira; J Mov Disord. 2024;17(4):447-449. Published online June 27, 2024; DOI: https://doi.org/10.14802/jmd.24022

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PDF Supplementary Material

Citations

Citations to this article as recorded by

Efficacy and Safety of Thalamotomy for Focal Hand Dystonia: A Systematic Review
Ruiqing Yang, Botao Xiong, Xiaoman Shi, Xinyuejia Huang, Wei Wang, Carlo Colosimo
Acta Neurologica Scandinavica.2025;[Epub] CrossRef

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