Journal of Movement Disorders

Original Article

Optimal Stimulation Sites and Long-Term Efficacy of Pallidal Deep-Brain Stimulation for Patients With Tardive Dystonia: Taku Nonaka, Shiro Horisawa, Kilsoo Kim, Masato Murakami, Masahiko Nishitani, Takakazu Kawamata, Takaomi Taira; J Mov Disord. 2026;19(1):49-57. Published online October 28, 2025; DOI: https://doi.org/10.14802/jmd.25164

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Objective
Globus pallidus internus deep brain stimulation (GPi-DBS) is an established treatment for dystonia, but its specific efficacy for tardive dystonia (TD) remains insufficiently documented. To evaluate the long-term clinical outcomes of GPi-DBS and to identify optimal stimulation sites in patients with medically refractory TD.
Methods
We retrospectively analyzed data from 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 voxelwise sweet spot analysis.
Results
At an average follow-up time of 42 months (range 12–4 months), the mean BFMDRS score improvement was 81.5%. The 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 patients with medically refractory TD, providing significant long-term symptom relief. The optimal stimulation sites were located in the posteroventral GPi, which is consistent with those reported for patients with other dystonia types.

Citations

Citations to this article as recorded by

Is functional neurosurgery offering new hope for patients with hyperkinetic disorders? A mini-review of the current data on the use of DBS in hyperkinetic movement disorders
Emily Tharp, Raja Mehanna
Parkinsonism & Related Disorders.2026; : 108419. CrossRef

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