Subthalamic Nucleus Deep Brain Stimulation for Meige Syndrome: Long-Term Outcomes and Analysis of Prognostic Factors.

Abstract

Background and objectives: The aim of this study was to explore the impacts of subthalamic nucleus deep brain stimulation (STN-DBS) on both motor and nonmotor symptoms in individuals with Meige syndrome, as well as further investigates prognostic factors for long-term postoperative outcomes.

Methods: We retrospectively reviewed a consecutive cohort of patients with intractable Meige syndrome who underwent STN-DBS at our center from January 2016 to July 2023. Motor function, quality of life, neuropsychological status, and mood state were evaluated with standardized scales at baseline and every 3 to 6 months thereafter. Univariate and multivariate linear regression analyses were used to determine independent risk factors that affect long-term motor function after STN-DBS.

Results: Fifty-five patients were ultimately analyzed with a mean follow-up of 62.1 ± 25.7 months. At the final postoperative assessment, movement and disability scores of the Burke-Fahn-Marsden Dystonia Rating Scale demonstrated improvements of 61% (P < .001) and 57% (P < .001), respectively. Postoperative scores on the 36-item Short-Form General Health Survey showed significant improvement from baseline. Global cognitive function and neuropsychological status remained stable during continuous neurostimulation. Multivariate linear regression analysis revealed that longer disease duration (standardized β coefficient = -0.294, 95% CI -0.039 to -0.007, P = .006), older age at surgery (standardized β coefficient = -0.382, 95% CI -0.014 to -0.004, P = .001), and smaller volume of tissue activated within the sensorimotor subregion of STN (standardized β coefficient = 0.309, 95% CI 0.001-0.004, P = .004) were independently correlated with poorer long-term motor performance.

Conclusion: Bilateral STN-DBS is an effective, safe, and promising treatment option for Meige syndrome, which can improve motor function and quality of life without cognitive and mood side effects. Early diagnosis, prompt intervention, and accurate lead placement in the dorsolateral STN are crucial to optimize long-term therapeutic outcomes.