Subthalamic Nucleus Deep Brain Stimulation for Dystonia: Evidence, Pros and Cons

The primary target for deep brain stimulation (DBS) for medication refractory dystonia has traditionally been the globus pallidus internus (GPi), however alternate targets have also been explored with the hope they might offer similar or superior outcomes with less side effects and reduced battery demands. Recent studies have shown comparable outcomes with both pallidal and subthalamic (STN) DBS, although the level of evidence is still superior for the GPi. There may not be an “optimal target” for all dystonia patients, with both targets offering the potential for excellent control of dystonia but more comparison studies are needed. In this review, we will discuss the history, efficacy, as well as target specific benefits and possible side effects of STN DBS for dystonia.