Globus pallidus internus versus subthalamic nucleus deep brain stimulation for Meige syndrome: a retrospective study on short- and long-term efficacy.

[OBJECTIVE] Meige syndrome is a complex movement disorder characterized by blepharospasm and oromandibular dystonia that is often resistant to conventional pharmacological and botulinum toxin treatments. Deep brain stimulation (DBS) offers a promising alternative, but the relative efficacy of globus pallidus internus (GPi) versus subthalamic nucleus (STN) targeting remains underexplored. Therefore, the aim of this study was to evaluate and compare the short- and long-term efficacy of GPi-DBS and STN-DBS in managing Meige syndrome.

[METHODS] This retrospective study analyzed patients with primary Meige syndrome who underwent either GPi-DBS or STN-DBS at a single institution from October 2018 to October 2024. The main outcome measure was the change in the Burke-Fahn-Marsden Dystonia Rating Scale for movement (BFMDRS-M) scores, which were assessed preoperatively and at 3 months and a mean of 37.2 months postoperatively.

[RESULTS] Of 162 patients (110 female, mean age 57.8 years) included in the analysis, 83 underwent GPi-DBS and 79 underwent STN-DBS. The GPi-DBS group had an average improvement rate of 53.3% in the mean BFMDRS-M score at 3 months postoperatively and 63.0% at the final follow-up. Similarly, the STN-DBS group had average improvement rates of 53.6% at 3 months and 65.2% at the final follow-up. At the final follow-up, 71.1% of patients in the GPi-DBS group and 70.9% of patients in the STN-DBS group had ≥ 50% improvement, while 41.0% and 46.8%, respectively, had > 75% improvement. There was no significant difference in short-term (p = 0.602) or long-term (p = 0.419) efficacy between the two groups.

[CONCLUSIONS] GPi-DBS and STN-DBS are both effective for the management of Meige syndrome, with no significant difference in overall efficacy. However, further research is required to confirm these findings.