Surface and Deep Signal Correlation in a Pediatric Dystonia Case with DBS

Deep Brain Stimulation (DBS) is a therapeutic strategy for the treatment of dystonia, also in pediatric settings. It acts selectively on deep areas such as the internal Globus Pallidus (GPi). In this study, we report a multimodal analysis carried out on a young patient suffering from generalized dystonia who underwent bilateral DBS implantation at the level of the GPi. The objective was to identify the neurophysiological correlates of dystonia. Through the synchronized recording of deep cerebral (Local Field Potentials, LFP), electroencephalographic, (EEG), and electromyographic (EMG) signals, dystonic events were identified and analyzed in different stimulation configurations (including ring mode and directional settings using contacts either proximal to or distal from GPi) and at various levels of stimulation intensity. Spectral analysis was performed on the signals to identify frequency bands associated with dystonic events and to investigate the effects of stimulation. The findings suggest that a personalized approach to DBS may improve the therapeutic management of pediatric dystonia.