OBJECTIVES: We report our experience and results with extradural cortical stimulation (ECS) in the surgical treatment of Parkinson's Disease (PD). Besides, we review the literature supporting the use of this technique. MATERIALS AND METHODS: Six patients with advanced PD and exclusion criteria for Deep Brain Stimulation (DBS) were included in our ECS protocol. With the aid of functional MRI and somato-sensory evoked potentials monitoring, the motor cortex projection over the scalp was drawn. Finally, under local anesthesia a stimulation lead was placed in the epidural space overlying the central sulcus. RESULTS: Patients showed mild daily life activities improvement with a slightly lower levodopa equivalent dose, but UPDRS part III scores showed no significant modification. CONCLUSIONS: Despite ECS is a minimally invasive surgical technique, our results only support its use in selected patients with advanced PD, in whom this therapy may be modestly effective. More experimental studies regarding the neuromodulation of the basal ganglia-cortex loops are required to optimize its clinical application.
OBJECTIVES: We report our experience and results with extradural cortical stimulation (ECS) in the surgical treatment of Parkinson's Disease (PD). Besides, we review the literature supporting the use of this technique. MATERIALS AND METHODS: Six patients with advanced PD and exclusion criteria for Deep Brain Stimulation (DBS) were included in our ECS protocol. With the aid of functional MRI and somato-sensory evoked potentials monitoring, the motor cortex projection over the scalp was drawn. Finally, under local anesthesia a stimulation lead was placed in the epidural space overlying the central sulcus. RESULTS:Patients showed mild daily life activities improvement with a slightly lower levodopa equivalent dose, but UPDRS part III scores showed no significant modification. CONCLUSIONS: Despite ECS is a minimally invasive surgical technique, our results only support its use in selected patients with advanced PD, in whom this therapy may be modestly effective. More experimental studies regarding the neuromodulation of the basal ganglia-cortex loops are required to optimize its clinical application.
Authors: S Senova; C Poupon; J Dauguet; H J Stewart; G P Dugué; C Jan; K Hosomi; G S Ralph; L Barnes; X Drouot; C Pouzat; J F Mangin; F Pain; I Doignon; R Aron-Badin; E Brouillet; E S Boyden; K A Mitrophanous; P Hantraye; S Palfi Journal: Sci Rep Date: 2018-02-20 Impact factor: 4.379
Authors: Carla Piano; Francesco Bove; Delia Mulas; Enrico Di Stasio; Alfonso Fasano; Anna Rita Bentivoglio; Antonio Daniele; Beatrice Cioni; Paolo Calabresi; Tommaso Tufo Journal: Brain Sci Date: 2021-03-26
Authors: Marisa De Rose; Giusy Guzzi; Domenico Bosco; Mary Romano; Serena Marianna Lavano; Massimiliano Plastino; Giorgio Volpentesta; Rosa Marotta; Angelo Lavano Journal: Neurol Res Int Date: 2012-11-08