Literature DB >> 27862267

Spinal cord stimulation improves gait in patients with Parkinson's disease previously treated with deep brain stimulation.

Carolina Pinto de Souza1, Clement Hamani1, Carolina Oliveira Souza1,2, William Omar Lopez Contreras1, Maria Gabriela Dos Santos Ghilardi1, Rubens Gisbert Cury2, Egberto Reis Barbosa2, Manoel Jacobsen Teixeira1, Erich Talamoni Fonoff1.   

Abstract

BACKGROUND: Deep brain stimulation and levodopatherapy ameliorate motor manifestations in Parkinson's disease, but their effects on axial signs are not sustained in the long term.
OBJECTIVES: The objective of this study was to investigate the safety and efficacy of spinal cord stimulation on gait disturbance in advanced Parkinson's disease.
METHODS: A total of 4 Parkinson's disease patients who experienced significant postural instability and gait disturbance years after chronic subthalamic stimulation were treated with spinal cord stimulation at 300 Hz. Timed-Up-GO and 20-meter-walk tests, UPDRS III, freezing of gait questionnaire, and quality-of-life scores were measured at 6 months and compared to baseline values. Blinded assessments to measure performance in the Timed-Up-GO and 20-meter-walk tests were carried out during sham stimulation at 300 Hz and 60 Hz.
RESULTS: Patients treated with spinal cord stimulation had approximately 50% to 65% improvement in gait measurements and 35% to 45% in UPDRS III and quality-of-life scores. During blinded evaluations, significant improvements in the Timed-Up-GO and 20-meter-walk tests were only recorded at 300 Hz.
CONCLUSION: Spinal cord stimulation at 300 Hz was well tolerated and led to a significant improvement in gait.
© 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Entities:  

Keywords:  freezing of gait; locomotion; parkinson; postural instability and gait disturbances; spinal cord

Mesh:

Year:  2016        PMID: 27862267     DOI: 10.1002/mds.26850

Source DB:  PubMed          Journal:  Mov Disord        ISSN: 0885-3185            Impact factor:   10.338


  18 in total

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