TY - JOUR
T1 - Spinal cord stimulation improves gait in patients with Parkinson's disease previously treated with deep brain stimulation
AU - Pinto de Souza, Carolina
AU - Hamani, Clement
AU - Oliveira Souza, Carolina
AU - Lopez Contreras, William Omar
AU - dos Santos Ghilardi, Maria Gabriela
AU - Cury, Rubens Gisbert
AU - Reis Barbosa, Egberto
AU - Jacobsen Teixeira, Manoel
AU - Talamoni Fonoff, Erich
N1 - Publisher Copyright:
© 2016 International Parkinson and Movement Disorder Society
PY - 2017/2/1
Y1 - 2017/2/1
N2 - 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.
AB - 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.
KW - freezing of gait
KW - locomotion
KW - parkinson
KW - postural instability and gait disturbances
KW - spinal cord
UR - http://www.scopus.com/inward/record.url?scp=85013070486&partnerID=8YFLogxK
U2 - 10.1002/mds.26850
DO - 10.1002/mds.26850
M3 - Artículo Científico
C2 - 27862267
AN - SCOPUS:85013070486
SN - 0885-3185
VL - 32
SP - 278
EP - 282
JO - Movement Disorders
JF - Movement Disorders
IS - 2
ER -