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High frequency extradural motor cortex stimulation transiently improves axial symptoms in a patient with Parkinson's disease
Author(s) -
Fasano Alfonso,
Piano Carla,
De Simone Celestino,
Cioni Beatrice,
Di Giuda Daniela,
Zinno Massimiliano,
Daniele Antonio,
Meglio Mario,
Giordano Alessandro,
Bentivoglio Anna Rita
Publication year - 2008
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21977
Subject(s) - stimulation , parkinson's disease , deep brain stimulation , motor symptoms , motor cortex , medicine , statistical parametric mapping , central nervous system disease , cortex (anatomy) , physical medicine and rehabilitation , psychology , neuroscience , surgery , disease , magnetic resonance imaging , radiology
In a primate model of Parkinson's disease (PD), the benefit of extradural motor cortex stimulation (EMCS) was associated with high‐frequency stimulation (130 Hz), whereas no significant motor improvement was achieved at 10 Hz or intermediate frequencies of stimulation. We report the case of a 72‐year‐old female patient affected by severe PD who underwent bilateral EMCS. In baseline med‐off condition the patient was unable to arise from a chair and to stand without assistance. Stimulation at 3 and 60 Hz failed to provide any improvement of symptoms, whereas, when stimulating at 130 Hz, axial akinesia and walking improved consistently: the patient, in med‐off condition, was able to arise from chair and to walk without assistance. The patient underwent two brain 99mTc‐ Ethylcysteinate Dimer‐SPECT studies: semiquantitative and Statistical Parametric Mapping revealed that the regional cerebral perfusion was significantly increased in the supplementary motor area during stimulation at 130 Hz. After five months, the benefit of EMCS gradually disappeared. © 2008 Movement Disorder Society