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Spinal cord stimulation improves gait in patients with Parkinson's disease previously treated with deep brain stimulation
Author(s) -
Pinto de Souza Carolina,
Hamani Clement,
Oliveira Souza Carolina,
Lopez Contreras William Omar,
dos Santos Ghilardi Maria Gabriela,
Cury Rubens Gisbert,
Reis Barbosa Egberto,
Jacobsen Teixeira Manoel,
Talamoni Fonoff Erich
Publication year - 2017
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.26850
Subject(s) - deep brain stimulation , parkinson's disease , gait disturbance , gait , physical medicine and rehabilitation , medicine , stimulation , spinal cord , quality of life (healthcare) , central nervous system disease , physical therapy , psychology , disease , surgery , nursing , psychiatry
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.