Spinal cord stimulation leads to “significant improvement” in gait in Parkinson’s disease patients previously treated with deep brain stimulation

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A recent study explores the safety and efficacy of spinal cord stimulation on gait disturbance in advanced Parkinson’s disease. The investigators found that spinal cord stimulation at 300Hz was well tolerated and led to a significant improvement in gait in patients with Parkinson’s disease.

Previous research has shown that 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. This study therefore sought to discover the effect of spinal cord stimulation on Parkinson’s disease patient who were previously treated with deep brain stimulation.

A total of four Parkinson’s disease patients were treated with spinal cord stimulation at 300Hz. These patients experienced significant postural instability and gait disturbance years after chronic subthalamic stimulation. The patients were assessed using Timed-Up-GO and 20-metre-walk tests, UPDRS III, freezing of gait questionnaire, and quality-of-life scores at six months and compared to baseline values. Blinded assessments to measure performance in the Timed-Up-GO and 20-metre-walk tests were carried out during sham stimulation at 300Hz and 60Hz.

“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 300Hz,” the study results showed.

The authors therefore conclude that spinal cord stimulation at 300Hz was well tolerated and led to a significant improvement in gait in Parkinson’s disease patients previously treated with deep brain stimulation.

The study was conducted by Carolina Pinto de Souza (Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil) and colleagues and published in the journal Movement Disorders.