Spinal Cord Stimulation – A New Therapeutic Approach for Motor Symptoms in Parkinson’s Disease

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Spinal cord stimulation (SCS) may be a new therapeutic approach for levodopa-resistant motor symptoms in Parkinson’s disease (PD), according to a study released today at the 21st International Congress of Parkinson’s Disease and Movement Disorders.

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The suggestion that SCS might alleviate FOG and improve walking is giving hope to many patients who are not eligible for DBS and are no longer improving with medication.

Spinal cord stimulation (SCS) may be a new therapeutic approach for levodopa-resistant motor symptoms in Parkinson’s disease (PD), according to a study released today at the 21st International Congress of Parkinson’s Disease and Movement Disorders.

Dopaminergic therapy and Deep Brain Stimulation (DBS) alleviate motor features in PD, however their effects on features such as gait dysfunction are reduced as the disease progresses. A team of researchers at the London Health Sciences Centre in London, ON, Canada, evaluated a total of five advanced PD male patients who underwent mid-thoracic SCS. All subjects were not eligible for DBS and had significant gait disturbances, freezing of gait (FOG), and postural instability. Various SCS settings were tested and gait characteristics were measured using a 20-foot Protokinetics Zeno Walkway, as well as timed sit-to-stand and automated FOG detection using foot pressures. Patients were also evaluated at each visit using the FOG questionnaire, the Unified Parkinson’s Disease Rating Scale (UPDRS) motor items, Activities-specific Balance Confidence Scale (ABC), and Parkinson’s Disease Questionnaire (PDQ-8).

Six months post-implantation, there was a mean improvement of 39.4% in the UPDRS motor score, 26.8% in the FOG questionnaire and 116.9% in the ABC score. The mean number of FOG episodes significantly declined from 16 pre-surgery to 0, while patients were “ON” levodopa and OFF stimulation. Ultimately, the study found safety and efficacy in using SCS to reduce freezing of gait and improve gait in subjects with advanced PD.

Nir Giladi, Chairman in the Department of Neurology at Tel Aviv Medical Center, states, “This is a very interesting initial observation with potential long term implications. FOG is a very disabling symptom causing frequent falls and negative impact on patients’ quality of life. The suggestion that SCS might alleviate FOG and improve walking is giving hope to many patients who are not eligible for DBS and are no longer improving with medication. Further studies are needed to demonstrate the superiority of SCS on placebo effect.”

About the International Congress of Parkinson's Disease and Movement Disorders: Meeting attendees gather to learn the latest research findings and state-of-the-art treatment options in Movement Disorders, including Parkinson's disease. Over 3,900 physicians and medical professionals from more than 89 countries will be able to view over 1,500 scientific abstracts submitted by clinicians from around the world.

About the International Parkinson and Movement Disorder Society: The International Parkinson and Movement Disorder Society (MDS), an international society of over 5,000 clinicians, scientists, and other healthcare professionals, is dedicated to improving patient care through education and research. For more information about MDS, visit http://www.movementdisorders.org.

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Elizabeth Clausen
@movedisorder
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