Spinal cord stimulation improves gait in patients with Parkinson's disease previously treated with deep brain stimulation

Mov Disord. 2017 Feb;32(2):278-282. doi: 10.1002/mds.26850. Epub 2016 Nov 10.

Abstract

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.

Keywords: freezing of gait; locomotion; parkinson; postural instability and gait disturbances; spinal cord.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Deep Brain Stimulation
  • Female
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / therapy*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Parkinson Disease / complications
  • Parkinson Disease / therapy*
  • Single-Blind Method
  • Spinal Cord Stimulation / methods*