High Cervical Spinal Cord Stimulation: A One Year Follow-Up Study on Motor and Non-Motor Functions in Parkinson’s Disease

Autor: Marco Paoloni, Paolo Mazzone, Margherita Giamundo, Annamaria Capozzo, Massimo Marano, Francesco Masedu, Fabio Viselli, Eugenio Scarnati, Stefano Ferraina
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Brain Sciences, Vol 9, Iss 4, p 78 (2019)
Brain Sciences
Volume 9
Issue 4
ISSN: 2076-3425
Popis: Background: The present study investigated the effectiveness of stimulation applied at cervical levels on pain and Parkinson&rsquo
s disease (PD) symptoms using either tonic or burst stimulation mode. Methods: Tonic high cervical spinal cord stimulation (T-HCSCS) was applied on six PD patients suffering from low back pain and failed back surgery syndrome, while burst HCSCS (B-HCSCS) was applied in twelve PD patients to treat primarily motor deficits. Stimulation was applied percutaneously with quadripolar or octapolar electrodes. Clinical evaluation was assessed by the Unified Parkinson&rsquo
s Disease Rating Scale (UPDRS) and the Hoehn and Yahr (H&
Y) scale. Pain was evaluated by a visual analog scale. Evaluations of gait and of performance in a cognitive motor task were performed in some patients subjected to B-HCSCS. One patient who also suffered from severe autonomic cardiovascular dysfunction was investigated to evaluate the effectiveness of B-HCSCS on autonomic functions. Results: B-HCSCS was more effective and had more consistent effects than T-HCSCS in reducing pain. In addition, B-HCSCS improved UPDRS scores, including motor sub-items and tremor and H&
Y score. Motor benefits appeared quickly after the beginning of B-HCSCS, in contrast to long latency improvements induced by T-HCSCS. A slight decrease of effectiveness was observed 12 months after implantation. B-HCSCS also improved gait and ability of patients to correctly perform a cognitive&ndash
motor task requiring inhibition of a prepared movement. Finally, B-HCSCS ameliorated autonomic control in the investigated patient. Conclusions: The results support a better usefulness of B-HCSCS compared to T-HCSCS in controlling pain and specific aspects of PD motor and non-motor deficits for at least one year.
Databáze: OpenAIRE
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