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 |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Parkinson's disease Visual analogue scale Stimulation Disease gait Article Tonic (physiology) lcsh:RC321-571 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Valsava maneuver Rating scale Medicine lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry 030304 developmental biology reaction time 0303 health sciences burst stimulation business.industry General Neuroscience Cognition medicine.disease Low back pain cervical spinal cord stimulation tonic stimulation Parkinson’s disease parkinson’s disease valsava maneuver medicine.symptom business 030217 neurology & neurosurgery |
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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