Mechanism of Action in Burst Spinal Cord Stimulation: Review and Recent Advances

Chakravarthy, Krishnan; Fishman, Michael; Zuidema, Xander; Hunter, Corey; Levy, Robert M.

doi:10.1093/pm/pnz073

“…The decrease in dopaminergic neural ring in the nigrostriatal pathway may disrupt the neural oscillations in the basal ganglia. Speci cally, it may lead to increased ring of striatal neurons in the indirect pathway, with the recruited neurons ring with an excess of beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) oscillations in the motor system (8). The two mainstay therapies of PD, dopamine and deep brain stimulation (DBS), have both been shown to alter the pathological changes in electrical oscillations (9,10).…”

Section: Introductionmentioning

confidence: 99%

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

Chakravarthy¹,

Chaturvedi

²

,

Agari

³

et al. 2020

Preprint

0

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Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG).Results: All patients experienced significant improvement in VAS scores with a mean reduction of 59% across all patients. Patients who chose the cycling burst stimulation parameter had an average 67% reduction in VAS scores, as compared to the continuous burst parameter group, which had an average 48% reduction in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with an average improvement of 12%. 64% of patients experienced clinically relevant improvements in the TUG, with an average improvement of 21%. Conclusions: This study points to the potential utility of SCS to address both pain and certain aspects of motor symptoms in PD patients who have and have not received DBS therapy.

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“…The decrease in dopaminergic neural ring in the nigrostriatal pathway may disrupt the neural oscillations in the basal ganglia. Speci cally, it may lead to increased ring of striatal neurons in the indirect pathway, with the recruited neurons ring with an excess of beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) oscillations in the motor system (8). The two mainstay therapies of PD, dopamine and deep brain stimulation (DBS), have both been shown to alter the pathological changes in electrical oscillations (9, 10).…”

Section: Introductionmentioning

confidence: 99%

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

Chakravarthy¹,

Chaturvedi

²

,

Agari

³

et al. 2020

Preprint

1

0

View full text Add to dashboard Cite

Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG).Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%.Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.

show abstract

“…The decrease in dopaminergic neural ring in the nigrostriatal pathway may disrupt the neural oscillations in the basal ganglia. Speci cally, it may lead to increased ring of striatal neurons in the indirect pathway, with the recruited neurons ring with an excess of beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) oscillations in the motor system (8). The two mainstay therapies of PD, dopamine and deep brain stimulation (DBS), have both been shown to alter the pathological changes in electrical oscillations (9,10).…”

Section: Introductionmentioning

confidence: 99%

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

Chakravarthy

¹

,

Chaturvedi

²

,

Agari

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS). Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG). Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%. Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.

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Mechanism of Action in Burst Spinal Cord Stimulation: Review and Recent Advances

Cited by 71 publications

References 78 publications

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

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