Spinal Cord Stimulation in Other Indications

Slavin, Konstantin V.; Eljamel, Sam

doi:10.1002/9781118346396.ch21

Cited by 1 publication

(2 citation statements)

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“…In keeping with what seen in our cases, other features can accompany the syndrome some years after the onset . SCS is a minimally invasive approach with an expanding number of off‐label indications: spasticity after stroke or spinal cord injury, peripheral vascular disease, neurogenic bladder, autonomic hyperreflexia, and gait disturbance in PD patients . Recently, a similar implant used in our patient was successfully used in the primate model of spinal cord injury .…”

Section: Casesupporting

confidence: 85%

“…Spinal cord stimulation (SCS) is a minimally invasive surgery approved for refractory pain syndromes. In recent years, studies in patients with pain or spinal cord lesions as well as in animal model of motor disorders have suggested that SCS might have positive effects on locomotion. Notwithstanding, the clinical experience in patients with Parkinson's disease (PD) has provided variable results, although a recent trial has found beneficial effects in a selected group or patients who also underwent deep brain stimulation (DBS) .…”

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confidence: 99%

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Spinal cord stimulation in primary progressive freezing of gait

et al. 2017

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between the treatment groups (P 5 .19); however, decreased appetite was reported more frequently in the topiramatetreated group. Because the UDysRS change slightly favored topiramate, we calculated the effect of not meeting our recruitment goal on statistical power to detect the desired change in the total UDysRS score using a frequentist conditional power model. 6 Given the present results and assuming that additional enrollment to our goal of 50 participants would continue in the current trend, our conditional power was estimated at 5.2%. A final sample of more than 350 participants would have been required to reach the goal of 80% power (see Supplemental Materials). We found a small topiramate-associated improvement in dyskinesia in comparison to placebo, but the impact was far less than predicted. We failed to find a significant change in our primary outcome and, given the failure to retain the blind by patients or raters, we are not pursuing this treatment further at the present time. Our conditional power analysis results suggest that our truncated sample size was not a major determinant in our negative findings. Our findings, along with those of Kobylecki and colleagues, 5 suggest that neither shorter term (3 weeks) nor longer term (8 weeks) topiramate treatment in PD patients either on or off concomitant amantadine is effective in the treatment of dyskinesia associated with levodopa treatment.

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Section: Casesupporting

confidence: 85%

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confidence: 99%