Tonic spinal cord stimulation as therapeutic option in Parkinson disease with axial symptoms: Effects on walking and quality of life

Hubsch, Cécile; d’Hardemare, Vincent; Maacha, Malek Ben; Ziégler, Marc; Patte-Karsenti, N.; Thiébaut, Jean-Baptiste; Gout, Olivier; Brandel, Jean‐Philippe

doi:10.1016/j.parkreldis.2019.02.044

Cited by 27 publications

(20 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The method was applied in most anecdotal reports serendipitously describing improvement in PD symptoms. The larger series reported to date followed this classical method, implanting percutaneous leads over the lumbar spinal cord enlargement (7, 8, 78). The best parameters for treating PD symptoms in that study included a relatively long pulse width (PW).…”

Section: Translational Helix: Concepts From the Bench To The Bedsidementioning

confidence: 99%

“…More recently Hubsch et al (8) have studied five PD patients with prominent axial symptoms who received monopolar stimulation (100 Hz/300 μs) from a single midline percutaneous epidural lead at the level of T10–T11. Patients were assessed OFF and ON levodopa at short term (60 days).…”

Section: Translational Helix: Concepts From the Bench To The Bedsidementioning

confidence: 99%

“…According to the report of de Souza et al (6), patients with advanced PD chronically treated with DBS who develop unresponsive FoG despite effective treatment to other symptoms, also benefit from SCS. Yet, PD patients who somehow cannot receive DBS may be another indication for SCS, once cardinal symptoms and gait problems respond (7, 8, 78). On the other hand, SCS does not seem to potentiate levodopa, as observed with subthalamic nucleus DBS, or to block dyskinesias, as commonly described following internal pallidum stimulation (6, 7).…”

Section: Translational Helix: Concepts From the Bench To The Bedsidementioning

confidence: 99%

“…In Parkinson's disease (PD), a common and disabling problem is freezing of gait (FoG). Although in its infancy, recent studies using SCS for the treatment of FoG have shown promising results (5–8).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Spinal Cord Stimulation for Freezing of Gait: From Bench to Bedside

et al. 2019

View full text Add to dashboard Cite

Spinal cord stimulation (SCS) has been used for the treatment of chronic pain for nearly five decades. With a high degree of efficacy and a low incidence of adverse events, it is now considered to be a suitable therapeutic alternative in most guidelines. Experimental studies suggest that SCS may also be used as a therapy for motor and gait dysfunction in parkinsonian states. The most common and disabling gait dysfunction in patients with Parkinson's disease (PD) is freezing of gait (FoG). We review the evolution of SCS for gait disorders from bench to bedside and discuss potential mechanisms of action, neural substrates, and clinical outcomes.

show abstract

Section: Translational Helix: Concepts From the Bench To The Bedsidementioning

confidence: 99%

Section: Translational Helix: Concepts From the Bench To The Bedsidementioning

confidence: 99%

Section: Translational Helix: Concepts From the Bench To The Bedsidementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Spinal Cord Stimulation for Freezing of Gait: From Bench to Bedside

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Finally, 2 studies were recently published. First, Hubsch et al 56 evaluated the influence of tonic (100 Hz/30 µs / T10-T11) SCS in 5 patients with prominent axial symptoms, primarily through the Stand-Walk-Sit Test (SWS) assessed by a blinded neurologist (this was not a double-blind study because patients could feel paresthesia). Patients were assessed 60 days poststimulation, both off and on levodopa.…”

Section: Spinal Cord Stimulation and Pdmentioning

confidence: 99%

History of and Insights Into Spinal Cord Stimulation in Parkinson Disease

Garcia¹,

Ricardo²,

Araújo

et al. 2020

Neurorehabil Neural Repair

View full text Add to dashboard Cite

Background Current available therapies for Parkinson disease (PD) have strong limitations, and patients usually present with refractory symptoms despite all efforts. Deep brain stimulation (DBS), which has been used in PD patients for decades (since 1987), has best indications for symptoms like tremor, motor fluctuations, or dyskinesia. However, postural instability and gait disturbances (PIGD) have restricted benefits with DBS. In 2009, spinal cord stimulation (SCS), a well-established therapy for chronic pain, has emerged as a potential alternative therapy that may help control unresponsive symptoms such as bradykinesia, PIGD, and freezing of gait. Methods The main studies regarding SCS in PD are reviewed here from the first studies in animal models to the latest clinical trials. Conclusions Despite promising findings, the heterogeneity of methodologies used and small samples in human studies pose a challenging problem to be addressed in order to have robust clinical evidence to support SCS as a viable PD treatment

show abstract

A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies

Hvingelby,

Carra,

Terkelsen

et al. 2024

Movement Disord Clin Pract

View full text Add to dashboard Cite

BackgroundParkinson's Disease (PD) is a progressive neurological disorder that results in potentially debilitating mobility deficits. Recently, spinal cord stimulation (SCS) has been proposed as a novel therapy for PD gait disorders. The highest levels of evidence remain limited for SCS.ObjectivesIn this systematic review and narrative synthesis, the literature was searched using combinations of key phrases indicating spinal cord stimulation and PD.MethodsWe included pre‐clinical studies and all published clinical trials, case reports, conference abstracts as well as protocols for ongoing clinical trials. Additionally, we included trials of SCS applied to atypical parkinsonism.ResultsA total of 45 human studies and trials met the inclusion criteria. Based on the narrative synthesis, a number of knowledge gaps and future avenues of potential research were identified. This review demonstrated that evidence for SCS is currently not sufficient to recommend it as an evidence‐based therapy for PD related gait disorders. There remain challenges and significant barriers to widespread implementation, including issues regarding patient selection, effective outcome selection, stimulation location and mode, and in programming parameter optimization. Results of early randomized controlled trials are currently pending. SCS is prone to placebo, lessebo and nocebo as well as blinding effects which may impact interpretation of outcomes, particularly when studies are underpowered.ConclusionTherapies such as SCS may build on current evidence and be shown to improve specific gait features in PD. Early negative trials should be interpreted with caution, as more evidence will be required to develop effective methodologies in order to drive clinical outcomes.

show abstract

Tonic spinal cord stimulation as therapeutic option in Parkinson disease with axial symptoms: Effects on walking and quality of life

Cited by 27 publications

References 5 publications

Spinal Cord Stimulation for Freezing of Gait: From Bench to Bedside

Spinal Cord Stimulation for Freezing of Gait: From Bench to Bedside

History of and Insights Into Spinal Cord Stimulation in Parkinson Disease

A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies

Contact Info

Product

Resources

About