Spinal Cord Stimulation Alleviates Motor Symptoms in Parkinson's Disease Patients

Spinal cord stimulation (SCS) decreases pain and reduces motor symptoms of Parkinson's disease, both as a singular therapy and as a "salvage therapy" after deep brain stimulation (DBS) therapies are found ineffective, according to a team of researchers in the United States and Japan.

The study findings were published in Bioelectronic Medicine.

‘Spinal cord stimulation may be therapeutically beneficial for patients with Parkinson's disease in terms of treatment for pain and motor symptoms, according to the study findings.’

Krishnan Chakravarthy, MD, PhD, assistant professor of anesthesiology at University of California San Diego School of Medicine, and colleagues recruited 15 patients with Parkinson's disease.

Parkinson's disease is a neurodegenerative disorder that is commonly characterized by physical symptoms, such as tremors, progressive difficulty in walking, talking, and non-motor symptoms, such as pain, mental or behavioral changes.

The mean age of the patients was 74, with an average of 17 years of disease duration. All of the patients were experiencing pain not reduced by previous treatments. Eight of them had undergone earlier DBS. Seven patients had received only drug treatments previously.

Deep brain stimulation (DBS) is a non-invasive, pain therapy in which electrical currents are used to stimulate specific parts of the brain.

Researchers implanted percutaneous electrodes (through the skin) near the patients' spines and then chose one of three types of electrical stimulation: continuous, on-off bursts or continuous bursts of varying intensity.

After following a continuous programmed treatment after implantation, the researchers stated that all the patients reported significant improvement, based on the Visual Analogue Scale (a measurement of pain intensity with a mean reduction of 59 percent across all patients and stimulation modes).

Overall, seventy-three percent of patients reported enhancement in the 10-meter walk, a test that measures walking speed to evaluate functional mobility and gait, with an average improvement of 12 percent. 64 percent of patients experienced enhancements in the Timed Up and Go (TUG) test.

Time Up to Go (TUG) is a test that measures the duration of a person's rise from a chair, three meters walk, turning around, walking back to the chair and sitting down. TUG evaluates the physical balance and stability, both standing and in motion. Average TUG improvement was 21 percent.

It is noted that further studies are necessary to determine whether improved motor function is due to neurological changes caused by SCS or simply reduced pain.

"We are seeing growing data on novel uses of spinal cord stimulation and specific waveforms on applications outside of chronic pain management, specifically Parkinson's disease. The potential ease of access and implantation of stimulators in the spinal cord compared to the brain suggests that this is a very exciting area for future exploration," said Chakravarthy, pain management specialist at UC San Diego Health.



Source: Medindia