Spinal cord stimulation for Parkinson’s disease

Abstract

The fast ageing of population has an inevitable impact on the prevalence of neurodegenerative diseases, including Parkinson’s disease (PD), which have been associated with alterations in the central and peripheral mechanisms resulting in specific patterns of gait and balance disturbance. These motor changes in PD often restrict functional independence and are a major cause of morbidity and mortality among these patients. The onset of falls and gait impairment is an important marker of reduced survival, irrespective of the nature of the underlying form of parkinsonism. The best treatment available for treating PD is still the dopamine replacement therapy, but it is not exempt of adverse effects almost as impairing as the disease after a period of effectiveness. Other therapy developed, the Deep Brain Stimulation (DBS), is very effective but highly invasive, and is restricted to a very low percentage of patients due to important comorbidity in elder population. Considering this disease as an excessive synchronic impairment allows using some principles proved useful treating other neurological conditions such as epilepsy. Afferent stimulation of the central nervous system has been shown in PD rodent models to be effective to produce a dramatic recovery from akinesia and restore gait. This stimulation can be achieved through epidural stimulation, a much less invasive manner. This is a novel use for a neuromodulation technique widely used for chronic pain treatment.