Effect of spinal cord stimulation on gait dysfunction in patients with Parkinson's Disease

Abstract

Gait problems as Freezing of Gait (FOG) and imbalance are common in Parkinson's Disease and are normally related to falls and poor quality of life. When the gait dysfunctions are not responsive to dopaminergic therapy, the management of these symptoms can be a challenge in clinical practice. Spinal Cord Stimulation (SCS) has been proposed as a potential therapy in a subset of patients with PD and gait problems, but the current results are still controversial, since the studies have involved few participants and are open-labeled designed. Objectives: To study the effect of SCS on gait and balance in patients with Parkinson's Disease. Methods: The present study is prospective, randomized, double-blind, cross-over design that will evaluate the efficacy of dorsal spinal cord stimulation in sixteen patients with Parkinson's Disease who exhibit gait changes not responsive to dopaminergic therapy. The primary endpoint will be the comparison of FOG between the ON versus Off-Stimulation conditions, quantified through a gait platform. Secondary outcomes will compare other quantitative variables of gait and balance, motor scales of PD, non-motor symptoms and quality of life. Statistical analysis will be performed using Analysis of Variance (ANOVA).Expected results: SCS should reduce gait changes and imbalance and improve quality of life in patients with Parkinson's Disease. (AU)