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Spinal cord stimulation therapy for gait dysfunction in progressive supranuclear palsy patients
Olivia Samotus1,2, Andrew Parrent1,2, Mandar Jog3,4
1Department of Clinical Neurological Sciences, London Health Sciences Centre, Lawson Health Research Institute, 339 Windermere Road, A10-026, London, ON, N6A 5A5, Canada.
Journal of Neurology
|October 4, 2020
Summary
Spinal cord stimulation (SCS) shows promise for treating progressive supranuclear palsy with Richardson's syndrome (PSP-RS), improving freezing of gait and mobility. Early intervention with SCS may benefit patients with dopaminergic-resistant gait issues.
Area of Science:
- Neurology
- Neurosurgery
- Rehabilitation Medicine
Background:
- Progressive supranuclear palsy (PSP) lacks effective symptomatic treatments.
- Spinal cord stimulation (SCS) has shown benefits for gait disorders in Parkinson's disease.
- This study investigates SCS for Richardson's syndrome PSP (PSP-RS).
Observation:
- Three female PSP-RS participants underwent epidural SCS implantation.
- Various SCS programs were tested to identify optimal settings for gait and FOG improvement.
- Spatiotemporal gait measures, FOG episodes, and clinical scales were assessed pre- and post-SCS.
Findings:
- SCS demonstrated significant improvements in FOG frequency, gait parameters like step length and velocity, and overall clinical impression in PSP-RS patients.
- One participant showed sustained FOG reduction and gait improvement over 12 months, with a modest L-dopa response.
- While one patient experienced worsening symptoms at 12 months, ambulatory gait parameters showed a universal improvement of 29.6% across all participants.
Implications:
- Spinal cord stimulation (SCS) presents a viable therapeutic option for managing gait disturbances and FOG in PSP-RS.
- Early consideration of SCS intervention may be beneficial for addressing dopaminergic-resistant gait symptoms in PSP.
- Further research is warranted to optimize SCS protocols and long-term outcomes for PSP patients.
