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Implantable Subcutaneous Peripheral Nerve Stimulation Improves Degenerative Ataxia.
Athanasia Alexoudi1, Eustathios Vlachakis1, Spyros N Deftereos2
1Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, GRC.
Cureus
|May 4, 2023
Summary
Subcutaneous cortex stimulation offers a promising new treatment for degenerative cerebellar ataxia, a condition with no current effective therapies. This neuromodulation technique showed clinical improvement and neurophysiologic changes in a patient, warranting further investigation.
Area of Science:
- Neurology
- Neurosurgery
- Biomedical Engineering
Background:
- Degenerative cerebellar ataxias lack evidence-based pharmacological or rehabilitation treatments, leaving patients with significant disability.
- Current medical management for these conditions is often insufficient to alleviate persistent symptoms.
Observation:
- A case study explored subcutaneous cortex stimulation, adapted from peripheral nerve stimulation protocols for chronic pain, in a patient with degenerative cerebellar ataxia.
- The patient, diagnosed at 18, experienced progressive ataxia and functional decline.
- An initial trial of parietal transcranial direct current stimulation yielded at least one month of clinical improvement.
Findings:
- Permanent implantation of parietal and occipital subcutaneous electrodes was performed to achieve a long-lasting effect.
- Twelve months post-implantation, the patient demonstrated symptom amelioration and altered neurophysiologic parameters.
- Subcutaneous cortex stimulation showed potential for treating degenerative cerebellar ataxia.
Implications:
- Central neuromodulation, particularly subcutaneous cortex stimulation, presents a novel therapeutic avenue for debilitating neurological disorders like cerebellar ataxia.
- Further research is crucial to elucidate the neurophysiological mechanisms and validate these promising outcomes for devastating conditions.
