Spinal Cord Stimulation for Freezing of Gait: From Bench to Bedside

Fonoff, Erich Talamoni; Lima‐Pardini, Andrea Cristina de; Coelho, Daniel Boari; Mônaco, Bernardo Assumpção de; Machado, Birajara Soares; Souza, Carolina Pinto; Ghilardi, Maria Gabrielala Dos Santos; Hamani, Clement

doi:10.3389/fneur.2019.00905

Cited by 35 publications

(27 citation statements)

References 97 publications

(150 reference statements)

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“…During freezing episodes, the intention to walk is uncoupled from the triggering of APA, and then consequent failure of the forward movement happened. SCS improved APA [116] and APA is found to be modulated by SMA [112], thus it has been supposed that SCS improved FOG probably by modulating SMA to improve APA and facilitate gait initiation [117].…”

Section: Spinal Cord Stimulation (Scs)mentioning

confidence: 98%

Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments

Gao

Tan

et al. 2020

Transl Neurodegener

120

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Background: Freezing of gait (FOG) is a common, disabling symptom of Parkinson's disease (PD), but the mechanisms and treatments of FOG remain great challenges for clinicians and researchers. The main focus of this review is to summarize the possible mechanisms underlying FOG, the risk factors for screening and predicting the onset of FOG, and the clinical trials involving various therapeutic strategies. In addition, the limitations and recommendations for future research design are also discussed. Main body: In the mechanism section, we briefly introduced the physiological process of gait control and hypotheses about the mechanism of FOG. In the risk factor section, gait disorders, PIGD phenotype, lower striatal DAT uptake were found to be independent risk factors of FOG with consistent evidence. In the treatment section, we summarized the clinical trials of pharmacological and non-pharmacological treatments. Despite the limited effectiveness of current medications for FOG, especially levodopa resistant FOG, there were some drugs that showed promise such as istradefylline and rasagiline. Non-pharmacological treatments encompass invasive brain and spinal cord stimulation, noninvasive repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) and vagus nerve stimulation (VNS), and physiotherapeutic approaches including cues and other training strategies. Several novel therapeutic strategies seem to be effective, such as rTMS over supplementary motor area (SMA), dual-site DBS, spinal cord stimulation (SCS) and VNS. Of physiotherapy, wearable cueing devices seem to be generally effective and promising.Conclusion: FOG model hypotheses are helpful for better understanding and characterizing FOG and they provide clues for further research exploration. Several risk factors of FOG have been identified, but need combinatorial optimization for predicting FOG more precisely. Although firm conclusions cannot be drawn on therapeutic efficacy, the literature suggested that some therapeutic strategies showed promise.

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Section: Spinal Cord Stimulation (Scs)mentioning

confidence: 98%

Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments

Gao

Tan

et al. 2020

Transl Neurodegener

120

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“…Severity of rigidity and axial features (UPDRS-III) was reduced while two participants reduced their daily levodopa intake, suggestive of SCS effect on axial systems. The most optimal SCS parameters include long pulse widths and lower frequencies [4].…”

mentioning

confidence: 99%

Long-term update of the effect of spinal cord stimulation in advanced Parkinson’s disease patients

Samotus¹,

Parrent²,

Jog³

2020

Brain Stimulation

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“…In addition, the optimal level for spinal stimulation, specific structures (segmental short circuits or ascending tracts) for effects of SCS, the most effective electrode geometry and specific parameters of stimulation remain undefined ( 133 ). Besides its potential therapeutic use, the development of SCS for the treatment of PD symptoms may also contribute to a better understanding of locomotor behaviors and complex pathophysiology of neurological disturbances, specifically FOG ( 134 ).…”

Section: Latest Approaches In Deep Brain Stimulation For Movement Dismentioning

confidence: 99%

Deep Brain Stimulation Initiative: Toward Innovative Technology, New Disease Indications, and Approaches to Current and Future Clinical Challenges in Neuromodulation Therapy

Sui

Tian

et al. 2021

Front. Neurol.

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Deep brain stimulation (DBS) is one of the most important clinical therapies for neurological disorders. DBS also has great potential to become a great tool for clinical neuroscience research. Recently, the National Engineering Laboratory for Neuromodulation at Tsinghua University held an international Deep Brain Stimulation Initiative workshop to discuss the cutting-edge technological achievements and clinical applications of DBS. We specifically addressed new clinical approaches and challenges in DBS for movement disorders (Parkinson's disease and dystonia), clinical application toward neurorehabilitation for stroke, and the progress and challenges toward DBS for neuropsychiatric disorders. This review highlighted key developments in (1) neuroimaging, with advancements in 3-Tesla magnetic resonance imaging DBS compatibility for exploration of brain network mechanisms; (2) novel DBS recording capabilities for uncovering disease pathophysiology; and (3) overcoming global healthcare burdens with online-based DBS programming technology for connecting patient communities. The successful event marks a milestone for global collaborative opportunities in clinical development of neuromodulation to treat major neurological disorders.

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Spinal Cord Stimulation for Freezing of Gait: From Bench to Bedside

Cited by 35 publications

References 97 publications

Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments

Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments

Long-term update of the effect of spinal cord stimulation in advanced Parkinson’s disease patients

Deep Brain Stimulation Initiative: Toward Innovative Technology, New Disease Indications, and Approaches to Current and Future Clinical Challenges in Neuromodulation Therapy

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