Spinal Stimulation for Movement Disorders

Abstract

Epidural spinal cord stimulation (SCS) is currently proposed to treat intractable neuropathic pain. Since the 1970s, isolated cases and small cohorts of patients suffering from dystonia, tremor, painful leg and moving toes (PLMT), or Parkinson's disease were also treated with SCS in the context of exploratory clinical studies. Despite the safety profile of SCS observed in these various types of movement disorders, the degree of improvement of abnormal movements following SCS has been heterogeneous among patients and across centers in open-label trials, stressing the need for larger, randomized, double-blind studies. This article provides a comprehensive review of both experimental and clinical studies of SCS application in movement disorders.

Electrical stimulation of the dorsal columns of the spinal cord for Parkinson's disease

“…Interestingly, over the years and in parallel with the growing use of this approach for chronic pain, several reports of the potential therapeutic effects of DCS in improving motor symptoms in patients suffering from various motor disorders, such as dystonia, multiple sclerosis, nonparkinsonian tremor, and painful leg and moving toes syndrome, have appeared in the literature …”

“…Moreover, most patients also exhibited a broad range of pain symptoms in addition to PD symptoms. Although most patients had relief from symptoms of pain, Thiriez and colleagues argue that the effect of DCS on PD motor symptoms in these multiple studies might depend on the patients' initial quality of response to l ‐dopa therapy. Thus, although the initial human results seem promising (summarized in Table ), large, randomized, double‐blind, clinical studies need to be performed to truly assess the potential therapeutic effects of DCS in PD and other motor disorders.…”

Spinal-generated movement disorders: a clinical review

“…SGMDs are central in origin, although in some SGMDs (such as painful legs-moving toes syndrome (PLMT) or orthostatic tremor (OT)), both peripheral and supraspinal mechanisms are also likely involved. We chose to highlight SGMDs in this review because they are unusual, and by considering them as a group we may highlight similar approaches to evaluation and treatment [ 1 ]. Before discussing SGMDs, we will review the relevant anatomy of the spinal cord.…”

Cervical spinal cord stimulation for the treatment of essential tremor

“…A more recent review on the use of SCS in the treatment of motor disorders, including dystonia, Parkinson’s disease, non-parkinsonian tremors and painful leg and moving toes, has been published20 which noted the lack of publications on the use of SCS in essential tremor and the scarcity of data published regarding tremor in general. Clinical reports on the use of SCS in the treatment of non-parkinsonian tremors are particularly limited.…”