<p>Spinal cord stimulation is a minimally invasive surgical technique which has been in successful use for a long time in the treatment of chronic pain syndromes. Over the past 15 years, many reports on the use of spinal stimulation in patients with advanced stages of Parkinson’s disease (PD) and isolated descriptions in patients with atypical parkinsonism have appeared. These observations often indicate that spinal stimulation has positive influences on gait disorders. One of the characteristic symptoms of the advanced stage of PD and some of the phenotypes of progressive supranuclear palsy is the phenomenon of freezing of gait; like postural instability, this is probably associated with impaired multimodal integration at different levels of control of locomotor function. Because of its poor response to dopaminergic therapy, freezing is one of the most disabling disorders in parkinsonism. This review presents current experience in the use of chronic epidural spinal cord stimulation in patients with PD and atypical parkinsonism for the correction of locomotor disorders, especially gait freezing.</p>

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Chronic Epidural Spinal Cord Stimulation for Correction of Gait Impairments in Patients with Parkinson’s Disease and Atypical Parkinsonism

  • V. V. Kovalev,
  • E. V. Bril,
  • M. S. Semenov,
  • L. T. Lepsveridze,
  • Yu.A. Seliverstov,
  • N. A. Suponeva

摘要

Spinal cord stimulation is a minimally invasive surgical technique which has been in successful use for a long time in the treatment of chronic pain syndromes. Over the past 15 years, many reports on the use of spinal stimulation in patients with advanced stages of Parkinson’s disease (PD) and isolated descriptions in patients with atypical parkinsonism have appeared. These observations often indicate that spinal stimulation has positive influences on gait disorders. One of the characteristic symptoms of the advanced stage of PD and some of the phenotypes of progressive supranuclear palsy is the phenomenon of freezing of gait; like postural instability, this is probably associated with impaired multimodal integration at different levels of control of locomotor function. Because of its poor response to dopaminergic therapy, freezing is one of the most disabling disorders in parkinsonism. This review presents current experience in the use of chronic epidural spinal cord stimulation in patients with PD and atypical parkinsonism for the correction of locomotor disorders, especially gait freezing.