High frequency extradural motor cortex stimulation transiently improves axial symptoms in a patient with Parkinson's disease

Movement Disorders : Official Journal of the Movement Disorder Society
Alfonso FasanoAnna Rita Bentivoglio

Abstract

In a primate model of Parkinson's disease (PD), the benefit of extradural motor cortex stimulation (EMCS) was associated with high-frequency stimulation (130 Hz), whereas no significant motor improvement was achieved at 10 Hz or intermediate frequencies of stimulation. We report the case of a 72-year-old female patient affected by severe PD who underwent bilateral EMCS. In baseline med-off condition the patient was unable to arise from a chair and to stand without assistance. Stimulation at 3 and 60 Hz failed to provide any improvement of symptoms, whereas, when stimulating at 130 Hz, axial akinesia and walking improved consistently: the patient, in med-off condition, was able to arise from chair and to walk without assistance. The patient underwent two brain 99mTc- Ethylcysteinate Dimer-SPECT studies: semiquantitative and Statistical Parametric Mapping revealed that the regional cerebral perfusion was significantly increased in the supplementary motor area during stimulation at 130 Hz. After five months, the benefit of EMCS gradually disappeared.

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Citations

Jun 8, 2012·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Alfonso FasanoAlfredo Berardelli
Dec 4, 2010·Brain : a Journal of Neurology·Anke H SnijdersIvan Toni
Jun 8, 2011·Brain : a Journal of Neurology·Elena MoroAndres M Lozano
Oct 12, 2013·Neuroscience and Biobehavioral Reviews·David Lindenbach, Christopher Bishop
Jan 15, 2015·Nature Reviews. Neurology·Alfonso FasanoBastiaan R Bloem
Dec 3, 2009·Expert Review of Neurotherapeutics·Jean-Pascal Lefaucheur
Dec 23, 2016·Annals of Neurology·Alfonso FasanoMichael D Fox
Dec 14, 2019·Brain : a Journal of Neurology·Matteo BolognaAlfredo Berardelli
Aug 2, 2012·Neurologia Medico-chirurgica·Youichi Saitoh
Mar 12, 2015·Journal of Parkinson's Disease·Alfonso FasanoNicolaas I Bohnen

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