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IMPROVEMENT OF PARKINSONIAN SYMPTOMS WITH SPINAL CORD STIMULATION: CONSEQUENCE OR COINCIDENCE?
  1. Fardad Soltani,
  2. Abdul Lalkhen
  1. University of Manchester; Salford Royal Foundation Trust

    Abstract

    Objectives This report presents a case where spinal cord stimulation resulted in an improvement in motor symptoms in a patient with Parkinson's disease.

    Materials and Methods Spinal cord stimulation is effective in the management of neuropathic pain. It has also been shown to be effective in alleviating the symptoms of other neurological motor conditions. A 68 year old woman presented to the pain clinic with post–laminectomy syndrome. She had a background of Parkinson's disease, hypertension and asthma. An octad electrode was placed in the T9–T11 position and connected an implantable pulse generator positioned in the right lower quadrant of the abdomen.

    Results Once appropriate adjustments to the stimulator settings were made (amplitude=1.5 V, frequency=60 Hz, pulse width=300 microseconds), the patient noticed a marked improvement in symptoms of leg pain. The patient and her husband noticed a significant improvement in her Parkinsonian symptoms when the stimulator was switched on–specifically a reduction in her left sided resting tremor. Possible underlying mechanisms include direct arousal of brain systems, interception of pathological synchronous β–band oscillations in the cortico–striatal pathways, and increased cortical and thalamic output to the striatum due to large cortical stimulation.

    Conclusions This report presents a case where spinal cord stimulation for neuropathic pain resulted in an improvement in the patient's Parkinsonian symptoms. We suggest that future studies should examine variables associated with the stimulator device, such as site of implantation, electrode geometry and device settings which may explain the mechanism of the effect of SCS in Parkinson's disease.

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