Spinal cord stimulation in Parkinson's disease: a review of the preclinical and clinical data and future prospects

Yi Cai, Rajiv D Reddy, Vishal Varshney, Krishnan V Chakravarthy, Yi Cai, Rajiv D Reddy, Vishal Varshney, Krishnan V Chakravarthy

Abstract

Parkinson's disease (PD) is a progressive neurodegenerative disease with an incidence of 0.1 to 0.2% over the age of 40 and a prevalence of over 1 million people in North America. The most common symptoms include tremor, bradykinesia, rigidity, pain, and postural instability, with significant impact in quality of life and mortality. To date there is ongoing research to determine the optimum therapy for PD. In this review we analyze the current data in the use of spinal cord stimulation (SCS) therapy for treatment for Parkinsonian symptoms. We specifically address waveform pattern, anatomic location and the role of spinal cord stimulation (SCS) as a salvage therapy after deep brain stimulation (DBS) therapy. We also outline current experimental evidence from preclinical research highlighting possible mechanisms of beneficial effects of SCS in this context. Though the use of SCS therapy is in its infancy for treatment of PD, the data points to an exciting area for ongoing research and exploration with positive outcomes from both cervical and thoracic tonic and BURSTDR spinal cord stimulation.

Keywords: Gait; Neuromodulation; Parkinson’s disease; Salvage therapy; Spinal cord stimulation.

Conflict of interest statement

Competing interestsDr. Chakravarthy is a consultant to Abbott, Bioness, Medtronic, Nalu Medical, Saluda Medical. He has stock options in Nalu Medical. He is founder of Newrom Biomedical. There are no other reported conflicts of interest for this body of work from the other authors.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
Potential Treatment Paradigm for Parkinson’s Disease using SCS and DBS

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