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Restoration of locomotive function in Parkinson's disease by spinal cord stimulation: mechanistic approach

Fuentes, Romulo; Petersson, Per LU and Nicolelis, Miguel A. L. (2010) In European Journal of Neuroscience 32(7). p.1100-1108
Abstract
Specific motor symptoms of Parkinson's disease (PD) can be treated effectively with direct electrical stimulation of deep nuclei in the brain. However, this is an invasive procedure, and the fraction of eligible patients is rather low according to currently used criteria. Spinal cord stimulation (SCS), a minimally invasive method, has more recently been proposed as a therapeutic approach to alleviate PD akinesia, in light of its proven ability to rescue locomotion in rodent models of PD. The mechanisms accounting for this effect are unknown but, from accumulated experience with the use of SCS in the management of chronic pain, it is known that the pathways most probably activated by SCS are the superficial fibers of the dorsal columns. We... (More)
Specific motor symptoms of Parkinson's disease (PD) can be treated effectively with direct electrical stimulation of deep nuclei in the brain. However, this is an invasive procedure, and the fraction of eligible patients is rather low according to currently used criteria. Spinal cord stimulation (SCS), a minimally invasive method, has more recently been proposed as a therapeutic approach to alleviate PD akinesia, in light of its proven ability to rescue locomotion in rodent models of PD. The mechanisms accounting for this effect are unknown but, from accumulated experience with the use of SCS in the management of chronic pain, it is known that the pathways most probably activated by SCS are the superficial fibers of the dorsal columns. We suggest that the prokinetic effect of SCS results from direct activation of ascending pathways reaching thalamic nuclei and the cerebral cortex. The afferent stimulation may, in addition, activate brainstem nuclei, contributing to the initiation of locomotion. On the basis of the striking change in the corticostriatal oscillatory mode of neuronal activity induced by SCS, we propose that, through activation of lemniscal and brainstem pathways, the locomotive increase is achieved by disruption of antikinetic low-frequency (< 30 Hz) oscillatory synchronization in the corticobasal ganglia circuits. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
electrical stimulation, Parkinson's disease, dorsal column, spinal cord
in
European Journal of Neuroscience
volume
32
issue
7
pages
1100 - 1108
publisher
Wiley-Blackwell
external identifiers
  • wos:000282572700005
  • scopus:78649366430
ISSN
1460-9568
DOI
10.1111/j.1460-9568.2010.07417.x
language
English
LU publication?
yes
id
f9f6f302-c350-4361-aeb9-ee7711ac6405 (old id 1727259)
date added to LUP
2010-12-01 12:04:30
date last changed
2018-06-10 03:06:39
@article{f9f6f302-c350-4361-aeb9-ee7711ac6405,
  abstract     = {Specific motor symptoms of Parkinson's disease (PD) can be treated effectively with direct electrical stimulation of deep nuclei in the brain. However, this is an invasive procedure, and the fraction of eligible patients is rather low according to currently used criteria. Spinal cord stimulation (SCS), a minimally invasive method, has more recently been proposed as a therapeutic approach to alleviate PD akinesia, in light of its proven ability to rescue locomotion in rodent models of PD. The mechanisms accounting for this effect are unknown but, from accumulated experience with the use of SCS in the management of chronic pain, it is known that the pathways most probably activated by SCS are the superficial fibers of the dorsal columns. We suggest that the prokinetic effect of SCS results from direct activation of ascending pathways reaching thalamic nuclei and the cerebral cortex. The afferent stimulation may, in addition, activate brainstem nuclei, contributing to the initiation of locomotion. On the basis of the striking change in the corticostriatal oscillatory mode of neuronal activity induced by SCS, we propose that, through activation of lemniscal and brainstem pathways, the locomotive increase is achieved by disruption of antikinetic low-frequency (&lt; 30 Hz) oscillatory synchronization in the corticobasal ganglia circuits.},
  author       = {Fuentes, Romulo and Petersson, Per and Nicolelis, Miguel A. L.},
  issn         = {1460-9568},
  keyword      = {electrical stimulation,Parkinson's disease,dorsal column,spinal cord},
  language     = {eng},
  number       = {7},
  pages        = {1100--1108},
  publisher    = {Wiley-Blackwell},
  series       = {European Journal of Neuroscience},
  title        = {Restoration of locomotive function in Parkinson's disease by spinal cord stimulation: mechanistic approach},
  url          = {http://dx.doi.org/10.1111/j.1460-9568.2010.07417.x},
  volume       = {32},
  year         = {2010},
}