Effects of spinal cord stimulation on postural control in Parkinson's disease patients with freezing of gait
- Federal University of ABC, Brazil
- University of São Paulo, Brazil
- University of Tokyo, Japan
- University of Toronto, Canada
Abstract
Freezing of gait (FoG) in Parkinson's disease (PD) is an incapacitating transient phenomenon, followed by continuous postural disorders. Spinal cord stimulation (SCS) is a promising intervention for FoG in patients with PD, however its effects on distinct domains of postural control is not well known. The aim of this study is to assess the effects of SCS on FoG and distinct domains of postural control. Four patients with FoG were implanted with SCS systems in the upper thoracic spine. Anticipatory postural adjustment (APA), reactive postural responses, gait and FoG were biomechanically assessed. In general, the results showed that SCS improved FoG and APA. However, SCS failed to improve reactive postural responses. SCS seems to influence cortical motor circuits, involving the supplementary motor area. On the other hand, reactive posture control to external perturbation that mainly relies on neuronal circuitries involving the brainstem and spinal cord, is less influenced by SCS.
Data availability
All data generated or analysed during this study are included in the manuscript and supporting files. Source data files have been provided for Figures 1 and 2.
Article and author information
Author details
Daniel Boari Coelho
Funding
Hospital das Clinicas, University of São Paulo Medical School
- Erich Talamoni Fonoff
Brazilian Council of Science and Technology
- Luis Augusto Teixeira
São Paulo Research Foundation
- Luis Augusto Teixeira
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Reviewing Editor
- Amol Yadav, Duke University
Ethics
Human subjects: The study was approved by the department review board and in the ethics committee atHospital das Clinicas of University of São Paulo and registered in the national clinicalresearch database (CAPPESQ-HCFMUSP #12690213.0.0000.0068), which requires allparticipants to be previously instructed about the procedures and to give written informedconsent prior to study inclusion. Patients included in the present study participated in theclinical trial also registered in the clinicaltrials.gov (#NCT02388204). All experiments wereperformed in accordance with the Declaration of Helsinki
Version history
- Received: April 19, 2018
- Accepted: July 28, 2018
- Accepted Manuscript published: August 2, 2018 (version 1)
- Version of Record published: August 14, 2018 (version 2)
Copyright
© 2018, de Lima-Pardini et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
Metrics
-
- 2,414
- views
-
- 422
- downloads
-
- 39
- citations
Views, downloads and citations are aggregated across all versions of this paper published by eLife.
Download links
A two-part list of links to download the article, or parts of the article, in various formats.
Downloads (link to download the article as PDF)
Open citations (links to open the citations from this article in various online reference manager services)
Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)
Effects of spinal cord stimulation on postural control in Parkinson's disease patients with freezing of gait
eLife 7:e37727.
https://doi.org/10.7554/eLife.37727
Further reading
-
- Neuroscience
The central tendency bias, or contraction bias, is a phenomenon where the judgment of the magnitude of items held in working memory appears to be biased toward the average of past observations. It is assumed to be an optimal strategy by the brain and commonly thought of as an expression of the brain’s ability to learn the statistical structure of sensory input. On the other hand, recency biases such as serial dependence are also commonly observed and are thought to reflect the content of working memory. Recent results from an auditory delayed comparison task in rats suggest that both biases may be more related than previously thought: when the posterior parietal cortex (PPC) was silenced, both short-term and contraction biases were reduced. By proposing a model of the circuit that may be involved in generating the behavior, we show that a volatile working memory content susceptible to shifting to the past sensory experience – producing short-term sensory history biases – naturally leads to contraction bias. The errors, occurring at the level of individual trials, are sampled from the full distribution of the stimuli and are not due to a gradual shift of the memory toward the sensory distribution’s mean. Our results are consistent with a broad set of behavioral findings and provide predictions of performance across different stimulus distributions and timings, delay intervals, as well as neuronal dynamics in putative working memory areas. Finally, we validate our model by performing a set of human psychophysics experiments of an auditory parametric working memory task.
-
- Neuroscience
The brain regulates food intake in response to internal energy demands and food availability. However, can internal energy storage influence the type of memory that is formed? We show that the duration of starvation determines whether Drosophila melanogaster forms appetitive short-term or longer-lasting intermediate memories. The internal glycogen storage in the muscles and adipose tissue influences how intensely sucrose-associated information is stored. Insulin-like signaling in octopaminergic reward neurons integrates internal energy storage into memory formation. Octopamine, in turn, suppresses the formation of long-term memory. Octopamine is not required for short-term memory because octopamine-deficient mutants can form appetitive short-term memory for sucrose and to other nutrients depending on the internal energy status. The reduced positive reinforcing effect of sucrose at high internal glycogen levels, combined with the increased stability of food-related memories due to prolonged periods of starvation, could lead to increased food intake.
