title: Spinal cord stimulation for gait impairment in spinocerebellar ataxia 7.
abstract: The aim of this study is to report on the clinical efficacy of epidural thoracic spinal cord stimulation on gait and balance in a 39-year-old man with genetically confirmed spinocerebellar ataxia 7. A RESUME Medtronic electrode was placed at the epidural T11 level. Spatiotemporal gait assessment using an electronic walkway and static posturography were obtained and analyzed in a blinded manner with and without stimulation. The Tinetti Mobility Test was also performed in the two conditions. At 11 months after surgery, there was a 3-point improvement in the Tinetti Mobility Test in the on stimulation condition, although there was no statistically significant difference in spatiotemporal gait parameters. Static posturography did not demonstrate a significant improvement in stability measures between the two conditions in a stochastic way. Thoracic epidural spinal cord stimulation had a mild but clinically meaningful beneficial effect in improving gait and balance in a patient with SCA-7. The underlying pathophysiologic mechanisms remain to be elucidated. Further experience with spinal cord stimulation in refractory gait disorders is warranted.
authors.affiliation: Movement Disorders Centre, Toronto Western Hospital, 399 Bathurst Str, Toronto, ON, M5T 2S8, Canada.
authors.forename: Christos
authors.initials: C
authors.lastname: Sidiropoulos
authors.forename: Kei
authors.initials: K
authors.lastname: Masani
authors.forename: Tiago
authors.initials: T
authors.lastname: Mestre
authors.forename: Matija
authors.initials: M
authors.lastname: Milosevic
authors.forename: Yu-Yan
authors.initials: YY
authors.lastname: Poon
authors.forename: Melanie
authors.initials: M
authors.lastname: Fallis
authors.forename: Binit B
authors.initials: BB
authors.lastname: Shah
authors.forename: Suneil K
authors.initials: SK
authors.lastname: Kalia
authors.forename: Milos R
authors.initials: MR
authors.lastname: Popovic
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
mesh_terms: D000328:Adult; D004824:Epidural Space / Q000601:surgery; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D062187:Spinal Cord Stimulation / Q000379:methods*; D020754:Spinocerebellar Ataxias / Q000235:genetics / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome