Spinal cord stimulation improves motor function and gait in spastic paraplegia type 4 (SPG4): Clinical and neurophysiological evaluation

Autor(es)

Souza, Carolina Pinto de ^[1] ; Coelho, Daniel Boari ^[2] ; Campos, Debora da Silva Fragoso ^[2] ; Ghilardi, Maria Gabriela dos Santos ^[1] ; Vicente, Edrin Claro de Oliveira ^[3] ; Gonzalez-Salazar, Carelis ^[4] ; Junior, Marcondes Cavalcante Fransa ^[4] ; Barsottini, Orlando Graziani Povoas ^[5] ; Pedroso, Jose Luiz ^[5] ; Fonoff, Erich Talamoni ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Neurol, Med Sch, Ave Ovideo Pires Campos 785, BR-01231000 Sao Paulo, SP - Brazil

^[2] Fed Univ ABC, Biomed Engn, Santo Andre, SP - Brazil

^[3] Neurosoft Co, Rua Vergueiro 1855, BR-04101000 Sao Paulo, SP - Brazil

^[4] Univ Estadual Campinas, Dept Neurol, Campinas - Brazil

^[5] Univ Fed Sao Paulo, Dept Neurol, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PARKINSONISM & RELATED DISORDERS; v. 83, p. 1-5, FEB 2021.
• Citações Web of Science: 0

Resumo

Introduction: Hereditary spastic paraplegia is a heterogeneous group of genetic disorders characterized by degeneration of the corticospinal tracts, coursing with progressive weakness and spasticity of the lower limbs. To date, there are no effective treatments for progressive deficits or disease-modifying therapy for those patients. We report encouraging results for spastic paraparesis after spinal cord stimulation. Methods: A 51-year-old woman suffering from progressive weakness and spasticity in lower limbs related to hereditary spastic paraplegia type 4 underwent spinal cord stimulation (SCS) and experienced also significant improvement in motor function. Maximum ballistic voluntary isometric contraction test, continuous passive motion test and gait analysis using a motion-capture system were performed in ON and OFF SCS conditions. Neurophysiologic assessment consisted of obtaining motor evoked potentials in both conditions. Results: Presurgical Spastic Paraplegia Rating Scale (SPRS) score was 26. One month after effective SCS was initiated, SPRS went down to 15. At 12 months follow up, she experienced substantial improvement in motor function and in gait performance, with SPRS scores 23 (OFF) and down to 20 (ON). There was an increased isometric muscle strength (knee extension, OFF: 41 N.m; ON: 71 N.m), lower knee extension and flexion torque values in continuous passive motion test (decrease in spastic tone) and improvement in gait (for example, step length increase). Conclusion: Despite being a case study, our findings suggest innovative lines of research for the treatment of spastic paraplegia. (AU)

• Processo FAPESP: 19/06604-1 - Aquisição de dados na avaliação clínica e modelagem biomecânica com inovações tecnológicas buscando a restauração de movimentos e o desempenho esportivo para pessoas com deficiências
• Beneficiário: Claudiane Arakaki Fukuchi
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado