OtherNeurorehabilitation and neural repair2019

Epidural Spinal Cord Stimulation Improves Motor Function in Rats With Chemically Induced Parkinsonism.

Hui Zhong, Chunni Zhu, Yoshihiko Minegishi and 8 others

PMID 31684831

WHAT IT FOUND

In rats with chemically induced parkinsonism, spinal epidural stimulation below the twitch threshold helped them start stepping and reduced abnormal foot placement.

This is animal evidence, not tested in people.

Key findings

01In 6-OHDA rats, spinal epidural stimulation raised successful stepping initiation to 51% of bouts at 2 weeks and 41% at 4 weeks, levels similar to sham, while without stimulation they did not initiate stepping at 2 weeks and initiated in only 2% of cases at 4 weeks.

02At 4 weeks, train stimulation reduced abnormal foot placement in the affected hindlimb from 82% of steps to 7%.

03The stimulation was below the twitch threshold and did not directly force forelimb or hindlimb stepping or cause a startle response.

STILL TO COME

How it was doneWhat they found

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What it does not show

This was a rat experiment, not a human trial, so it does not show what would happen in patients. Only 14 rats were used, and brain tissue from 2 animals was unusable, leaving 8 6-OHDA rats for the dopamine-loss measure. The 6-OHDA lesion was unilateral and may not reproduce the same mechanisms as Parkinson's disease in people. The experimenters could see when stimulation was on or off, even if they were blinded to group, so initiation and duration measures could be biased. The authors state that the relative contribution of spinal networks versus ascending brain pathways remains unclear.

Declared interests

The paper lists NIH extramural and non-U.S. government research support. No author conflicts of interest are reported in the supplied text.

The easy way to misread this

Do not read this as evidence that spinal cord stimulation improves walking in people with Parkinson's disease. The study was in rats with a chemical brain lesion, and the authors say the mechanisms in rats and Parkinson's disease may differ.

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The study

Participants
14 rats (10 6-OHDA, 4 sham)
Certainty of evidence
Low

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    Cite

    Hui Zhong, Chunni Zhu, Yoshihiko Minegishi, et al. Epidural Spinal Cord Stimulation Improves Motor Function in Rats With Chemically Induced Parkinsonism. Neurorehabilitation and neural repair. 2019.

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