Spinal cord stimulation (SCS) is receiving increasing interests for treating pain and gait disorders in patients with Parkinson’s disease (PD). In an SCS study, it is hard to apply a double-blind approach, especially at low frequencies, as the stimulation normally induces paresthesia which can be perceived by the patient. We herein demonstrate a case treated with SCS in which a blinding design was accomplished by an accidental dislocation of a stimulation lead. A 73-year-old man with PD was admitted to our hospital because of relapsed low back pain. This was due to the dislocation of a previously implanted SCS lead, which caused a decrease in its effectiveness in alleviating pain (from 81 to 43% measured by King’s Parkinson’s Disease Pain Scale) and improving gait (from 35 to 28% measured by the timed up and go test). A second SCS surgery using a paddle lead solved this problem, with improvements in pain and gait rebounded to 81 and 45%. In this case, the paresthesia induced by SCS (using either a paddle lead or percutaneous leads) was below the threshold of perception when the patient was sitting and standing, and a dislocation of one previously implanted percutaneous lead did not cause evident changes in his sensation of paresthesia. At last follow-up, the patient’s quality of life had improved by 40% as measured by the 8-item Parkinson’s Disease questionnaire (PDQ-8). This study could serve partly as a proof that low-frequency SCS is effective in improving pain as well as gait problems in PD patients, which was unlikely a result of a placebo effect.

1.
Sivanesan
E
,
Maher
DP
,
Raja
SN
,
Linderoth
B
,
Guan
Y
.
Supraspinal Mechanisms of Spinal Cord Stimulation for Modulation of Pain: Five Decades of Research and Prospects for the Future
.
Anesthesiology
.
2019
Apr
;
130
(
4
):
651
65
.
[PubMed]
0003-3022
2.
Hubsch
C
,
D’Hardemare
V
,
Ben Maacha
M
,
Ziegler
M
,
Patte-Karsenti
N
,
Thiebaut
JB
, et al
Tonic spinal cord stimulation as therapeutic option in Parkinson disease with axial symptoms: effects on walking and quality of life
.
Parkinsonism Relat Disord
.
2019
Jun
;
63
:
235
7
.
[PubMed]
1353-8020
3.
de Andrade
EM
,
Ghilardi
MG
,
Cury
RG
,
Barbosa
ER
,
Fuentes
R
,
Teixeira
MJ
, et al
Spinal cord stimulation for Parkinson’s disease: a systematic review
.
Neurosurg Rev
.
2016
Jan
;
39
(
1
):
27
35
.
[PubMed]
0344-5607
4.
de Souza
CP
,
Dos Santos
MG
,
Hamani
C
,
Fonoff
ET
.
Spinal cord stimulation for gait dysfunction in Parkinson’s disease: essential questions to discuss
.
Mov Disord
.
2018
Nov
;
33
(
11
):
1828
9
.
[PubMed]
0885-3185
5.
Kalia
LV
,
Lang
AE
.
Parkinson’s disease
.
Lancet
.
2015
Aug
;
386
(
9996
):
896
912
.
[PubMed]
0140-6736
6.
Chaudhuri
KR
,
Rizos
A
,
Trenkwalder
C
,
Rascol
O
,
Pal
S
,
Martino
D
, et al;
EUROPAR and the IPMDS Non Motor PD Study Group
.
King’s Parkinson’s disease pain scale, the first scale for pain in PD: an international validation
.
Mov Disord
.
2015
Oct
;
30
(
12
):
1623
31
.
[PubMed]
0885-3185
7.
Pinto de Souza
C
,
Hamani
C
,
Oliveira Souza
C
,
Lopez Contreras
WO
,
Dos Santos Ghilardi
MG
,
Cury
RG
, et al
Spinal cord stimulation improves gait in patients with Parkinson’s disease previously treated with deep brain stimulation
.
Mov Disord
.
2017
Feb
;
32
(
2
):
278
82
.
[PubMed]
0885-3185
8.
Santana
MB
,
Halje
P
,
Simplício
H
,
Richter
U
,
Freire
MA
,
Petersson
P
, et al
Spinal cord stimulation alleviates motor deficits in a primate model of Parkinson disease
.
Neuron
.
2014
Nov
;
84
(
4
):
716
22
.
[PubMed]
0896-6273
9.
Samotus
O
,
Parrent
A
,
Jog
M
.
Spinal Cord Stimulation Therapy for Gait Dysfunction in Advanced Parkinson’s Disease Patients
.
Mov Disord
.
2018
May
;
33
(
5
):
783
92
.
[PubMed]
0885-3185
10.
Fénelon
G
,
Goujon
C
,
Gurruchaga
JM
,
Cesaro
P
,
Jarraya
B
,
Palfi
S
, et al
Spinal cord stimulation for chronic pain improved motor function in a patient with Parkinson’s disease
.
Parkinsonism Relat Disord
.
2012
Feb
;
18
(
2
):
213
4
.
[PubMed]
1353-8020
11.
Gandolfi
M
,
Geroin
C
,
Antonini
A
,
Smania
N
,
Tinazzi
M
.
Understanding and Treating Pain Syndromes in Parkinson’s Disease
.
Int Rev Neurobiol
.
2017
;
134
:
827
58
.
[PubMed]
0074-7742
12.
Fuentes
R
,
Petersson
P
,
Siesser
WB
,
Caron
MG
,
Nicolelis
MA
.
Spinal cord stimulation restores locomotion in animal models of Parkinson’s disease
.
Science
.
2009
Mar
;
323
(
5921
):
1578
82
.
[PubMed]
0036-8075
13.
Nishioka
K
,
Nakajima
M
.
Beneficial Therapeutic Effects of Spinal Cord Stimulation in Advanced Cases of Parkinson’s Disease With Intractable Chronic Pain: A Case Series
.
Neuromodulation
.
2015
Dec
;
18
(
8
):
751
3
.
[PubMed]
1094-7159
14.
Kobayashi
R
,
Kenji
S
,
Taketomi
A
,
Murakami
H
,
Ono
K
,
Otake
H
.
New mode of burst spinal cord stimulation improved mental status as well as motor function in a patient with Parkinson’s disease
.
Parkinsonism Relat Disord
.
2018
Dec
;
57
:
82
3
.
[PubMed]
1353-8020
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