Spinal Cord Stimulation Alleviates Motor Deficits in a Primate Model of Parkinson Disease

• Published in: Neuron (Cambridge, Mass.) Vol. 84; no. 4; pp. 716 - 722
• Main Authors: Santana, Maxwell B., Halje, Pär, Simplício, Hougelle, Richter, Ulrike, Freire, Marco Aurelio M., Petersson, Per, Fuentes, Romulo, Nicolelis, Miguel A.L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 19.11.2014; Elsevier Limited
• Subjects: Animals; Automation; Basic Medicine; Behavior; Callithrix; Disease Models, Animal; Dopamine; Laboratory animals; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Medicinska och farmaceutiska grundvetenskaper; Monkeys & apes; Motor Activity - physiology; Neurons - physiology; Neurosciences; Neurovetenskaper; Parkinson Disease - physiopathology; Parkinson Disease - therapy; Parkinson's disease; Primates; Rodents; Software; Spinal Cord - physiopathology; Spinal Cord Stimulation; Studies; Treatment Outcome
• ISSN: 0896-6273; 1097-4199
• DOI: 10.1016/j.neuron.2014.08.061

Although deep brain electrical stimulation can alleviate the motor symptoms of Parkinson disease (PD), just a small fraction of patients with PD can take advantage of this procedure due to its invasive nature. A significantly less invasive method—epidural spinal cord stimulation (SCS)—has been suggested as an alternative approach for symptomatic treatment of PD. However, the mechanisms underlying motor improvements through SCS are unknown. Here, we show that SCS reproducibly alleviates motor deficits in a primate model of PD. Simultaneous neuronal recordings from multiple structures of the cortico-basal ganglia-thalamic loop in parkinsonian monkeys revealed abnormal highly synchronized neuronal activity within each of these structures and excessive functional coupling among them. SCS disrupted this pathological circuit behavior in a manner that mimics the effects caused by pharmacological dopamine replacement therapy or deep brain stimulation. These results suggest that SCS should be considered as an additional treatment option for patients with PD. •Spinal cord stimulation restores motor function in primates with severe parkinsonism•Parkinsonism is associated with aberrant basal ganglia functional connectivity•Levodopa treatment and spinal cord stimulation have common physiological effects Santana et al. show that epidural spinal cord stimulation decreases pathological oscillatory activity in motor brain circuits and alleviates motor deficits in primates with parkinsonism, suggesting it can be used as a therapy for Parkinson’s disease.