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Volume 11
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Article

Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

by
Carla Piano
1,
Francesco Bove
1,2,*,
Delia Mulas
3,
Enrico Di Stasio
4,5,
Alfonso Fasano
6,7,8,
Anna Rita Bentivoglio
1,2,
Antonio Daniele
1,2,
Beatrice Cioni
9,
Paolo Calabresi
1,2 and
Tommaso Tufo
9
1
Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
2
Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
3
Institute of Neurology, Mater Olbia Hospital, 07026 Olbia, Italy
4
Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
5
Cheminstry, Biocheminstry and Clinical Molecular Biology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
6
Edmond J. Safra Program in Parkinson’s Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, ON M5T 2S8, Canada
7
Krembil Brain Institute, Toronto, ON M5T 1M8, Canada
8
Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON M5G 2A2, Canada
9
Neurosurgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
Brain Sci. 2021, 11(4), 416; https://doi.org/10.3390/brainsci11040416
Submission received: 26 February 2021 / Revised: 18 March 2021 / Accepted: 23 March 2021 / Published: 26 March 2021
(This article belongs to the Special Issue Brain Stimulation and Neuroplasticity)
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Abstract

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.
Keywords: motor cortex stimulation; Parkinson’s disease; movement disorders; neuromodulation motor cortex stimulation; Parkinson’s disease; movement disorders; neuromodulation

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MDPI and ACS Style

Piano, C.; Bove, F.; Mulas, D.; Di Stasio, E.; Fasano, A.; Bentivoglio, A.R.; Daniele, A.; Cioni, B.; Calabresi, P.; Tufo, T. Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome. Brain Sci. 2021, 11, 416. https://doi.org/10.3390/brainsci11040416

AMA Style

Piano C, Bove F, Mulas D, Di Stasio E, Fasano A, Bentivoglio AR, Daniele A, Cioni B, Calabresi P, Tufo T. Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome. Brain Sciences. 2021; 11(4):416. https://doi.org/10.3390/brainsci11040416

Chicago/Turabian Style

Piano, Carla, Francesco Bove, Delia Mulas, Enrico Di Stasio, Alfonso Fasano, Anna Rita Bentivoglio, Antonio Daniele, Beatrice Cioni, Paolo Calabresi, and Tommaso Tufo. 2021. "Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome" Brain Sciences 11, no. 4: 416. https://doi.org/10.3390/brainsci11040416

APA Style

Piano, C., Bove, F., Mulas, D., Di Stasio, E., Fasano, A., Bentivoglio, A. R., Daniele, A., Cioni, B., Calabresi, P., & Tufo, T. (2021). Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome. Brain Sciences, 11(4), 416. https://doi.org/10.3390/brainsci11040416

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