Burst spinal cord stimulation for pain and motor function in Parkinson's disease: A case series.

INTRODUCTION: Spinal cord stimulation (SCS) is an established strategy for pain reduction used in whole world including Japan to treat chronic intractable pain. Pain is a frequent comorbidity of Parkinson's disease (PD), leading to poorer quality of life. SCS has been reported to effectively reduce pain in PD and may also improve motor function, but most studies have employed the modality of tonic stimulation. As such, the effects of SCS using the newly developed paradigm of burst stimulation in PD remain relatively unexplored. METHODS: This case series reviewed PD patients who underwent SCS using BurstDR stimulation to treat intractable lower back pain (LBP). Pain and motor outcomes were assessed before and at several timepoints after implantation over a 24-week observation period. RESULTS: Pain indices (visual analogue scale [VAS] and short-form McGill Pain Questionnaire 2 [SF-MPQ-2] scores) improved in nearly all patients. Improvements were especially notable in the dimension of affective pain (SF-MPQ-2). Functional motor improvements were evident in the Unified Parkinson's Disease Rating Scale (UPDRS), especially walking-related items, and timed-up-and-go (TUG) test performance, which generally persisted through week 24 of observation. CONCLUSION: Burst SCS improved pain (especially the affective component) in PD patients with LBP, with effects generally lasting for at least 24 weeks. Neither paresthesia nor obvious adverse events were experienced in any case. Motor symptoms as scored of UPDRS Part III had the trends of improvement in lower limb akinesia at week 24 and gait at week 4. These findings suggest that burst SCS may be an effective treatment option for LBP and may be influenced to gait-related motor symptoms in PD.

[Personality traits of Japanese patients with focal dystonia-Variable classification by affected body part and occupation].

We administered the Revised Neo Personality Inventory (NEO-PI-R) to 92 Japanese patients with focal dystonia and analyzed the relation of their personality traits, affected body parts, and occupations using a decision tree method. Results show that participants' personality traits were related to their occupation rather than the body part. Occupational dystonia patients including musicians exhibited neurotic tendencies and a high level of anxiety. Moreover, patients with occupational upper limb dystonia had realistic thinking patterns. Patients with musicians' dystonia were open about their emotional experiences: both positive and negative.