Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil; Biomedical Engineering, Federal University of ABC, São Paulo, Brazil
Carolina Pinto Souza
Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Carolina Oliveira Souza
Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Maria Gabriela dos Santos Ghilardi
Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Tiago Garcia
Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Mariana Voos
Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
Matija Milosevic
Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan
Clement Hamani
Division of Neurosurgery, Sunnybrook Research Institute, Harquail Centre for Neuromodulation, University of Toronto, Toronto, Canada; Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
Luis Augusto Teixeira
Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
Erich Talamoni Fonoff
Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Freezing of gait (FoG) in Parkinson’s disease (PD) is an incapacitating transient phenomenon, followed by continuous postural disorders. Spinal cord stimulation (SCS) is a promising intervention for FoG in patients with PD, however, its effects on distinct domains of postural control is not well known. The aim of this study is to assess the effects of SCS on FoG and distinct domains of postural control. Four patients with FoG were implanted with SCS systems in the upper thoracic spine. Anticipatory postural adjustment (APA), reactive postural responses, gait and FoG were biomechanically assessed. In general, the results showed that SCS improved FoG and APA. However, SCS failed to improve reactive postural responses. SCS seems to influence cortical motor circuits, involving the supplementary motor area. On the other hand, reactive posture control to external perturbation that mainly relies on neuronal circuitries involving the brainstem and spinal cord, is less influenced by SCS.
