• Christos Sidiropoulos, Kei Masani, Tiago Mestre, Matija Milosevic, Yu-Yan Poon, Melanie Fallis, Binit B Shah, Suneil K Kalia, Milos R Popovic, Andres M Lozano, and Elena Moro.
• Movement Disorders Centre, Toronto Western Hospital, 399 Bathurst Str, Toronto, ON, M5T 2S8, Canada.
• J. Neurol. 2014 Mar 1; 261 (3): 570-4.

AbstractThe aim of this study is to report on the clinical efficacy of epidural thoracic spinal cord stimulation on gait and balance in a 39-year-old man with genetically confirmed spinocerebellar ataxia 7. A RESUME Medtronic electrode was placed at the epidural T11 level. Spatiotemporal gait assessment using an electronic walkway and static posturography were obtained and analyzed in a blinded manner with and without stimulation. The Tinetti Mobility Test was also performed in the two conditions. At 11 months after surgery, there was a 3-point improvement in the Tinetti Mobility Test in the on stimulation condition, although there was no statistically significant difference in spatiotemporal gait parameters. Static posturography did not demonstrate a significant improvement in stability measures between the two conditions in a stochastic way. Thoracic epidural spinal cord stimulation had a mild but clinically meaningful beneficial effect in improving gait and balance in a patient with SCA-7. The underlying pathophysiologic mechanisms remain to be elucidated. Further experience with spinal cord stimulation in refractory gait disorders is warranted.

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