AUTHOR=Li Jiping , Mei Shanshan , Zhang Xiaohua , Wang Yunpeng , Jia Xiaofei , Liu Jinlong , Xu Erhe , Mao Wei , Zhang Yuqing 

TITLE=Case report: Combined therapy of bilateral subthalamic nucleus deep brain stimulation and spinal cord stimulation significantly improves motor function in a patient with multiple system atrophy with predominant parkinsonism

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 16 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.929273

DOI=10.3389/fnins.2022.929273

ISSN=1662-453X

ABSTRACT=Multiple system atrophy with predominant parkinsonism (MSA-P) is a highly incapacitating disease with a short life-expectancy and symptomatic therapy is still limited. In this report, we present the case of a 65-year-old female with a 3-year history of severe rigidity, bradykinesia, and gait dysfunction alongside severe freezing of gait who diagnosed as MSA-P. She underwent combined therapy of bilateral subthalamic nucleus-deep brain stimulation (STN-DBS) and low-thoracic spinal cord stimulation (SCS). The double-blind evaluation of the Movement Disorder Society Sponsored Revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS III) and 7-meter Timed Up and Go (TUG) at follow-ups showed her cardinal parkinsonian symptoms benefit significantly from DBS stimulation, while, the improvement of SCS was mainly embodied in lower limb symptoms. The combined stimulation achieved a better improvement of motor function than either DBS or SCS stimulation alone. Most notably, the improvement of lower limb symptoms was significantly enhanced by the combined stimulation.