Spinal cord stimulation in the treatment of post-stroke patients: current state and future directions

Acta Neurochir Suppl. 2007;97(Pt 1):277-82. doi: 10.1007/978-3-211-33079-1_37.

Abstract

A decrease in cerebral blood flow (CBF) and brain metabolic activity are well-known complications of stroke. Spinal cord stimulation (SCS) is successfully being used for the treatment of several low-perfusion syndromes. The aim of this chapter is to describe the data that support the effect of SCS on CBF and the use of SCS in the treatment of stroke and cerebral low perfusion syndromes. In addition, we present our relevant studies. Since April 1995, we have assessed 49 non-stroke patients. The following parameters were measured pre- and post-stroke: (1) CBF in healthy contralateral tissue by single photon emission computed tomography (SPECT), (2) systolic and diastolic velocity in the middle cerebral artery (MCA) by transcranial Doppler, (3) blood flow quantification in the common carotid artery (CCA) by color Doppler, and (4) glucose metabolism in healthy contralateral tissue by positron emission tomography (PET). Our results showed that during cervical SCS there was a significant (p < 0.001) increase in systolic (> or =21%) and diastolic (>26%) velocity in the MCA, and CCA blood flow (> or =51%) as well as glucose metabolism (44%). We concluded that cervical SCS (cSCS) can modify CBF and brain metabolism. Its potential role in the management of stroke and low-perfusion syndromes is further investigated by experimental studies and reports describing clinical experience. Appropriate clinical trials are warranted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Blood Flow Velocity / physiology
  • Blood Flow Velocity / radiation effects
  • Blood Viscosity
  • Brain / blood supply
  • Brain / physiopathology
  • Cerebral Arteries / physiopathology
  • Electric Stimulation Therapy / methods*
  • Glucose / metabolism
  • Humans
  • Spinal Cord / physiopathology
  • Spinal Cord / radiation effects*
  • Stroke / complications
  • Stroke / metabolism
  • Stroke / pathology
  • Stroke / therapy*

Substances

  • Glucose