PT  - JOURNAL ARTICLE
AU  - Victor S Hvingelby
AU  - Miriam Højholt Terkelsen
AU  - Erik L Johnsen
AU  - Mette Møller
AU  - Erik Hvid Danielsen
AU  - Tove Henriksen
AU  - Andreas Nørgaard Glud
AU  - Yen Tai
AU  - Anne Sofie Møller Andersen
AU  - Kaare Meier
AU  - Per Borghammer
AU  - Elena Moro
AU  - Jens Christian Hedemann Sørensen
AU  - Nicola Pavese
TI  - Spinal cord stimulation therapy for patients with Parkinson’s disease and gait problems (STEP-PD): study protocol for an exploratory, double-blind, randomised, placebo-controlled feasibility trial
AID  - 10.1136/bmjno-2022-000333
DP  - 2022 Aug 01
TA  - BMJ Neurology Open
PG  - e000333
VI  - 4
IP  - 2
4099  - http://neurologyopen.bmj.com/content/4/2/e000333.short
4100  - http://neurologyopen.bmj.com/content/4/2/e000333.full
SO  - BMJ Neurol Open2022 Aug 01; 4
AB  - Introduction Gait difficulties are common in Parkinson’s disease (PD) and cause significant disability. These symptoms are often resistant to treatment. Spinal cord stimulation (SCS) has been found to improve gait, including freezing of gait, in a small number of patients with PD. The mechanism of action is unclear, and some patients are non-responders. With this double-blind, placebo-controlled efficacy and feasibility clinical and imaging study, we aim to shed light on the mechanism of action of SCS and collect data to inform development of a scientifically sound clinical trial protocol. We also aim to identify clinical and imaging biomarkers at baseline that could be predictive of a favourable or a negative outcome of SCS and improve patient selection.Methods and analysis A total of 14 patients will be assessed with clinical rating scales and gait evaluations at baseline, and at 6 and 12 months after SCS implantation. They will also receive serial 18F-deoxyglucose and 18FEOBV PET scans to assess the effects of SCS on cortical/subcortical activity and brain cholinergic function. The first two patients will be included in an open pilot study while the rest will be randomised to receive active treatment or placebo (no stimulation) for 6 months. From this point, the entire cohort will enter an open label active treatment phase for a subsequent 6 months.Ethics and dissemination This study was reviewed and approved by the Committee on Health Research Ethics, Central Denmark RM. It is funded by the Danish Council for Independent Research. Independent of outcome, the results will be published in peer-reviewed journals and presented at national and international conferences.Trial registration number NCT05110053; ClinicalTrials.gov Identifier.