{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:48:42Z","timestamp":1787755722340,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2019\/11000\u20108"],"award-info":[{"award-number":["2019\/11000\u20108"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epidural electrical spinal cord stimulation has been studied for more than a decade for Parkinson's disease symptoms, but compelling evidence for its effectiveness is still lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to evaluate the effectiveness of spinal cord stimulation in Parkinson's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants had Parkinson's disease diagnosis, gait impairment and freezing of gait, and no pain. Paddle electrodes were implanted at the T2\u2010T4 level. After 6\u2009months of parameter selection, subthreshold and sham stimulation were compared through a double\u2010blinded randomized evaluation and further compared with suprathreshold stimulation. A second 6\u2010 to 8\u2010month period of parameter adjustment and a final long\u2010term open evaluation followed. Outcomes were determined via Timed Up and Go (TUG), Movement Disorders Society Unified Parkinson's Disease Scale (MDS UPDRS) Part III, Mini BESTest, New Freezing of Gait Questionnaire, Parkinson's Disease Questionnaire 39, Fall Efficiency Scale International, and accelerometer\u2010based gait analysis. Functional magnetic resonance imaging was also performed during the double\u2010blind evaluation period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study was terminated for futility after eight patients underwent implantation and seven completed double\u2010blind evaluations. TUG duration ON stimulation was median 11.59 (19.7\u201310.9) seconds <jats:italic>on<\/jats:italic> medication and 24.49 (48.1\u201313.7) seconds <jats:italic>off<\/jats:italic> medication, which was not statistically different from sham with 12.38 (13.7\u201311.8) and 16.93 (30\u201314.4) seconds <jats:italic>on<\/jats:italic> respective medication status. Likewise, no significant differences were found for MDS UPDRS Part III scores, respectively, ON active stimulation for 29 (33.5\u201323) and 42 (51\u201340) seconds and on sham 28 (30.5\u201326) and 50 (51.5\u201344) seconds. No effect from stimulation was identified in any other outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No effect of spinal cord stimulation in Parkinson's disease symptoms was identified. \u00a9 2025 International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.30187","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T05:37:23Z","timestamp":1743745043000},"page":"1279-1290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Spinal Cord Stimulation Failed to Improve Parkinson's Disease Symptoms in Randomized Crossover Double\u2010Blinded Evaluation"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-8455","authenticated-orcid":false,"given":"Rafael Bernhart","family":"Carra","sequence":"first","affiliation":[{"name":"Department of Neurology, Movement Disorders Center, School 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