{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:50:59Z","timestamp":1787241059655,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T00:00:00Z","timestamp":1662768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["19411968300"],"award-info":[{"award-number":["19411968300"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["81971294"],"award-info":[{"award-number":["81971294"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["19411968300"],"award-info":[{"award-number":["19411968300"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971294"],"award-info":[{"award-number":["81971294"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>High cervical spinal cord stimulation (HCSCS) was found to have therapeutic effects on Parkinsonian gait disturbance. However, the results were inconsistent and confounded with symptoms of pain. This study aimed to reveal the gait and dysarthric effects of HCSCS in PD (Parkinson\u2019s disease) and MSA-P (Parkinson variant of multiple system atrophy) patients without pain. Three PD and five MSA-P patients without painful comorbidities were assessed for gait performance and speech before SCS surgery and at 3- and 6-month follow-up. Stride length and the time spent in the Timed Up-and-Go task showed little change after HCSCS surgery. Overall voice quality (measured by dysphonia severity index) and perceptual speech intelligence improved significantly at 3 months, but improvements slightly diminished at 6 months postoperatively. Change in quality of life (measured by 8-item Parkinson\u2019s disease questionnaire) was also notable at 3 months but narrowed over time following HCSCS. In conclusion, HCSCS showed therapeutic effects in improving the dysarthria but not gait disturbance in pain-free PD and MSA-P patients.<\/jats:p>","DOI":"10.3390\/brainsci12091222","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T20:52:25Z","timestamp":1663015945000},"page":"1222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of High Cervical Spinal Cord Stimulation on Gait Disturbance and Dysarthropneumophonia in Parkinson\u2019s Disease and Parkinson Variant of Multiple System Atrophy: A Case Series"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4813-4337","authenticated-orcid":false,"given":"Linbin","family":"Wang","sequence":"first","affiliation":[{"name":"Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyan","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9935-433X","authenticated-orcid":false,"given":"Boyan","family":"Fang","sequence":"additional","affiliation":[{"name":"Neurological Rehabilitation Center, Beijing Rehabilitation Hospital, The Affiliated Hospital of Capital Medical University, Badachu Road, Shijingshan District, Beijing 100000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8300-8646","authenticated-orcid":false,"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianyou","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/j.parkreldis.2014.04.024","article-title":"Assessing Speech Dysfunction Using BOLD and Acoustic Analysis in Parkinsonism","volume":"20","author":"Saxena","year":"2014","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jns.2011.07.020","article-title":"Aspects of Speech Rate and Regularity in Parkinson\u2019s Disease","volume":"310","author":"Skodda","year":"2011","journal-title":"J. Neurol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.bandl.2015.04.007","article-title":"Differences in Early Speech Patterns between Parkinson Variant of Multiple System Atrophy and Parkinson\u2019s Disease","volume":"147","author":"Huh","year":"2015","journal-title":"Brain Lang."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1213\/00000539-196707000-00025","article-title":"Electrical Inhibition of Pain by Stimulation of the Dorsal Columns: Preliminary Clinical Report","volume":"46","author":"Shealy","year":"1967","journal-title":"Anesth. Analg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1002\/mds.27299","article-title":"Spinal Cord Stimulation Therapy for Gait Dysfunction in Advanced Parkinson\u2019s Disease Patients","volume":"33","author":"Samotus","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1002\/mds.28065","article-title":"Spinal Cord Stimulation for Very Advanced Parkinson\u2019s Disease: A 1-Year Prospective Trial","volume":"35","author":"Prasad","year":"2020","journal-title":"Mov. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1126\/science.1164901","article-title":"Spinal Cord Stimulation Restores Locomotion in Animal Models of Parkinson\u2019s Disease","volume":"323","author":"Fuentes","year":"2009","journal-title":"Science"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.neuron.2014.08.061","article-title":"Spinal Cord Stimulation Alleviates Motor Deficits in a Primate Model of Parkinson Disease","volume":"84","author":"Santana","year":"2014","journal-title":"Neuron"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/ner.12119","article-title":"Effectiveness of Cervical Spinal Cord Stimulation for the Management of Chronic Pain","volume":"17","author":"Deer","year":"2014","journal-title":"Neuromodulation Technol. Neural Interface"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mazzone, P., Viselli, F., Ferraina, S., Giamundo, M., Marano, M., Paoloni, M., Masedu, F., Capozzo, A., and Scarnati, E. (2019). High Cervical Spinal Cord Stimulation: A One Year Follow-Up Study on Motor and Non-Motor Functions in Parkinson\u2019s Disease. Brain Sci., 9.","DOI":"10.3390\/brainsci9040078"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1212\/WNL.0b013e3181d9ed58","article-title":"Spinal cord stimulation failed to relieve akinesia or restore locomotion in parkinson disease","volume":"74","author":"Thevathasan","year":"2010","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.jocn.2012.08.018","article-title":"A Patient with Parkinson\u2019s Disease Benefits from Spinal Cord Stimulation","volume":"20","author":"Hassan","year":"2013","journal-title":"J. Clin. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.parkreldis.2020.01.002","article-title":"Does Acute Peripheral Trauma Contribute to Idiopathic Adult-Onset Dystonia?","volume":"71","author":"Defazio","year":"2020","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1044\/jshr.3805.1001","article-title":"The Influence of Speaking Rate on Vowel Space and Speech Intelligibility for Individuals with Amyotrophic Lateral Sclerosis","volume":"38","author":"Turner","year":"1995","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1044\/jslhr.4303.796","article-title":"The Dysphonia Severity Index: An Objective Measure of Vocal Quality Based on a Multiparameter Approach","volume":"43","author":"Wuyts","year":"2000","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.parkreldis.2011.07.015","article-title":"Spinal Cord Stimulation for Chronic Pain Improved Motor Function in a Patient with Parkinson\u2019s Disease","volume":"18","author":"Goujon","year":"2012","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Soltani, F., and Lalkhen, A. (2013). Improvement of parkinsonian symptoms with spinal cord stimulation: Consequence or coincidence?. J. Neurol Neurosurg. Psychiatry, 84.","DOI":"10.1136\/jnnp-2013-306573.165"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/ner.12005","article-title":"pietro Spinal Cord Stimulation for the Treatment of Sensory Symptoms in Advanced Parkinson\u2019s Disease","volume":"16","author":"Landi","year":"2013","journal-title":"Neuromodulation Technol. Neural Interface"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s13311-014-0291-0","article-title":"Spinal Stimulation for Movement Disorders","volume":"11","author":"Thiriez","year":"2014","journal-title":"Neurotherapeutics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s42234-020-00041-9","article-title":"Spinal Cord Stimulation in Parkinson\u2019s Disease: A Review of the Preclinical and Clinical Data and Future Prospects","volume":"6","author":"Cai","year":"2020","journal-title":"Bioelectron Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1540-8159.1987.tb05947.x","article-title":"Spinal Cord Stimulation and Motor Disorders","volume":"10","author":"Waltz","year":"1987","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1159\/000114650","article-title":"The Interobserver and Test-Retest Variability of the Dysphonia Severity Index","volume":"60","author":"Hakkesteegt","year":"2008","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.jvoice.2015.08.013","article-title":"An Analysis of the Effects of Voice Therapy on Patients with Early Vocal Fold Polyps","volume":"30","author":"Zhuge","year":"2016","journal-title":"J. Voice"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S1474-4422(04)00854-3","article-title":"Treatments for Dysarthria in Parkinson\u2019s Disease","volume":"3","author":"Pinto","year":"2004","journal-title":"Lancet Neurol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10143-015-0651-1","article-title":"Spinal Cord Stimulation for Parkinson\u2019s Disease: A Systematic Review","volume":"39","author":"Ghilardi","year":"2016","journal-title":"Neurosurg. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Wang, B.J., Carter, F.L., and Altman, K.W. (2020). Relationship between Dysarthria and Oral-Oropharyngeal Dysphagia: The Present Evidence. Ear Nose Throat J.","DOI":"10.1177\/0145561320951647"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/9\/1222\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:28:54Z","timestamp":1760142534000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/9\/1222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,10]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["brainsci12091222"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12091222","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,10]]}}}