Spinal Cord Stimulation for Multiple System Atrophy
Multiple System Atrophy
About this trial
This is an interventional treatment trial for Multiple System Atrophy
Eligibility Criteria
Inclusion Criteria:
- Meeting possible or probable multiple system atrophy (MSA) criteria according to the 2008 second consensus statement on the diagnosis of MSA.
- Citizens of the People's Republic of China, aged >18 years and <80 years.
- Hoehn-Yahr stage ≤3.
- The presence of significant symptoms of dysarthria, dysphagia, orthostatic hypotension or urinary hypotension in patients with MSA.
- Maintaining medication during the study period.
- Good compliance, signed written informed consent, and consent to surgical treatment of cervical spinal cord stimulation (SCS).
Exclusion Criteria:
- Patients with severe neuropsychiatric disorders or a history of severe neuropsychiatric disorders.
- Patients with significant cognitive impairment (Mini-Mental State Exam < 24) or inability to complete the questionnaire independently.
- Presence of anatomical abnormalities or other lesions of the cervical spine that interfere with electrode implantation
- Dysarthria, swallowing difficulties, orthostatic hypotension from other causes not related to MSA.
- Critically ill or unstable vital signs.
- Other conditions that in the opinion of the investigator make them unsuitable for participation in this study.
Sites / Locations
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineRecruiting
Arms of the Study
Arm 1
Experimental
Spinal cord stimulation(SCS) implantation
Phase I: C2-4 is selected as the puncture location. Percutaneous puncture is performed under X-ray guidance. One or two electrodes are placed in the patient's epidural cavity, and the electrode position is adjusted intraoperatively by the patient's feedback of the current stimulation position until the current can cover the entire area. An extension lead is connected, an external temporary stimulator is attached, and the patient decides whether to proceed to full implantation in phase II after 7-10 days of phase I testing experience. Phase II: The complete SCS system is implanted under local anesthesia or epidural anesthesia after successful testing. A subcutaneous capsular bag is usually created in the lower abdomen and the implanted electrodes are connected to the pulse generator through a connecting wire in the subcutaneous tunnel.