Parkinson's disease (PDS) is a syndrome characterized by tremor, bradykinesia, rigidity, and postural disturbances. Causes include Parkinson's disease (PD), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). Non-motor symptoms of PDS, such as neurogenic orthostatic hypotension (nOH), have received more intensive research due to their greater disabling potential compared to motor symptoms. In patients with PD and MSA, nOH can lead to intolerance to medications such as levodopa, significantly increasing the risk of falls, accelerating cognitive decline, and increasing the risk of all-cause mortality. However, conventional pharmacological treatments (such as midodrine, droxidopa, and fludrocortisone) and non-pharmacological approaches (such as compression abdominal bands, elastic stockings, and deep brain stimulation) for non-motor symptoms such as nOH have numerous limitations, including short-term efficacy, uncertain efficacy, and side effects. Therefore, exploring new non-pharmacological treatments to improve nOH and delay disease progression in patients with PDS is crucial for improving their quality of life and prognosis. Spinal cord stimulation (SCS), including invasive (epidural) spinal cord stimulation (eSCS) and non-invasive (transcutaneous) spinal cord stimulation (tSCS), is a novel neuromodulatory technique with clinical applications in a variety of neurological diseases. Currently, several small-sample studies have suggested the potential efficacy of SCS for nOH caused by spinal cord injury (SCI). This study innovatively proposes the use of eSCS and tSCS to improve nOH and related clinical symptoms in patients with PDS. A prospective, single-center, randomized, controlled clinical trial is planned to compare the efficacy of invasive and non-invasive SCS in treating nOH, thereby providing new insights for the effective treatment of PDS.
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Change of blood pressure from baseline to immediately post-operation or post transcutaneous stimulation
Timeframe: Immediately post surgery or post transcutaneous stimulation
Change of blood pressure from baseline to 3 months post-operation or post transcutaneous stimulation
Timeframe: 3 months post surgery or post transcutaneous stimulation
Change of blood pressure from baseline to 6 months post-operation or post transcutaneous stimulation
Timeframe: 6 months post surgery or post transcutaneous stimulation
Change of blood pressure from baseline to 9 months post-operation or post transcutaneous stimulation
Timeframe: 9 months post surgery or post transcutaneous stimulation
Change of blood pressure from baseline to 12 months post-operation or post transcutaneous stimulation
Timeframe: 12 months post surgery or post transcutaneous stimulation
Change of blood pressure from baseline to 18 months post-operation or post transcutaneous stimulation
Timeframe: 18 months post surgery or post transcutaneous stimulation
Change of blood pressure from baseline to 24 months post-operation or post transcutaneous stimulation
Timeframe: 24 months post surgery or post transcutaneous stimulation