Dentate nucleus deep brain stimulation for spinocerebellar ataxia: results of a six-month follow-up

Spinocerebellar ataxia (SCA) is a genetically heterogeneous neurodegenerative disorder lacking effective treatments currently. While noninvasive cerebellum neuromodulation showed positive results, invasive techniques like deep brain stimulation (DBS) have not been fully assessed for SCA patients. This study evaluated the treatment outcomes of DBS targeting the cerebellar dentate nucleus (DN) in six SCA patients (SCA1, SCA3, SCA12) over a six-month follow-up. Bilateral DN-DBS leads were precisely implanted using a neurosurgical robot. The stimulation parameters, including current, frequency, and pulse width, were programmed iteratively at predefined intervals, and the improvements in ataxia symptoms were evaluated based on the Scale for the Assessment and Rating of Ataxia (SARA) and the International Cooperative Ataxia Rating Scale (ICARS). Current results showed that current amplitude was fundamental to ensuring therapeutic efficacy, while frequency differentially alleviated tremor with high-frequency stimulation and gait disorder at low frequencies. At the six-month follow-up, the SARA and ICARS scores decreased by 43% (8.17 {+/-} 2.58 vs. 14.33 {+/-} 1.51, p=0.014) and 51% (18.67 {+/-} 7.50 vs. 38.17 {+/-} 8.13, p=0.013) respectively compared with baseline. Our study demonstrated the promising therapeutic benefits of DN-DBS for SCA patients and provided preliminary experience for individualized parameter programming.