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High grade gliomas (HGG) have decreased blood flow resulting in hypoxia, limited access by chemotherapeutic agents, and reduced radiation-sensitivity. Spinal cord stimulation (SCS) has been used successfully in the treatment of pain and ischemic syndromes. The present article summarizes our investigations into the effects of SCS in patients with HGG. Before their scheduled radio-chemotherapy, 23 patients with HGG were assessed pre- and post-SCS using several evaluation techniques: 1) transcranial Doppler (TCD) for middle cerebral artery blood flow; 2) color Doppler for common carotid artery blood flow; 3) single photon emission computed tomography (SPECT) for tumor blood flow; 4) polarographic probe technique for tumor pO2 measurement; 5) positron emission tomography (PET) for tumor glucose metabolism. Pre-SCS, the tumors were more ischemic and more hypoxic than healthy tissues. Post-SCS, there was significant: 1) increase in blood flow measured by TCD (≥18%), color Doppler (≥61%) and SPE CT (15%), 2) increase in oxygenation and decrease (≥45%) in percentage of hypoxic values <10mmHg and <5mmHg, and 3) increase (43%) in glucose metabolism. Our studies show that SCS can modify loco-regional blood flow and oxygen supply, as well as glucose-metabolism in HGG. This suggests that SCS could prove useful as an adjuvant treatment to radio-chemotherapy. These data merit further confirmatory studies. [ABSTRACT FROM AUTHOR]

A decrease in cerebral blood flow (CBF) and brain metabolic activity are well-known complications of stroke. Spinal cord stimulation (SCS) is successfully being used for the treatment of several low-perfusion syndromes. The aim of this chapter is to describe the data that support the effect of SCS on CBF and the use of SCS in the treatment of stroke and cerebral low perfusion syndromes. In addition, we present our relevant studies. Since April 1995, we have assessed 49 non-stroke patients. The following parameters were measured pre- and post-stroke: 1) CBF in healthy contralateral tissue by single photon emission computed tomography (SPECT), 2) systolic and diastolic velocity in the middle cerebral artery (MCA) by transcranial Doppler, 3) blood flow quantifi- cation in the common carotid artery (CCA) by color Doppler, and 4) glucose metabolism in healthy contralateral tissue by positron emission tomography (PET). Our results showed that during cervical SCS there was a significant (p<0.001) increase in systolic (≥21%) and diastolic (>26%) velocity in the MCA, and CCA blood flow (≥51%) as well as glucose metabolism (44%). We concluded that cervical SCS (cSCS) can modify CBF and brain metabolism. Its potential role in the management of stroke and low-perfusion syndromes is further investigated by experimental studies and reports describing clinical experience. Appropriate clinical trials are warranted. [ABSTRACT FROM AUTHOR]