Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology.
Identifieur interne : 000347 ( PubMed/Corpus ); précédent : 000346; suivant : 000348Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology.
Auteurs : Clement Hamani ; Tipu Aziz ; Bastiaan R. Bloem ; Peter Brown ; Stephan Chabardes ; Terry Coyne ; Kelly Foote ; Edgar Garcia-Rill ; Etienne C. Hirsch ; Andres M. Lozano ; Paolo A M. Mazzone ; Michael S. Okun ; William Hutchison ; Peter Silburn ; Ludvic Zrinzo ; Mesbah Alam ; Laurent Goetz ; Erlick Pereira ; Anand Rughani ; Wesley Thevathasan ; Elena Moro ; Joachim K. KraussSource :
- Stereotactic and functional neurosurgery [ 1423-0372 ] ; 2016.
Abstract
Several lines of evidence over the last few years have been important in ascertaining that the pedunculopontine nucleus (PPN) region could be considered as a potential target for deep brain stimulation (DBS) to treat freezing and other problems as part of a spectrum of gait disorders in Parkinson disease and other akinetic movement disorders. Since the introduction of PPN DBS, a variety of clinical studies have been published. Most indicate improvements in freezing and falls in patients who are severely affected by these problems. The results across patients, however, have been variable, perhaps reflecting patient selection, heterogeneity in target selection and differences in surgical methodology and stimulation settings. Here we outline both the accumulated knowledge and the domains of uncertainty in surgical anatomy and terminology. Specific topics were assigned to groups of experts, and this work was accumulated and reviewed by the executive committee of the working group. Areas of disagreement were discussed and modified accordingly until a consensus could be reached. We demonstrate that both the anatomy and the functional role of the PPN region need further study. The borders of the PPN and of adjacent nuclei differ when different brainstem atlases and atlas slices are compared. It is difficult to delineate precisely the PPN pars dissipata from the nucleus cuneiformis, as these structures partially overlap. This lack of clarity contributes to the difficulty in targeting and determining the exact localization of the electrodes implanted in patients with akinetic gait disorders. Future clinical studies need to consider these issues.
DOI: 10.1159/000449010
PubMed: 27723662
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Krauss</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27723662</idno><idno type="pmid">27723662</idno><idno type="doi">10.1159/000449010</idno><idno type="wicri:Area/PubMed/Corpus">000347</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000347</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology.</title><author><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name><affiliation><nlm:affiliation>Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont., Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Aziz, Tipu" sort="Aziz, Tipu" uniqKey="Aziz T" first="Tipu" last="Aziz">Tipu Aziz</name></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name></author><author><name sortKey="Brown, Peter" sort="Brown, Peter" uniqKey="Brown P" first="Peter" last="Brown">Peter Brown</name></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name></author><author><name sortKey="Coyne, Terry" sort="Coyne, Terry" uniqKey="Coyne T" first="Terry" last="Coyne">Terry Coyne</name></author><author><name sortKey="Foote, Kelly" sort="Foote, Kelly" uniqKey="Foote K" first="Kelly" last="Foote">Kelly Foote</name></author><author><name sortKey="Garcia Rill, Edgar" sort="Garcia Rill, Edgar" uniqKey="Garcia Rill E" first="Edgar" last="Garcia-Rill">Edgar Garcia-Rill</name></author><author><name sortKey="Hirsch, Etienne C" sort="Hirsch, Etienne C" uniqKey="Hirsch E" first="Etienne C" last="Hirsch">Etienne C. Hirsch</name></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M" last="Lozano">Andres M. Lozano</name></author><author><name sortKey="Mazzone, Paolo A M" sort="Mazzone, Paolo A M" uniqKey="Mazzone P" first="Paolo A M" last="Mazzone">Paolo A M. Mazzone</name></author><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S" last="Okun">Michael S. Okun</name></author><author><name sortKey="Hutchison, William" sort="Hutchison, William" uniqKey="Hutchison W" first="William" last="Hutchison">William Hutchison</name></author><author><name sortKey="Silburn, Peter" sort="Silburn, Peter" uniqKey="Silburn P" first="Peter" last="Silburn">Peter Silburn</name></author><author><name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name></author><author><name sortKey="Alam, Mesbah" sort="Alam, Mesbah" uniqKey="Alam M" first="Mesbah" last="Alam">Mesbah Alam</name></author><author><name sortKey="Goetz, Laurent" sort="Goetz, Laurent" uniqKey="Goetz L" first="Laurent" last="Goetz">Laurent Goetz</name></author><author><name sortKey="Pereira, Erlick" sort="Pereira, Erlick" uniqKey="Pereira E" first="Erlick" last="Pereira">Erlick Pereira</name></author><author><name sortKey="Rughani, Anand" sort="Rughani, Anand" uniqKey="Rughani A" first="Anand" last="Rughani">Anand Rughani</name></author><author><name sortKey="Thevathasan, Wesley" sort="Thevathasan, Wesley" uniqKey="Thevathasan W" first="Wesley" last="Thevathasan">Wesley Thevathasan</name></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></author><author><name sortKey="Krauss, Joachim K" sort="Krauss, Joachim K" uniqKey="Krauss J" first="Joachim K" last="Krauss">Joachim K. Krauss</name></author></analytic><series><title level="j">Stereotactic and functional neurosurgery</title><idno type="eISSN">1423-0372</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Several lines of evidence over the last few years have been important in ascertaining that the pedunculopontine nucleus (PPN) region could be considered as a potential target for deep brain stimulation (DBS) to treat freezing and other problems as part of a spectrum of gait disorders in Parkinson disease and other akinetic movement disorders. Since the introduction of PPN DBS, a variety of clinical studies have been published. Most indicate improvements in freezing and falls in patients who are severely affected by these problems. The results across patients, however, have been variable, perhaps reflecting patient selection, heterogeneity in target selection and differences in surgical methodology and stimulation settings. Here we outline both the accumulated knowledge and the domains of uncertainty in surgical anatomy and terminology. Specific topics were assigned to groups of experts, and this work was accumulated and reviewed by the executive committee of the working group. Areas of disagreement were discussed and modified accordingly until a consensus could be reached. We demonstrate that both the anatomy and the functional role of the PPN region need further study. The borders of the PPN and of adjacent nuclei differ when different brainstem atlases and atlas slices are compared. It is difficult to delineate precisely the PPN pars dissipata from the nucleus cuneiformis, as these structures partially overlap. This lack of clarity contributes to the difficulty in targeting and determining the exact localization of the electrodes implanted in patients with akinetic gait disorders. Future clinical studies need to consider these issues.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">27723662</PMID><DateCreated><Year>2016</Year><Month>10</Month><Day>10</Day></DateCreated><DateRevised><Year>2017</Year><Month>04</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1423-0372</ISSN><JournalIssue CitedMedium="Internet"><Volume>94</Volume><Issue>5</Issue><PubDate><Year>2016</Year></PubDate></JournalIssue><Title>Stereotactic and functional neurosurgery</Title><ISOAbbreviation>Stereotact Funct Neurosurg</ISOAbbreviation></Journal><ArticleTitle>Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology.</ArticleTitle><Pagination><MedlinePgn>298-306</MedlinePgn></Pagination><Abstract><AbstractText>Several lines of evidence over the last few years have been important in ascertaining that the pedunculopontine nucleus (PPN) region could be considered as a potential target for deep brain stimulation (DBS) to treat freezing and other problems as part of a spectrum of gait disorders in Parkinson disease and other akinetic movement disorders. Since the introduction of PPN DBS, a variety of clinical studies have been published. Most indicate improvements in freezing and falls in patients who are severely affected by these problems. The results across patients, however, have been variable, perhaps reflecting patient selection, heterogeneity in target selection and differences in surgical methodology and stimulation settings. Here we outline both the accumulated knowledge and the domains of uncertainty in surgical anatomy and terminology. Specific topics were assigned to groups of experts, and this work was accumulated and reviewed by the executive committee of the working group. Areas of disagreement were discussed and modified accordingly until a consensus could be reached. We demonstrate that both the anatomy and the functional role of the PPN region need further study. The borders of the PPN and of adjacent nuclei differ when different brainstem atlases and atlas slices are compared. It is difficult to delineate precisely the PPN pars dissipata from the nucleus cuneiformis, as these structures partially overlap. This lack of clarity contributes to the difficulty in targeting and determining the exact localization of the electrodes implanted in patients with akinetic gait disorders. Future clinical studies need to consider these issues.</AbstractText><CopyrightInformation>© 2016 S. Karger AG, Basel.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hamani</LastName><ForeName>Clement</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont., Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aziz</LastName><ForeName>Tipu</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Bloem</LastName><ForeName>Bastiaan R</ForeName><Initials>BR</Initials></Author><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>Peter</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Chabardes</LastName><ForeName>Stephan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Coyne</LastName><ForeName>Terry</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Foote</LastName><ForeName>Kelly</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Garcia-Rill</LastName><ForeName>Edgar</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Hirsch</LastName><ForeName>Etienne C</ForeName><Initials>EC</Initials></Author><Author ValidYN="Y"><LastName>Lozano</LastName><ForeName>Andres M</ForeName><Initials>AM</Initials></Author><Author ValidYN="Y"><LastName>Mazzone</LastName><ForeName>Paolo A M</ForeName><Initials>PA</Initials></Author><Author ValidYN="Y"><LastName>Okun</LastName><ForeName>Michael S</ForeName><Initials>MS</Initials></Author><Author ValidYN="Y"><LastName>Hutchison</LastName><ForeName>William</ForeName><Initials>W</Initials></Author><Author ValidYN="Y"><LastName>Silburn</LastName><ForeName>Peter</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Zrinzo</LastName><ForeName>Ludvic</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Alam</LastName><ForeName>Mesbah</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Goetz</LastName><ForeName>Laurent</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Pereira</LastName><ForeName>Erlick</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Rughani</LastName><ForeName>Anand</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Thevathasan</LastName><ForeName>Wesley</ForeName><Initials>W</Initials></Author><Author ValidYN="Y"><LastName>Moro</LastName><ForeName>Elena</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Krauss</LastName><ForeName>Joachim K</ForeName><Initials>JK</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>G0901503</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>MC_UU_12024/1</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>10</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Stereotact Funct Neurosurg</MedlineTA><NlmUniqueID>8902881</NlmUniqueID><ISSNLinking>1011-6125</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Neuroscience. 1999 Mar;89(3):759-70</RefSource><PMID Version="1">10199611</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Sleep Res Online. 1998;1(1):62-70</RefSource><PMID Version="1">11382858</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Brain Res. 1994 Jun 6;647(2):299-306</RefSource><PMID Version="1">7922506</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Psychiatry Res. 1991 May;40(1):31-48</RefSource><PMID Version="1">1682969</PMID></CommentsCorrections><CommentsCorrections 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HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/RBID.i -Sk "pubmed:27723662" \
| HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a ParkinsonCanadaV1
| This area was generated with Dilib version V0.6.29. |  |