Unilateral pedunculopontine stimulation improves falls in Parkinson's disease.
Identifieur interne : 000D86 ( PubMed/Curation ); précédent : 000D85; suivant : 000D87Unilateral pedunculopontine stimulation improves falls in Parkinson's disease.
Auteurs : Elena Moro ; Clement Hamani ; Yu-Yan Poon ; Thamar Al-Khairallah ; Jonathan O. Dostrovsky ; William D. Hutchison ; Andres M. LozanoSource :
- Brain : a journal of neurology [ 1460-2156 ] ; 2010.
English descriptors
- KwdEn :
- Accidental Falls (prevention & control), Aged, Deep Brain Stimulation (methods), Double-Blind Method, Female, Humans, Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Pedunculopontine Tegmental Nucleus (physiology), Pilot Projects, Postural Balance (physiology).
- MESH :
- complications : Parkinson Disease.
- methods : Deep Brain Stimulation.
- physiology : Pedunculopontine Tegmental Nucleus, Postural Balance.
- physiopathology : Parkinson Disease.
- prevention & control : Accidental Falls.
- therapy : Parkinson Disease.
- Aged, Double-Blind Method, Female, Humans, Male, Middle Aged, Pilot Projects.
Abstract
Postural instability and falls are a major source of disability in patients with advanced Parkinson's disease. These problems are currently not well addressed by either pharmacotherapy nor by subthalamic nucleus deep-brain stimulation surgery. The neuroanatomical substrates of posture and gait are poorly understood but a number of important observations suggest a major role for the pedunculopontine nucleus and adjacent areas in the brainstem. We conducted a double-blinded evaluation of unilateral pedunculopontine nucleus deep-brain stimulation in a pilot study in six advanced Parkinson's disease patients with significant gait and postural abnormalities. There was no significant difference in the double-blinded on versus off stimulation Unified Parkinson's Disease Rating Scale motor scores after 3 or 12 months of continuous stimulation and no improvements in the Unified Parkinson's Disease Rating Scale part III scores compared to baseline. In contrast, patients reported a significant reduction in falls in the on and off medication states both at 3 and 12 months after pedunculopontine nucleus deep-brain stimulation as captured in the Unified Parkinson's Disease Rating Scale part II scores. Our results suggest that pedunculopontine nucleus deep-brain stimulation may be effective in preventing falls in patients with advanced Parkinson's disease but that further evaluation of this procedure is required.
DOI: 10.1093/brain/awp261
PubMed: 19846583
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Elena Moro<affiliation><nlm:affiliation>Division of Neurosurgery, 4-447 Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8 Canada.</nlm:affiliation><wicri:noCountry code="subField">M5T 2S8 Canada</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Unilateral pedunculopontine stimulation improves falls in Parkinson's disease.</title><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><nlm:affiliation>Division of Neurosurgery, 4-447 Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8 Canada.</nlm:affiliation><wicri:noCountry code="subField">M5T 2S8 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></author><author><name sortKey="Al Khairallah, Thamar" sort="Al Khairallah, Thamar" uniqKey="Al Khairallah T" first="Thamar" last="Al-Khairallah">Thamar Al-Khairallah</name></author><author><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O" last="Dostrovsky">Jonathan O. Dostrovsky</name></author><author><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D" last="Hutchison">William D. Hutchison</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></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="RBID">pubmed:19846583</idno><idno type="pmid">19846583</idno><idno type="doi">10.1093/brain/awp261</idno><idno type="wicri:Area/PubMed/Corpus">000D86</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000D86</idno><idno type="wicri:Area/PubMed/Curation">000D86</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000D86</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Unilateral pedunculopontine stimulation improves falls in Parkinson's disease.</title><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><nlm:affiliation>Division of Neurosurgery, 4-447 Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8 Canada.</nlm:affiliation><wicri:noCountry code="subField">M5T 2S8 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></author><author><name sortKey="Al Khairallah, Thamar" sort="Al Khairallah, Thamar" uniqKey="Al Khairallah T" first="Thamar" last="Al-Khairallah">Thamar Al-Khairallah</name></author><author><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O" last="Dostrovsky">Jonathan O. Dostrovsky</name></author><author><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D" last="Hutchison">William D. Hutchison</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></analytic><series><title level="j">Brain : a journal of neurology</title><idno type="eISSN">1460-2156</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (prevention & control)</term><term>Aged</term><term>Deep Brain Stimulation (methods)</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Pedunculopontine Tegmental Nucleus (physiology)</term><term>Pilot Projects</term><term>Postural Balance (physiology)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Pedunculopontine Tegmental Nucleus</term><term>Postural Balance</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Accidental Falls</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pilot Projects</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Postural instability and falls are a major source of disability in patients with advanced Parkinson's disease. These problems are currently not well addressed by either pharmacotherapy nor by subthalamic nucleus deep-brain stimulation surgery. The neuroanatomical substrates of posture and gait are poorly understood but a number of important observations suggest a major role for the pedunculopontine nucleus and adjacent areas in the brainstem. We conducted a double-blinded evaluation of unilateral pedunculopontine nucleus deep-brain stimulation in a pilot study in six advanced Parkinson's disease patients with significant gait and postural abnormalities. There was no significant difference in the double-blinded on versus off stimulation Unified Parkinson's Disease Rating Scale motor scores after 3 or 12 months of continuous stimulation and no improvements in the Unified Parkinson's Disease Rating Scale part III scores compared to baseline. In contrast, patients reported a significant reduction in falls in the on and off medication states both at 3 and 12 months after pedunculopontine nucleus deep-brain stimulation as captured in the Unified Parkinson's Disease Rating Scale part II scores. Our results suggest that pedunculopontine nucleus deep-brain stimulation may be effective in preventing falls in patients with advanced Parkinson's disease but that further evaluation of this procedure is required.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">19846583</PMID><DateCreated><Year>2010</Year><Month>01</Month><Day>05</Day></DateCreated><DateCompleted><Year>2010</Year><Month>02</Month><Day>12</Day></DateCompleted><DateRevised><Year>2010</Year><Month>04</Month><Day>05</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1460-2156</ISSN><JournalIssue CitedMedium="Internet"><Volume>133</Volume><Issue>Pt 1</Issue><PubDate><Year>2010</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Brain : a journal of neurology</Title><ISOAbbreviation>Brain</ISOAbbreviation></Journal><ArticleTitle>Unilateral pedunculopontine stimulation improves falls in Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>215-24</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/brain/awp261</ELocationID><Abstract><AbstractText>Postural instability and falls are a major source of disability in patients with advanced Parkinson's disease. These problems are currently not well addressed by either pharmacotherapy nor by subthalamic nucleus deep-brain stimulation surgery. The neuroanatomical substrates of posture and gait are poorly understood but a number of important observations suggest a major role for the pedunculopontine nucleus and adjacent areas in the brainstem. We conducted a double-blinded evaluation of unilateral pedunculopontine nucleus deep-brain stimulation in a pilot study in six advanced Parkinson's disease patients with significant gait and postural abnormalities. There was no significant difference in the double-blinded on versus off stimulation Unified Parkinson's Disease Rating Scale motor scores after 3 or 12 months of continuous stimulation and no improvements in the Unified Parkinson's Disease Rating Scale part III scores compared to baseline. In contrast, patients reported a significant reduction in falls in the on and off medication states both at 3 and 12 months after pedunculopontine nucleus deep-brain stimulation as captured in the Unified Parkinson's Disease Rating Scale part II scores. Our results suggest that pedunculopontine nucleus deep-brain stimulation may be effective in preventing falls in patients with advanced Parkinson's disease but that further evaluation of this procedure is required.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Moro</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Division of Neurosurgery, 4-447 Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8 Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hamani</LastName><ForeName>Clement</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Poon</LastName><ForeName>Yu-Yan</ForeName><Initials>YY</Initials></Author><Author ValidYN="Y"><LastName>Al-Khairallah</LastName><ForeName>Thamar</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Dostrovsky</LastName><ForeName>Jonathan O</ForeName><Initials>JO</Initials></Author><Author ValidYN="Y"><LastName>Hutchison</LastName><ForeName>William D</ForeName><Initials>WD</Initials></Author><Author ValidYN="Y"><LastName>Lozano</LastName><ForeName>Andres M</ForeName><Initials>AM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2009</Year><Month>10</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Brain</MedlineTA><NlmUniqueID>0372537</NlmUniqueID><ISSNLinking>0006-8950</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Neurol. 2010 Apr;257(4):683-5</RefSource><PMID Version="1">20300764</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000058" MajorTopicYN="N">Accidental Falls</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D046690" MajorTopicYN="N">Deep Brain Stimulation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004311" MajorTopicYN="N">Double-Blind Method</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D045042" MajorTopicYN="N">Pedunculopontine Tegmental Nucleus</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004856" MajorTopicYN="N">Postural Balance</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year><Month>10</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2009</Year><Month>10</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>2</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">19846583</ArticleId><ArticleId IdType="pii">awp261</ArticleId><ArticleId IdType="doi">10.1093/brain/awp261</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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