Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology
Identifieur interne : 003C85 ( Ncbi/Checkpoint ); précédent : 003C84; suivant : 003C86Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology
Auteurs : Clement Hamani [Canada] ; Tipu Aziz [Royaume-Uni] ; Bastiaan R. Bloem [Pays-Bas] ; Peter Brown [Royaume-Uni] ; Stephan Chabardes [France] ; Terry Coyne [Australie] ; Kelly Foote [États-Unis] ; Edgar Garcia-Rill [États-Unis] ; Etienne C. Hirsch [France] ; Andres M. Lozano [Canada] ; Paolo A. M. Mazzone [Italie] ; Michael S. Okun [États-Unis] ; William Hutchison [Canada] ; Peter Silburn [Australie] ; Ludvic Zrinzo [Royaume-Uni] ; Mesbah Alam [Allemagne] ; Laurent Goetz [France] ; Erlick Pereira [Royaume-Uni] ; Anand Rughani [Canada] ; Wesley Thevathasan [Australie] ; Elena Moro [France] ; Joachim K. Krauss [Allemagne]Source :
- Stereotactic and functional neurosurgery [ 1011-6125 ] ; 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.
Url:
DOI: 10.1159/000449010
PubMed: 27723662
PubMed Central: 5298183
Affiliations:
- Allemagne, Australie, Canada, France, Italie, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, Auvergne-Rhône-Alpes, Basse-Saxe, Grand Londres, Gueldre, Latium, Ontario, Oxfordshire, Rhône-Alpes, Victoria (État), Île-de-France
- Grenoble, Hanovre, Londres, Melbourne, Nimègue, Oxford, Paris, Rome, Toronto
- Université d'Oxford, Université de Melbourne, Université de Toronto
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<author><name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name>
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<country xml:lang="fr">France</country>
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<author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
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<wicri:regionArea>Department of Neurology-CHU, University Joseph Fourier, Grenoble</wicri:regionArea>
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<author><name sortKey="Krauss, Joachim K" sort="Krauss, Joachim K" uniqKey="Krauss J" first="Joachim K." last="Krauss">Joachim K. Krauss</name>
<affiliation wicri:level="3"><nlm:aff id="A14">Department of Neurosurgery, Medical School Hannover, Hannover, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurosurgery, Medical School Hannover, Hannover</wicri:regionArea>
<placeName><region type="land" nuts="2">Basse-Saxe</region>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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>
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<affiliation wicri:level="1"><nlm:aff id="A2">Research Imaging Centre, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ont., Canada</nlm:aff>
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<author><name sortKey="Aziz, Tipu" sort="Aziz, Tipu" uniqKey="Aziz T" first="Tipu" last="Aziz">Tipu Aziz</name>
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<author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R." last="Bloem">Bastiaan R. Bloem</name>
<affiliation wicri:level="3"><nlm:aff id="A4">Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Neurology, Radboud University Medical Center, Nijmegen</wicri:regionArea>
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</placeName>
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<author><name sortKey="Brown, Peter" sort="Brown, Peter" uniqKey="Brown P" first="Peter" last="Brown">Peter Brown</name>
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<wicri:regionArea>Department of Clinical Neurology, John Radcliffe Hospital, University of Oxford, Oxford</wicri:regionArea>
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<author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name>
<affiliation wicri:level="3"><nlm:aff id="A6">Department of Neurosurgery-CHU, Grenoble Institute of Neurosciences-INSERM U836 CEA-UJF-CHU, University Joseph Fourier, Grenoble, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Neurosurgery-CHU, Grenoble Institute of Neurosciences-INSERM U836 CEA-UJF-CHU, University Joseph Fourier, Grenoble</wicri:regionArea>
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<author><name sortKey="Coyne, Terry" sort="Coyne, Terry" uniqKey="Coyne T" first="Terry" last="Coyne">Terry Coyne</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Centre for Clinical Research, University of Queensland, Brisbane, Qld., Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Centre for Clinical Research, University of Queensland, Brisbane, Qld.</wicri:regionArea>
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<author><name sortKey="Foote, Kelly" sort="Foote, Kelly" uniqKey="Foote K" first="Kelly" last="Foote">Kelly Foote</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Department of Neurosurgery, University of Florida, Gainesville, Fla, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurosurgery, University of Florida, Gainesville, Fla</wicri:regionArea>
<wicri:noRegion>Fla</wicri:noRegion>
</affiliation>
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<author><name sortKey="Garcia Rill, Edgar" sort="Garcia Rill, Edgar" uniqKey="Garcia Rill E" first="Edgar" last="Garcia-Rill">Edgar Garcia-Rill</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Department of Anatomy and Neurobiology, University of Arkansas for Medical Sciences, Little Rock, Ark., USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Anatomy and Neurobiology, University of Arkansas for Medical Sciences, Little Rock, Ark.</wicri:regionArea>
<wicri:noRegion>Ark.</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hirsch, Etienne C" sort="Hirsch, Etienne C" uniqKey="Hirsch E" first="Etienne C." last="Hirsch">Etienne C. Hirsch</name>
<affiliation wicri:level="3"><nlm:aff id="A9">Institut du Cerveau et de la Moelle épinière, ICM, Inserm, CNRS, UMR 7225, Sorbonne Universités, UPMC Université, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut du Cerveau et de la Moelle épinière, ICM, Inserm, CNRS, UMR 7225, Sorbonne Universités, UPMC Université, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont., Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont.</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</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>
<affiliation wicri:level="3"><nlm:aff id="A10">OU for Stereotactic and Functional Neurosurgery, ASLRMC – CTO Hospital, Rome, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>OU for Stereotactic and Functional Neurosurgery, ASLRMC – CTO Hospital, Rome</wicri:regionArea>
<placeName><settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name>
<affiliation wicri:level="1"><nlm:aff id="A11">University of Florida Center for Movement Disorders, Departments of Neurology and Neurosurgery, Gainesville, Fla., USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Florida Center for Movement Disorders, Departments of Neurology and Neurosurgery, Gainesville, Fla.</wicri:regionArea>
<wicri:noRegion>Fla.</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hutchison, William" sort="Hutchison, William" uniqKey="Hutchison W" first="William" last="Hutchison">William Hutchison</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont., Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont.</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Silburn, Peter" sort="Silburn, Peter" uniqKey="Silburn P" first="Peter" last="Silburn">Peter Silburn</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Centre for Clinical Research, University of Queensland, Brisbane, Qld., Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Centre for Clinical Research, University of Queensland, Brisbane, Qld.</wicri:regionArea>
<wicri:noRegion>Qld.</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name>
<affiliation wicri:level="3"><nlm:aff id="A13">Unit of Functional Neurosurgery, UCL Institute of Neurology, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Unit of Functional Neurosurgery, UCL Institute of Neurology, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Alam, Mesbah" sort="Alam, Mesbah" uniqKey="Alam M" first="Mesbah" last="Alam">Mesbah Alam</name>
<affiliation wicri:level="3"><nlm:aff id="A14">Department of Neurosurgery, Medical School Hannover, Hannover, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurosurgery, Medical School Hannover, Hannover</wicri:regionArea>
<placeName><region type="land" nuts="2">Basse-Saxe</region>
<settlement type="city">Hanovre</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Goetz, Laurent" sort="Goetz, Laurent" uniqKey="Goetz L" first="Laurent" last="Goetz">Laurent Goetz</name>
<affiliation wicri:level="3"><nlm:aff id="A6">Department of Neurosurgery-CHU, Grenoble Institute of Neurosciences-INSERM U836 CEA-UJF-CHU, University Joseph Fourier, Grenoble, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Neurosurgery-CHU, Grenoble Institute of Neurosciences-INSERM U836 CEA-UJF-CHU, University Joseph Fourier, Grenoble</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Grenoble</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Pereira, Erlick" sort="Pereira, Erlick" uniqKey="Pereira E" first="Erlick" last="Pereira">Erlick Pereira</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
</author>
<author><name sortKey="Rughani, Anand" sort="Rughani, Anand" uniqKey="Rughani A" first="Anand" last="Rughani">Anand Rughani</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont., Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ont.</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Thevathasan, Wesley" sort="Thevathasan, Wesley" uniqKey="Thevathasan W" first="Wesley" last="Thevathasan">Wesley Thevathasan</name>
<affiliation wicri:level="4"><nlm:aff id="A15">Melbourne Brain Centre, Department of Medicine, University of Melbourne, Melbourne, Vic., Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Melbourne Brain Centre, Department of Medicine, University of Melbourne, Melbourne, Vic.</wicri:regionArea>
<orgName type="university">Université de Melbourne</orgName>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A16">Bionics Institute of Australia, Melbourne, Vic., Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Bionics Institute of Australia, Melbourne, Vic.</wicri:regionArea>
<wicri:noRegion>Vic.</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
<affiliation wicri:level="3"><nlm:aff id="A17">Department of Neurology-CHU, University Joseph Fourier, Grenoble, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Neurology-CHU, University Joseph Fourier, Grenoble</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Grenoble</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Krauss, Joachim K" sort="Krauss, Joachim K" uniqKey="Krauss J" first="Joachim K." last="Krauss">Joachim K. Krauss</name>
<affiliation wicri:level="3"><nlm:aff id="A14">Department of Neurosurgery, Medical School Hannover, Hannover, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurosurgery, Medical School Hannover, Hannover</wicri:regionArea>
<placeName><region type="land" nuts="2">Basse-Saxe</region>
<settlement type="city">Hanovre</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Stereotactic and functional neurosurgery</title>
<idno type="ISSN">1011-6125</idno>
<idno type="eISSN">1423-0372</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p id="P2">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.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Australie</li>
<li>Canada</li>
<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Auvergne-Rhône-Alpes</li>
<li>Basse-Saxe</li>
<li>Grand Londres</li>
<li>Gueldre</li>
<li>Latium</li>
<li>Ontario</li>
<li>Oxfordshire</li>
<li>Rhône-Alpes</li>
<li>Victoria (État)</li>
<li>Île-de-France</li>
</region>
<settlement><li>Grenoble</li>
<li>Hanovre</li>
<li>Londres</li>
<li>Melbourne</li>
<li>Nimègue</li>
<li>Oxford</li>
<li>Paris</li>
<li>Rome</li>
<li>Toronto</li>
</settlement>
<orgName><li>Université d'Oxford</li>
<li>Université de Melbourne</li>
<li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="Canada"><region name="Ontario"><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name>
</region>
<name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name>
<name sortKey="Hutchison, William" sort="Hutchison, William" uniqKey="Hutchison W" first="William" last="Hutchison">William Hutchison</name>
<name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
<name sortKey="Rughani, Anand" sort="Rughani, Anand" uniqKey="Rughani A" first="Anand" last="Rughani">Anand Rughani</name>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Aziz, Tipu" sort="Aziz, Tipu" uniqKey="Aziz T" first="Tipu" last="Aziz">Tipu Aziz</name>
</region>
<name sortKey="Brown, Peter" sort="Brown, Peter" uniqKey="Brown P" first="Peter" last="Brown">Peter Brown</name>
<name sortKey="Pereira, Erlick" sort="Pereira, Erlick" uniqKey="Pereira E" first="Erlick" last="Pereira">Erlick Pereira</name>
<name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name>
</country>
<country name="Pays-Bas"><region name="Gueldre"><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R." last="Bloem">Bastiaan R. Bloem</name>
</region>
</country>
<country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name>
</region>
<name sortKey="Goetz, Laurent" sort="Goetz, Laurent" uniqKey="Goetz L" first="Laurent" last="Goetz">Laurent Goetz</name>
<name sortKey="Hirsch, Etienne C" sort="Hirsch, Etienne C" uniqKey="Hirsch E" first="Etienne C." last="Hirsch">Etienne C. Hirsch</name>
<name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
</country>
<country name="Australie"><noRegion><name sortKey="Coyne, Terry" sort="Coyne, Terry" uniqKey="Coyne T" first="Terry" last="Coyne">Terry Coyne</name>
</noRegion>
<name sortKey="Silburn, Peter" sort="Silburn, Peter" uniqKey="Silburn P" first="Peter" last="Silburn">Peter Silburn</name>
<name sortKey="Thevathasan, Wesley" sort="Thevathasan, Wesley" uniqKey="Thevathasan W" first="Wesley" last="Thevathasan">Wesley Thevathasan</name>
<name sortKey="Thevathasan, Wesley" sort="Thevathasan, Wesley" uniqKey="Thevathasan W" first="Wesley" last="Thevathasan">Wesley Thevathasan</name>
</country>
<country name="États-Unis"><noRegion><name sortKey="Foote, Kelly" sort="Foote, Kelly" uniqKey="Foote K" first="Kelly" last="Foote">Kelly Foote</name>
</noRegion>
<name sortKey="Garcia Rill, Edgar" sort="Garcia Rill, Edgar" uniqKey="Garcia Rill E" first="Edgar" last="Garcia-Rill">Edgar Garcia-Rill</name>
<name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name>
</country>
<country name="Italie"><region name="Latium"><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>
</region>
</country>
<country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Alam, Mesbah" sort="Alam, Mesbah" uniqKey="Alam M" first="Mesbah" last="Alam">Mesbah Alam</name>
</region>
<name sortKey="Krauss, Joachim K" sort="Krauss, Joachim K" uniqKey="Krauss J" first="Joachim K." last="Krauss">Joachim K. Krauss</name>
</country>
</tree>
</affiliations>
</record>
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