Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease
Identifieur interne : 002503 ( Istex/Curation ); précédent : 002502; suivant : 002504Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease
Auteurs : M. U. Ferraye [France] ; B. Deb [France] ; V. Fraix [France] ; L. Goetz [France] ; C. Ardouin [France] ; J. Yelnik [France] ; C. Henry-Lagrange [France] ; E. Seigneuret [France] ; B. Piallat [France] ; P. Krack [France] ; J.-F. Le Bas [France] ; A.-L. Benabid [France] ; S. Chabards [France] ; P. Pollak [France]Source :
- Brain [ 0006-8950 ] ; 2010-01.
Abstract
Gait disturbances are frequent and disabling in advanced Parkinson's disease. These symptoms respond poorly to usual medical and surgical treatments but were reported to be improved by stimulation of the pedunculopontine nucleus. We studied the effects of stimulating the pedunculopontine nucleus area in six patients with severe freezing of gait, unresponsive to levodopa and subthalamic nucleus stimulation. Electrodes were implanted bilaterally in the pedunculopontine nucleus area. Electrode placement was checked by postoperative magnetic resonance imaging. The primary outcome measures were a composite gait score, freezing of gait questionnaire score and duration of freezing episodes occurring during a walking protocol at baseline and one-year follow-up. A double-blind cross-over study was carried out from months 4 to 6 after surgery with or without pedunculopontine nucleus area stimulation. At one-year follow-up, the duration of freezing episodes under off-drug condition improved, as well as falls related to freezing. The other primary outcome measures did not significantly change, nor did the results during the double-blind evaluation. Individual results showed major improvement of all gait measures in one patient, moderate improvement of some tests in four patients and global worsening in one patient. Stimulation frequency ranged between 15 and 25 Hz. Oscillopsia and limb myoclonus could hinder voltage increase. No serious adverse events occurred. Although freezing of gait can be improved by low-frequency electrical stimulation of the pedunculopontine nucleus area in some patients with Parkinson's disease our overall results are disappointing compared to the high levels of expectation raised by previous open label studies. Further controlled studies are needed to determine whether optimization of patient selection, targeting and setting of stimulation parameters might improve the outcome to a point that could transform this experimental approach to a treatment with a reasonable riskbenefit ratio.
Url:
DOI: 10.1093/brain/awp229
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: Pour aller vers cette notice dans l'étape Curation :002505
Links to Exploration step
ISTEX:8CD3E269DDE0A53AB7BE2EBA33B1CF022C12187ELe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease</title><author><name sortKey="Ferraye, M U" sort="Ferraye, M U" uniqKey="Ferraye M" first="M. U." last="Ferraye">M. U. Ferraye</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Deb, B" sort="Deb, B" uniqKey="Deb B" first="B." last="Deb">B. Deb</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: Bettina.Debu@ujf-grenoble.fr</mods:affiliation><country wicri:rule="url">France</country></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Goetz, L" sort="Goetz, L" uniqKey="Goetz L" first="L." last="Goetz">L. Goetz</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C." last="Ardouin">C. Ardouin</name><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Yelnik, J" sort="Yelnik, J" uniqKey="Yelnik J" first="J." last="Yelnik">J. Yelnik</name><affiliation wicri:level="1"><mods:affiliation>4 INSERM UMR_S975, Fdration de Neurologie, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>4 INSERM UMR_S975, Fdration de Neurologie, Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>5 University Pierre et Marie Curie, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>5 University Pierre et Marie Curie, Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>6 Hpital de la Piti-Salptrire, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>6 Hpital de la Piti-Salptrire, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Henry Lagrange, C" sort="Henry Lagrange, C" uniqKey="Henry Lagrange C" first="C." last="Henry-Lagrange">C. Henry-Lagrange</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Seigneuret, E" sort="Seigneuret, E" uniqKey="Seigneuret E" first="E." last="Seigneuret">E. Seigneuret</name><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Piallat, B" sort="Piallat, B" uniqKey="Piallat B" first="B." last="Piallat">B. Piallat</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P." last="Krack">P. Krack</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Le Bas, J F" sort="Le Bas, J F" uniqKey="Le Bas J" first="J.-F." last="Le Bas">J.-F. Le Bas</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Chabards, S" sort="Chabards, S" uniqKey="Chabards S" first="S." last="Chabards">S. Chabards</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:8CD3E269DDE0A53AB7BE2EBA33B1CF022C12187E</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1093/brain/awp229</idno><idno type="url">https://api.istex.fr/document/8CD3E269DDE0A53AB7BE2EBA33B1CF022C12187E/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002505</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002505</idno><idno type="wicri:Area/Istex/Curation">002503</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease</title><author><name sortKey="Ferraye, M U" sort="Ferraye, M U" uniqKey="Ferraye M" first="M. U." last="Ferraye">M. U. Ferraye</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Deb, B" sort="Deb, B" uniqKey="Deb B" first="B." last="Deb">B. Deb</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: Bettina.Debu@ujf-grenoble.fr</mods:affiliation><country wicri:rule="url">France</country></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Goetz, L" sort="Goetz, L" uniqKey="Goetz L" first="L." last="Goetz">L. Goetz</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C." last="Ardouin">C. Ardouin</name><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Yelnik, J" sort="Yelnik, J" uniqKey="Yelnik J" first="J." last="Yelnik">J. Yelnik</name><affiliation wicri:level="1"><mods:affiliation>4 INSERM UMR_S975, Fdration de Neurologie, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>4 INSERM UMR_S975, Fdration de Neurologie, Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>5 University Pierre et Marie Curie, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>5 University Pierre et Marie Curie, Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>6 Hpital de la Piti-Salptrire, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>6 Hpital de la Piti-Salptrire, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Henry Lagrange, C" sort="Henry Lagrange, C" uniqKey="Henry Lagrange C" first="C." last="Henry-Lagrange">C. Henry-Lagrange</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Seigneuret, E" sort="Seigneuret, E" uniqKey="Seigneuret E" first="E." last="Seigneuret">E. Seigneuret</name><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Piallat, B" sort="Piallat, B" uniqKey="Piallat B" first="B." last="Piallat">B. Piallat</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P." last="Krack">P. Krack</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Le Bas, J F" sort="Le Bas, J F" uniqKey="Le Bas J" first="J.-F." last="Le Bas">J.-F. Le Bas</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Chabards, S" sort="Chabards, S" uniqKey="Chabards S" first="S." last="Chabards">S. Chabards</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation wicri:level="1"><mods:affiliation>1 University of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>1 University of Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>2 INSERM, U836, Grenoble Institute of Neuroscience, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>2 INSERM, U836, Grenoble Institute of Neuroscience</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>3 University Hospital of Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>3 University Hospital of Grenoble</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2010-01">2010-01</date><biblScope unit="volume">133</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="205">205</biblScope><biblScope unit="page" to="214">214</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">8CD3E269DDE0A53AB7BE2EBA33B1CF022C12187E</idno><idno type="DOI">10.1093/brain/awp229</idno><idno type="ArticleID">awp229</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Gait disturbances are frequent and disabling in advanced Parkinson's disease. These symptoms respond poorly to usual medical and surgical treatments but were reported to be improved by stimulation of the pedunculopontine nucleus. We studied the effects of stimulating the pedunculopontine nucleus area in six patients with severe freezing of gait, unresponsive to levodopa and subthalamic nucleus stimulation. Electrodes were implanted bilaterally in the pedunculopontine nucleus area. Electrode placement was checked by postoperative magnetic resonance imaging. The primary outcome measures were a composite gait score, freezing of gait questionnaire score and duration of freezing episodes occurring during a walking protocol at baseline and one-year follow-up. A double-blind cross-over study was carried out from months 4 to 6 after surgery with or without pedunculopontine nucleus area stimulation. At one-year follow-up, the duration of freezing episodes under off-drug condition improved, as well as falls related to freezing. The other primary outcome measures did not significantly change, nor did the results during the double-blind evaluation. Individual results showed major improvement of all gait measures in one patient, moderate improvement of some tests in four patients and global worsening in one patient. Stimulation frequency ranged between 15 and 25 Hz. Oscillopsia and limb myoclonus could hinder voltage increase. No serious adverse events occurred. Although freezing of gait can be improved by low-frequency electrical stimulation of the pedunculopontine nucleus area in some patients with Parkinson's disease our overall results are disappointing compared to the high levels of expectation raised by previous open label studies. Further controlled studies are needed to determine whether optimization of patient selection, targeting and setting of stimulation parameters might improve the outcome to a point that could transform this experimental approach to a treatment with a reasonable riskbenefit ratio.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonFranceV1/Data/Istex/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002503 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Curation/biblio.hfd -nk 002503 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonFranceV1
|flux= Istex
|étape= Curation
|type= RBID
|clé= ISTEX:8CD3E269DDE0A53AB7BE2EBA33B1CF022C12187E
|texte= Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease
}}
| This area was generated with Dilib version V0.6.29. |  |