TY  - JOUR
AU  - Galazky, Imke
AU  - Kaufmann, Jörn
AU  - Lorenzl, Stefan
AU  - Ebersbach, Georg
AU  - Gandor, Florin
AU  - Zaehle, Tino
AU  - Specht, Sylke
AU  - Stallforth, Sabine
AU  - Sobieray, Uwe
AU  - Wirkus, Edyta
AU  - Casjens, Franziska
AU  - Heinze, Hans-Jochen
AU  - Kupsch, Andreas
AU  - Voges, Jürgen
TI  - Deep brain stimulation of the pedunculopontine nucleus for treatment of gait and balance disorder in progressive supranuclear palsy: Effects of frequency modulations and clinical outcome.
JO  - Parkinsonism & related disorders
VL  - 50
SN  - 1353-8020
CY  - Amsterdam [u.a.]
PB  - Elsevier Science
M1  - DZNE-2020-06292
SP  - 81-86
PY  - 2018
AB  - The pedunculopontine nucleus has been suggested as a potential deep brain stimulation target for axial symptoms such as gait and balance impairment in idiopathic Parkinson's disease as well as atypical Parkinsonian disorders.Seven consecutive patients with progressive supranuclear palsy received bilateral pedunculopontine nucleus deep brain stimulation. Inclusion criteria comprised of the clinical diagnosis of progressive supranuclear palsy, a levodopa-resistant gait and balance disorder, age <75 years, and absence of dementia or major psychiatric co-morbidities. Effects of stimulation frequencies at 8, 20, 60 and 130 Hz on motor scores and gait were assessed. Motor scores were followed up for two years postoperatively. Activities of daily living, frequency of falls, health-related quality of life, cognition and mood at 12 months were compared to baseline parameters. Surgical and stimulation related adverse events were assessed.Bilateral pedunculopontine nucleus deep brain stimulation at 8 Hz significantly improved axial motor symptoms and cyclic gait parameters, while high frequency stimulation did not ameliorate gait and balance but improved hypokinesia. This improvement however did not translate into clinically relevant benefits. Frequency of falls was not reduced. Activities of daily living, quality of life and frontal cognitive functions declined, while mood remained unchanged.Bilateral pedunculopontine nucleus deep brain stimulation in progressive supranuclear palsy generates frequency-dependent effects with improvement of cyclic gait parameters at low frequency and amelioration of hypokinesia at high frequency stimulation. However, these effects do not translate into a clinically important improvement.
KW  - Accidental Falls: prevention & control
KW  - Activities of Daily Living
KW  - Aged
KW  - Cognitive Dysfunction: etiology
KW  - Cognitive Dysfunction: therapy
KW  - Deep Brain Stimulation: methods
KW  - Female
KW  - Gait Disorders, Neurologic: etiology
KW  - Gait Disorders, Neurologic: therapy
KW  - Humans
KW  - Hypokinesia: etiology
KW  - Hypokinesia: therapy
KW  - Male
KW  - Outcome Assessment, Health Care
KW  - Pedunculopontine Tegmental Nucleus
KW  - Postural Balance
KW  - Quality of Life
KW  - Supranuclear Palsy, Progressive: complications
KW  - Supranuclear Palsy, Progressive: therapy
KW  - Deep brain stimulation (Other)
KW  - Gait (Other)
KW  - Parkinsonian disorders (Other)
KW  - Pedunculopontine nucleus (Other)
KW  - Progressive supranuclear palsy (Other)
KW  - Quality of life (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:29503154
DO  - DOI:10.1016/j.parkreldis.2018.02.027
UR  - https://pub.dzne.de/record/139970
ER  -