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.

Galazky, Imke; Kaufmann, Jörn; Heinze, Hans-Jochen; Zaehle, Tino; Ebersbach, Georg; Lorenzl, Stefan; Wirkus, Edyta; Specht, Sylke; Casjens, Franziska; Kupsch, Andreas; Sobieray, Uwe; Gandor, Florin; Stallforth, Sabine; Voges, Jürgen

doi:10.1016/j.parkreldis.2018.02.027

Items
Marc 21

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024	7	_	\|a 10.1016/j.parkreldis.2018.02.027 \|2 doi
024	7	_	\|a pmid:29503154 \|2 pmid
024	7	_	\|a 1353-8020 \|2 ISSN
024	7	_	\|a 1873-5126 \|2 ISSN
024	7	_	\|a altmetric:34248018 \|2 altmetric
037	_	_	\|a DZNE-2020-06292
041	_	_	\|a English
082	_	_	\|a 610
100	1	_	\|a Galazky, Imke \|0 P:(DE-HGF)0 \|b 0 \|e Corresponding author
245	_	_	\|a 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.
260	_	_	\|a Amsterdam [u.a.] \|c 2018 \|b Elsevier Science
264	_	1	\|3 print \|2 Crossref \|b Elsevier BV \|c 2018-05-01
336	7	_	\|a article \|2 DRIVER
336	7	_	\|a Output Types/Journal article \|2 DataCite
336	7	_	\|a Journal Article \|b journal \|m journal \|0 PUB:(DE-HGF)16 \|s 1705935691_13659 \|2 PUB:(DE-HGF)
336	7	_	\|a ARTICLE \|2 BibTeX
336	7	_	\|a JOURNAL_ARTICLE \|2 ORCID
336	7	_	\|a Journal Article \|0 0 \|2 EndNote
520	_	_	\|a 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.
536	_	_	\|a 344 - Clinical and Health Care Research (POF3-344) \|0 G:(DE-HGF)POF3-344 \|c POF3-344 \|f POF III \|x 0
542	_	_	\|i 2018-05-01 \|2 Crossref \|u https://www.elsevier.com/tdm/userlicense/1.0/
588	_	_	\|a Dataset connected to CrossRef, PubMed,
650	_	7	\|a Deep brain stimulation \|2 Other
650	_	7	\|a Gait \|2 Other
650	_	7	\|a Parkinsonian disorders \|2 Other
650	_	7	\|a Pedunculopontine nucleus \|2 Other
650	_	7	\|a Progressive supranuclear palsy \|2 Other
650	_	7	\|a Quality of life \|2 Other
650	_	2	\|a Accidental Falls: prevention & control \|2 MeSH
650	_	2	\|a Activities of Daily Living \|2 MeSH
650	_	2	\|a Aged \|2 MeSH
650	_	2	\|a Cognitive Dysfunction: etiology \|2 MeSH
650	_	2	\|a Cognitive Dysfunction: therapy \|2 MeSH
650	_	2	\|a Deep Brain Stimulation: methods \|2 MeSH
650	_	2	\|a Female \|2 MeSH
650	_	2	\|a Gait Disorders, Neurologic: etiology \|2 MeSH
650	_	2	\|a Gait Disorders, Neurologic: therapy \|2 MeSH
650	_	2	\|a Humans \|2 MeSH
650	_	2	\|a Hypokinesia: etiology \|2 MeSH
650	_	2	\|a Hypokinesia: therapy \|2 MeSH
650	_	2	\|a Male \|2 MeSH
650	_	2	\|a Outcome Assessment, Health Care \|2 MeSH
650	_	2	\|a Pedunculopontine Tegmental Nucleus \|2 MeSH
650	_	2	\|a Postural Balance \|2 MeSH
650	_	2	\|a Quality of Life \|2 MeSH
650	_	2	\|a Supranuclear Palsy, Progressive: complications \|2 MeSH
650	_	2	\|a Supranuclear Palsy, Progressive: therapy \|2 MeSH
700	1	_	\|a Kaufmann, Jörn \|b 1
700	1	_	\|a Lorenzl, Stefan \|b 2
700	1	_	\|a Ebersbach, Georg \|b 3
700	1	_	\|a Gandor, Florin \|b 4
700	1	_	\|a Zaehle, Tino \|0 P:(DE-HGF)0 \|b 5
700	1	_	\|a Specht, Sylke \|b 6
700	1	_	\|a Stallforth, Sabine \|b 7
700	1	_	\|a Sobieray, Uwe \|0 P:(DE-2719)2761749 \|b 8 \|u dzne
700	1	_	\|a Wirkus, Edyta \|b 9
700	1	_	\|a Casjens, Franziska \|b 10
700	1	_	\|a Heinze, Hans-Jochen \|0 P:(DE-2719)2260426 \|b 11 \|u dzne
700	1	_	\|a Kupsch, Andreas \|b 12
700	1	_	\|a Voges, Jürgen \|0 P:(DE-2719)9000330 \|b 13 \|e Last author \|u dzne
773	1	8	\|a 10.1016/j.parkreldis.2018.02.027 \|b : Elsevier BV, 2018-05-01 \|p 81-86 \|3 journal-article \|2 Crossref \|t Parkinsonism & Related Disorders \|v 50 \|y 2018 \|x 1353-8020
773	_	_	\|a 10.1016/j.parkreldis.2018.02.027 \|g Vol. 50, p. 81 - 86 \|0 PERI:(DE-600)2027635-7 \|q 50<81 - 86 \|p 81-86 \|t Parkinsonism & related disorders \|v 50 \|y 2018 \|x 1353-8020
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Marc 21

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