Journal Article

DZNE-2020-06292

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png 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, I. (Corresponding author) ; Kaufmann, J. ; Lorenzl, S. ; Ebersbach, G. ; Gandor, F. ; Zaehle, T. ; Specht, S. ; Stallforth, S. ; Sobieray, U.DZNE* ; Wirkus, E. ; Casjens, F. ; Heinze, H.-J.DZNE* ; Kupsch, A. ; Voges, J. (Last author)DZNE*

2018
Elsevier Science Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.parkreldis.2018.02.027

Abstract: 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.

Keyword(s): Accidental Falls: prevention & control (MeSH) ; Activities of Daily Living (MeSH) ; Aged (MeSH) ; Cognitive Dysfunction: etiology (MeSH) ; Cognitive Dysfunction: therapy (MeSH) ; Deep Brain Stimulation: methods (MeSH) ; Female (MeSH) ; Gait Disorders, Neurologic: etiology (MeSH) ; Gait Disorders, Neurologic: therapy (MeSH) ; Humans (MeSH) ; Hypokinesia: etiology (MeSH) ; Hypokinesia: therapy (MeSH) ; Male (MeSH) ; Outcome Assessment, Health Care (MeSH) ; Pedunculopontine Tegmental Nucleus (MeSH) ; Postural Balance (MeSH) ; Quality of Life (MeSH) ; Supranuclear Palsy, Progressive: complications (MeSH) ; Supranuclear Palsy, Progressive: therapy (MeSH) ; Deep brain stimulation ; Gait ; Parkinsonian disorders ; Pedunculopontine nucleus ; Progressive supranuclear palsy ; Quality of life

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Contributing Institute(s):

1. Core KAP (Kooperationseinheit Angewandte Präventionsforschung) (Core Technical Staff)
2. U Clinical Researchers - Magdeburg (U Clinical Researchers - Magdeburg)

Research Program(s):

1. 344 - Clinical and Health Care Research (POF3-344) (POF3-344)

Appears in the scientific report 2018

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Database coverage:
; ; Clarivate Analytics Master Journal List ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; IF < 5 ; JCR ; JCR ; SCOPUS ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection ; Web of Science Core Collection

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