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000258786 0247_ $$2doi$$a10.3233/JPD-225031
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000258786 041__ $$aEnglish
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000258786 1001_ $$0P:(DE-2719)9000036$$aBreit, Sorin$$b0$$udzne
000258786 245__ $$aStructural-Functional Correlates of Response to Pedunculopontine Stimulation in a Randomized Clinical Trial for Axial Symptoms of Parkinson's Disease.
000258786 260__ $$aAmsterdam$$bIOS Press$$c2023
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000258786 520__ $$aAxial symptoms of Parkinson's disease (PD) can be debilitating and are often refractory to conventional therapies such as dopamine replacement therapy and deep brain stimulation (DBS) of the subthalamic nuclei (STN).Evaluate the efficacy of bilateral DBS of the pedunculopontine nucleus area (PPNa) and investigate structural and physiological correlates of clinical response.A randomized, double-blind, cross-over clinical trial was employed to evaluate the efficacy of bilateral PPNa-DBS on axial symptoms. Lead positions and neuronal activity were evaluated with respect to clinical response. Connectomic cortical activation profiles were generated based on the volumes of tissue activated.PPNa-DBS modestly improved (p = 0.057) axial symptoms in the medication-off condition, with greatest positive effects on gait symptoms (p = 0.027). Electrode placements towards the anterior commissure (ρ= 0.912; p = 0.011) or foramen caecum (ρ= 0.853; p = 0.031), near the 50% mark of the ponto-mesencephalic junction, yielded better therapeutic responses. Recording trajectories of patients with better therapeutic responses (i.e., more anterior electrode placements) had neurons with lower firing-rates (p = 0.003) and higher burst indexes (p = 0.007). Structural connectomic profiles implicated activation of fibers of the posterior parietal lobule which is involved in orienting behavior and locomotion.Bilateral PPNa-DBS influenced gait symptoms in patients with PD. Anatomical and physiological information may aid in localization of a favorable stimulation target.
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000258786 650_2 $$2MeSH$$aHumans
000258786 650_2 $$2MeSH$$aParkinson Disease: therapy
000258786 650_2 $$2MeSH$$aParkinson Disease: drug therapy
000258786 650_2 $$2MeSH$$aDeep Brain Stimulation: methods
000258786 650_2 $$2MeSH$$aSubthalamic Nucleus
000258786 650_2 $$2MeSH$$aPedunculopontine Tegmental Nucleus
000258786 650_2 $$2MeSH$$aGait
000258786 650_7 $$2Other$$aParkinson’s disease
000258786 650_7 $$2Other$$aDeep brain stimulation
000258786 650_7 $$2Other$$aParkinson’s disease
000258786 650_7 $$2Other$$apedunculopontine nucleus
000258786 7001_ $$aMilosevic, Luka$$b1
000258786 7001_ $$aNaros, Georgios$$b2
000258786 7001_ $$0P:(DE-2719)9000446$$aCebi, Idil$$b3
000258786 7001_ $$0P:(DE-2719)9000341$$aWeiss, Daniel$$b4
000258786 7001_ $$aGharabaghi, Alireza$$b5
000258786 773__ $$0PERI:(DE-600)2599550-9$$a10.3233/JPD-225031$$gVol. 13, no. 4, p. 563 - 573$$n4$$p563 - 573$$tJournal of Parkinson's Disease$$v13$$x1877-7171$$y2023
000258786 8564_ $$uhttps://content.iospress.com/articles/journal-of-parkinsons-disease/jpd225031
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