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@ARTICLE{Breit:258786,
      author       = {Breit, Sorin and Milosevic, Luka and Naros, Georgios and
                      Cebi, Idil and Weiss, Daniel and Gharabaghi, Alireza},
      title        = {{S}tructural-{F}unctional {C}orrelates of {R}esponse to
                      {P}edunculopontine {S}timulation in a {R}andomized
                      {C}linical {T}rial for {A}xial {S}ymptoms of {P}arkinson's
                      {D}isease.},
      journal      = {Journal of Parkinson's Disease},
      volume       = {13},
      number       = {4},
      issn         = {1877-7171},
      address      = {Amsterdam},
      publisher    = {IOS Press},
      reportid     = {DZNE-2023-00680},
      pages        = {563 - 573},
      year         = {2023},
      abstract     = {Axial 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.},
      keywords     = {Humans / Parkinson Disease: therapy / Parkinson Disease:
                      drug therapy / Deep Brain Stimulation: methods / Subthalamic
                      Nucleus / Pedunculopontine Tegmental Nucleus / Gait /
                      Parkinson’s disease (Other) / Deep brain stimulation
                      (Other) / Parkinson’s disease (Other) / pedunculopontine
                      nucleus (Other)},
      cin          = {AG Gasser},
      ddc          = {610},
      cid          = {I:(DE-2719)1210000},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pmc          = {pmc:PMC10357146},
      pubmed       = {pmid:37092235},
      doi          = {10.3233/JPD-225031},
      url          = {https://pub.dzne.de/record/258786},
}