Home > Publications Database > Structural-Functional Correlates of Response to Pedunculopontine Stimulation in a Randomized Clinical Trial for Axial Symptoms of Parkinson's Disease. > print

001     258786
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024 7 _ |a 10.3233/JPD-225031
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024 7 _ |a 1877-7171
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037 _ _ |a DZNE-2023-00680
041 _ _ |a English
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100 1 _ |a Breit, Sorin
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245 _ _ |a Structural-Functional Correlates of Response to Pedunculopontine Stimulation in a Randomized Clinical Trial for Axial Symptoms of Parkinson's Disease.
260 _ _ |a Amsterdam
|c 2023
|b IOS Press
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520 _ _ |a 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.
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650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Parkinson Disease: therapy
|2 MeSH
650 _ 2 |a Parkinson Disease: drug therapy
|2 MeSH
650 _ 2 |a Deep Brain Stimulation: methods
|2 MeSH
650 _ 2 |a Subthalamic Nucleus
|2 MeSH
650 _ 2 |a Pedunculopontine Tegmental Nucleus
|2 MeSH
650 _ 2 |a Gait
|2 MeSH
650 _ 7 |a Parkinson’s disease
|2 Other
650 _ 7 |a Deep brain stimulation
|2 Other
650 _ 7 |a Parkinson’s disease
|2 Other
650 _ 7 |a pedunculopontine nucleus
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700 1 _ |a Milosevic, Luka
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700 1 _ |a Naros, Georgios
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700 1 _ |a Cebi, Idil
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700 1 _ |a Weiss, Daniel
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700 1 _ |a Gharabaghi, Alireza
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773 _ _ |a 10.3233/JPD-225031
|g Vol. 13, no. 4, p. 563 - 573
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|t Journal of Parkinson's Disease
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856 4 _ |u https://content.iospress.com/articles/journal-of-parkinsons-disease/jpd225031
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910 1 _ |a Deutsches Zentrum für Neurodegenerative Erkrankungen
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