Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
Parkinsonism Relat Disord. 2018 May;50:81-86. doi: 10.1016/j.parkreldis.2018.02.027. Epub 2018 Feb 19.
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.
被认为是潜在的深部脑刺激靶点的豆状核苍白球，用于治疗特发性帕金森病以及非典型性帕金森氏病的轴性症状，如步态和平衡障碍。
7 例进行性核上性麻痹患者接受双侧苍白球丘脑底核深部脑刺激。纳入标准包括进行性核上性麻痹的临床诊断、左旋多巴抵抗性步态和平衡障碍、年龄<75 岁、无痴呆或主要精神合并症。评估了 8、20、60 和 130Hz 刺激频率对运动评分和步态的影响。术后对运动评分进行了两年的随访。在 12 个月时，与基线参数相比，评估了日常生活活动、跌倒频率、健康相关生活质量、认知和情绪。评估了手术和刺激相关不良事件。
双侧苍白球丘脑底核深部脑刺激 8Hz 可显著改善轴性运动症状和周期性步态参数，而高频刺激不能改善步态和平衡，但能改善运动迟缓。然而，这种改善并没有转化为临床相关的益处。跌倒频率没有降低。日常生活活动、生活质量和额叶认知功能下降，而情绪保持不变。
双侧苍白球丘脑底核深部脑刺激在进行性核上性麻痹中产生频率依赖性效应，低频刺激改善周期性步态参数，高频刺激改善运动迟缓。然而，这些效果并没有转化为临床上的显著改善。
