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Clinical Experience with Pedunculopontine Nucleus Stimulation in Conditions with Nigrostriatal Disconnection.
- Source :
-
World neurosurgery [World Neurosurg] 2016 May; Vol. 89, pp. 9-18. Date of Electronic Publication: 2015 Dec 15. - Publication Year :
- 2016
-
Abstract
- Background: The pedunculopontine nucleus (PPN) is a part of the mesencephalic locomotor region and, in recent years, it has been considered a new surgical target for deep brain stimulation (DBS) for movement disorders including atypical parkinsonian syndromes such as progressive supranuclear palsy (PSP) and multiple system atrophy. Involvement of the PPN may play an important role in gait impairment in these disorders and the development of PPN DBS could potentially provide treatment for this disabling problem. However, the role of the PPN and the specific pathways involved in gait control and other motor functions are poorly understood.<br />Methods: We present a chronological account of our group's experience in the use of PPN DBS. This entails the treatment of four patients with disabling movement disorders who all exhibited either marked damage or disconnection of the nigro-striatal pathway.<br />Results: Within our series, the results were variable in that 2 of the 4 patients benefited greatly from DBS but the other 2 did not.<br />Conclusions: Our findings suggest that in carefully selected patients, PPN DBS can potentially alleviate symptoms due to dopaminergic striatal inactivity; symptoms that are typically resistant to stimulation of other subcortical targets used for parkinsonian syndromes and movement disorders.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Child
Female
Gait Disorders, Neurologic diagnostic imaging
Gait Disorders, Neurologic physiopathology
Humans
Male
Middle Aged
Treatment Outcome
Deep Brain Stimulation methods
Gait Disorders, Neurologic therapy
Pedunculopontine Tegmental Nucleus diagnostic imaging
Pedunculopontine Tegmental Nucleus physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 89
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 26704205
- Full Text :
- https://doi.org/10.1016/j.wneu.2015.11.054