Long-term double-blinded unilateral pedunculopontine area stimulation in Parkinson's disease

• Published in: Movement disorders Vol. 31; no. 10; pp. 1570 - 1574
• Main Authors: Mestre, Tiago A., Sidiropoulos, Christos, Hamani, Clement, Poon, Yu-Yan, Lozano, Andres M., Lang, Anthony E., Moro, Elena
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2016; Wiley Subscription Services, Inc
• Subjects: Aged; deep brain stimulation; Deep Brain Stimulation - methods; Double-Blind Method; falls; Female; Follow-Up Studies; freezing of gait; Gait Disorders, Neurologic - etiology; Gait Disorders, Neurologic - therapy; Humans; Male; Middle Aged; Movement disorders; Outcome Assessment (Health Care); Parkinson Disease - complications; Parkinson Disease - therapy; Parkinson's disease; pedunculopontine nucleus; Pedunculopontine Tegmental Nucleus; pedunculopontine nucleus; Parkinson's disease; falls; freezing of gait; deep brain stimulation
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.26710

ABSTRACT Background Gait‐related symptoms are often refractory to current available treatment options with a significant reduction in quality of life in Parkinson's disease. Objectives The objective of this study was to determine the long‐term efficacy and safety of unilateral pedunculopontine area stimulation for refractory gait and balance impairment in Parkinson's disease. Methods This study used periodic randomized double‐blinded assessments until 4 years postoperatively. The primary outcomes were gait‐related items of the UPDRS part II and the MDS‐UPDRS part III. Results At baseline, the median age and disease duration was 63 years (interquartile range: 62, 65) and 15 years (interquartile range: 11, 20). At 2 years, patient‐reported freezing (UPDRS part II, off‐time) was significantly better when compared with baseline (P =.028), with 62.5% of responders. At 4 years, there was no significant change in the used outcomes, but 66.7 % (n = 4 of 6) were responders for off‐time patient‐reported freezing and falling. Conclusions Pedunculopontine area stimulation has an initial but not sustained benefit for gait‐related symptoms. © 2016 International Parkinson and Movement Disorder Society