Deep brain stimulation for parkinsonian gait disorders.
The cardinal motor manifestation of Parkinson's disease (PD) is being treated with greater and greater efficacy with both newer medications as well as both subthalamic nucleus (STN) and globus pallidus internus (GPI) deep brain stimulation (DBS). The burden of disease is shifting towards the non-dopaminergic disease manifestations including gait and posture. Based on evidence in the literature and in animal models, recent trials are underway to examine the effects of pedunculopontine nucleus DBS on the treatment of parkinsonian gait disorder. We review the rationale behind this treatment and the status of the current trials.
Lozano
Andres M
AM
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, UHN, 399 Bathurst Street WW 4-447, Toronto, ON, M5T2S8, Canada. lozano@uhnres.utoronto.ca
Snyder
Brian J
BJ
D046690:Deep Brain Stimulation / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000379:methods*; D020233:Gait Disorders, Neurologic / Q000628:therapy*; D005917:Globus Pallidus / Q000503:physiopathology; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D045042:Pedunculopontine Tegmental Nucleus / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D020531:Subthalamic Nucleus / Q000503:physiopathology