title: Effects of pedunculopontine area and pallidal DBS on gait ignition in Parkinson's disease.
abstract: BACKGROUND
  Freezing of gait is a disabling feature of Parkinson's disease, and so far no established treatment exists. Deep brain stimulation of the pedunculopontine area has been proposed to treat refractory gait disorders, yet data on measurable effects, especially in combination with stimulation of other targets, are scarce.
  
  
  METHODS
  Acute effects of either low frequency pedunculopontine stimulation or high frequency stimulation of the posteroventral lateral globus pallidus internus and a combination of both in a 66-year-old man with advanced Parkinson's disease were assessed. Four weeks after the intervention, the gait was examined with patient blinded in each condition using computerized gait analysis.
  
  
  RESULTS
  Isolated pedunculopontine or pallidal stimulation had a mild impact on gait ignition and freezing of gait, but combined stimulation had a marked effect.
  
  
  CONCLUSIONS
  Combined multifocal stimulation may be a promising option for gait ignition and freezing of gait in advanced Parkinson's disease.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. Electronic address: schrader.christoph@mh-hannover.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schrader
authors.forename: Frank
authors.initials: F
authors.lastname: Seehaus
authors.forename: H Holger
authors.initials: HH
authors.lastname: Capelle
authors.forename: Anja
authors.initials: A
authors.lastname: Windhagen
authors.forename: Henning
authors.initials: H
authors.lastname: Windhagen
authors.forename: Joachim K
authors.initials: JK
authors.lastname: Krauss
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000628:therapy*; D005917:Globus Pallidus / Q000502:physiology*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D045042:Pedunculopontine Tegmental Nucleus / Q000502:physiology*
keywords: Deep brain stimulation; Freezing of gait; Globus pallidus; Parkinson's disease; Pedunculopontine nucleus