title: Low-frequency versus high-frequency stimulation of the pedunculopontine nucleus area in Parkinson's disease: a randomised controlled trial.
abstract: OBJECTIVE
  To compare the influence of low-frequency (10-25 Hz) versus higher (60-80 Hz) frequency stimulation of the pedunculopontine nucleus area (PPNa) on akinaesia, freezing of gait and daytime sleepiness.
  
  
  METHODS
  We included nine patients with Parkinson's disease (PD) and severe gait disorders. In this double-blind randomised cross-over study, patients were assessed after 24 h of PPNa stimulation. Assessments included the motor part of the Unified Parkinson's Disease Rating Scale, the Epworth Sleepiness Scale and a behavioural gait assessment.
  
  
  RESULTS
  Compared with 60-80 Hz, 10-25 Hz PPNa stimulation led to decreased akinaesia, gait difficulties and daytime sleepiness in 7/9 patients. In one patient, these symptoms were aggravated under 10-25 Hz stimulation compared with 60-80 Hz.
  
  
  CONCLUSIONS
  These results are in keeping with the benefits of chronic PPNa stimulation for gait and postural difficulties in patients with PD, and with regard to the influence of patients' clinical characteristics, differential neuronal loss in the PPNa and electrode location. We conclude that in patients with PPNa stimulation, low frequency provides a better outcome than high-frequency stimulation.
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France University Hospital of Grenoble, Grenoble, France.
authors.forename: D
authors.initials: D
authors.lastname: Nosko
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands.
authors.forename: M U
authors.initials: MU
authors.lastname: Ferraye
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France University Hospital of Grenoble, Grenoble, France.
authors.forename: V
authors.initials: V
authors.lastname: Fraix
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France University Hospital of Grenoble, Grenoble, France.
authors.forename: L
authors.initials: L
authors.lastname: Goetz
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France University Hospital of Grenoble, Grenoble, France.
authors.forename: S
authors.initials: S
authors.lastname: Chabardès
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France University Hospital of Grenoble, Grenoble, France University Hospital of Geneva, Geneva, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Pollak
authors.affiliation: University of Grenoble, Grenoble, France INSERM, U836, Grenoble Institute of Neuroscience, Grenoble, France.
authors.forename: B
authors.initials: B
authors.lastname: Debû
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D046690:Deep Brain Stimulation / Q000379:methods*; D004311:Double-Blind Method; D004567:Electrodes, Implanted; D005260:Female; D020233:Gait Disorders, Neurologic / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000628:therapy; D010300:Parkinson Disease / Q000628:therapy*; D045042:Pedunculopontine Tegmental Nucleus; D012893:Sleep Wake Disorders / Q000628:therapy; D020531:Subthalamic Nucleus; D016896:Treatment Outcome
keywords: Gait; Movement Disorders; Neurosurgery; Parkinson's Disease