title: Long-term double-blinded unilateral pedunculopontine area stimulation in Parkinson's disease.
abstract: Gait-related symptoms are often refractory to current available treatment options with a significant reduction in quality of life in Parkinson's disease.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  Pedunculopontine area stimulation has an initial but not sustained benefit for gait-related symptoms. © 2016 International Parkinson and Movement Disorder Society.
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada. tmestre@toh.on.ca.|Parkinson's disease and Movement Disorders Center, Division of Neurology, Department of Medicine, University of Ottawa Brain and Mind Institute, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (current affiliation). tmestre@toh.on.ca.
authors.forename: Tiago A
authors.initials: TA
authors.lastname: Mestre
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.|Parkinson's Disease and Movement Disorders Program, Henry Ford Health System, West Bloomfield, Michigan, USA (current affiliation).
authors.forename: Christos
authors.initials: C
authors.lastname: Sidiropoulos
authors.affiliation: Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors.forename: Clement
authors.initials: C
authors.lastname: Hamani
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors.forename: Yu-Yan
authors.initials: YY
authors.lastname: Poon
authors.affiliation: Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.|Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, Université Joseph Fourier, Grenoble, France (current affiliation).
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D045042:Pedunculopontine Tegmental Nucleus
keywords: Parkinson's disease; deep brain stimulation; falls; freezing of gait; pedunculopontine nucleus