title: A meta-analysis of the pedunculopontine nucleus deep-brain stimulation effects on Parkinson's disease.
abstract: Postural instability and gait disturbance (PIGD) are common symptoms in patients with advanced Parkinson's disease (PD). The deep-brain stimulation (DBS) of the pedunculopontine nucleus (PPN) shows a promising effect on PIGD. However, the quantitative effects of PPN DBS for PD, especially for PIGD, and the efficacy of PPN DBS combined with levodopa are controversial and ambiguous to clinical practice. We carried out a meta-analysis of original researches on PPN to PIGD/PD from the electronic databases MEDLINE and EMBASE. The scores of united Parkinson's disease rating scores (UPDRS) III were used to evaluate the improvement in motor function and the scores of UPDRS III subitems 27-30 were used to evaluate the improvement in PIGD. The outcome was expressed as the mean difference and the percentage change between the scores of baseline and end point. The quality of studies was assessed using the 'assessing risk of bias' table. Overall, 909 articles were screened and seven studies were included with a total of 45 patients. The improvement in PIGD was significant, but there were no such effects on motor function. All the differences in PIGD scores were greater in the OFF medicine state rather than the ON medicine state, especially in the comparison between postsurgery ON stimulation and presurgery. PPN DBS indeed improved PIGD in advanced PD patients. This result could inspire more researchers to focus on its clinical application.
authors: aDepartment of Orthopaedics, The First College of Clinical Medicine bDepartment of Hematology, The Academy of Pediatrics cDepartment of Hepatobiliary Surgery, The Second College of Clinical Medicine dMolecular Medicine and Cancer Research Center eThe College of Basic Medical Sciences, Chongqing Medical University, Chongqing, China.
authors: Han
authors: H
authors: Wang
authors: Huiqin
authors: H
authors: Gao
authors: Tianyu
authors: T
authors: Jiao
authors: Zhongli
authors: Z
authors: Luo
mesh_terms: D000818:Animals; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D046690:Deep Brain Stimulation / Q000379:methods*; D006801:Humans; D010300:Parkinson Disease / Q000628:therapy*; D045042:Pedunculopontine Tegmental Nucleus / Q000502:physiology*