Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology

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dc.contributor.authorHamani, Clement
dc.contributor.authorAziz, Tipu
dc.contributor.authorBloem, Bastiaan
dc.contributor.authorBrown, Peter
dc.contributor.authorChabardes, Stephen
dc.contributor.authorCoyne, Terry
dc.contributor.authorFoote, Kelly
dc.contributor.authorGarcia-Rill, Edgar
dc.contributor.authorHirsch, Etienne
dc.contributor.authorLozano, Andres
dc.contributor.authorMazzone, Paolo
dc.contributor.authorOkun, Michael
dc.contributor.authorHutchison, William
dc.contributor.authorSilburn, Peter
dc.contributor.authorZrinzo, Ludvic
dc.contributor.authorAlam, Mesbah
dc.contributor.authorGoetz, Laurent
dc.contributor.authorPereira, Erlick
dc.contributor.authorRughani, Anand
dc.contributor.authorThevathasan, Wesley
dc.contributor.authorMoro, Elena
dc.contributor.authorKrauss, Joachim
dc.date.accessioned2017-09-19T01:51:42Z
dc.date.available2017-09-19T01:51:42Z
dc.date.issued2016-10
dc.description.abstractSeveral lines of evidence over the last few years have been important in ascertaining that the pedunculopontine nucleus (PPN) region could be considered as a potential target for deep brain stimulation (DBS) to treat freezing and other problems as part of a spectrum of gait disorders in Parkinson disease and other akinetic movement disorders. Since the introduction of PPN DBS, a variety of clinical studies have been published. Most indicate improvements in freezing and falls in patients who are severely affected by these problems. The results across patients, however, have been variable, perhaps reflecting patient selection, heterogeneity in target selection and differences in surgical methodology and stimulation settings. Here we outline both the accumulated knowledge and the domains of uncertainty in surgical anatomy and terminology. Specific topics were assigned to groups of experts, and this work was accumulated and reviewed by the executive committee of the working group. Areas of disagreement were discussed and modified accordingly until a consensus could be reached. We demonstrate that both the anatomy and the functional role of the PPN region need further study. The borders of the PPN and of adjacent nuclei differ when different brainstem atlases and atlas slices are compared. It is difficult to delineate precisely the PPN pars dissipata from the nucleus cuneiformis, as these structures partially overlap. This lack of clarity contributes to the difficulty in targeting and determining the exact localization of the electrodes implanted in patients with akinetic gait disorders. Future clinical studies need to consider these issues.en_US
dc.identifier.citationHamani, C., T. Aziz, B. R. Bloem, P. Brown, S. Chabardes, T. Coyne, K. Foote, E. Garcia-Rill, E. C. Hirsch, A. M. Lozano, P. A. Mazzone, M. S. Okun, W. Hutchison, P. Silburn, L. Zrinzo, M. Alam, L. Goetz, E. Pereira, A. Rughani, W. Thevathasan, E. Moro, and J. K. Krauss. 2016. Pedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminology. Stereotactic and Functional Neurosurgery. 94(5): 298-306.en_US
dc.identifier.issn1423-0372 (Electronic) 1011-6125 (Linking)
dc.identifier.urihttp://repository.bionicsinstitute.org:8080/handle/123456789/265
dc.language.isoenen_US
dc.publisherKarger AG, Baselen_US
dc.subjectAnatomyen_US
dc.subjectBrainstemen_US
dc.subjectDeep brain stimulationen_US
dc.subjectPedunculopontine nucleusen_US
dc.subjectParkinson's diseaseen_US
dc.titlePedunculopontine Nucleus Region Deep Brain Stimulation in Parkinson Disease: Surgical Anatomy and Terminologyen_US
dc.typeArticleen_US
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