caa a22 4500 445376902 CHVBK 20180317143005.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00702-011-0673-y doi (NATIONALLICENCE)springer-10.1007/s00702-011-0673-y Subthalamic nucleus versus pedunculopontine nucleus stimulation in Parkinson disease: synergy or antagonism? [Elektronische Daten] [M. Ferraye, B. Debû, V. Fraix, P. Krack, S. Charbardès, E. Seigneuret, A.-L. Benabid, P. Pollak] Stimulation of the subthalamic nucleus (STN) improves the cardinal features of Parkinson disease (PD). However, its efficacy on gait disorders is less satisfying in the long term. In recent years, the pedunculopontine (PPN) nucleus has emerged as a possible promising deep brain stimulation target for gait disorders in PD. In this review, we examine whether STN and PPN act synergistically or antagonistically. Results suggest that the combination of STN and PPN stimulations leads to a significant further improvement in gait as compared with STN stimulation alone, but additive effects on the classical motor triad are questionable. Thus, they highlight the specificity of STN stimulation over PPN's for the PD cardinal features and the specificity of PPN stimulation over STN for gait disorders. In addition, low-frequency stimulation of the PPN may improve alertness. The additive rather than potentiating effects of STN and PPN stimulations suggest that they may be mediated by distinct pathways. Nevertheless, considering the inconsistencies in published results regarding the influence of PPN stimulation on gait disorders, work is still needed before one can know whether it will convert into a standard surgical treatment and to decipher its place beside STN stimulation. Springer-Verlag, 2011 Deep brain stimulation nationallicence Postural instability nationallicence Gait difficulties nationallicence Freezing of gait nationallicence Ferraye M. University J. Fourier Grenoble 1, 38041, Grenoble, France aut Debû B. University J. Fourier Grenoble 1, 38041, Grenoble, France aut Fraix V. INSERM, U836, 38041, Grenoble, France aut Krack P. University J. Fourier Grenoble 1, 38041, Grenoble, France aut Charbardès S. University J. Fourier Grenoble 1, 38041, Grenoble, France aut Seigneuret E. INSERM, U836, 38041, Grenoble, France aut Benabid A.-L University J. Fourier Grenoble 1, 38041, Grenoble, France aut Pollak P. University J. Fourier Grenoble 1, 38041, Grenoble, France aut Journal of Neural Transmission Springer Vienna 118/10(2011-10-01), 1469-1475 0300-9564 118:10<1469 2011 118 702 https://doi.org/10.1007/s00702-011-0673-y text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00702-011-0673-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ferraye M. University J. Fourier Grenoble 1, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Debû B. University J. Fourier Grenoble 1, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Fraix V. INSERM, U836, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Krack P. University J. Fourier Grenoble 1, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Charbardès S. University J. Fourier Grenoble 1, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Seigneuret E. INSERM, U836, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Benabid A.-L University J. Fourier Grenoble 1, 38041, Grenoble, France aut NATIONALLICENCE 700 1- Pollak P. University J. Fourier Grenoble 1, 38041, Grenoble, France aut NATIONALLICENCE 773 0- Journal of Neural Transmission Springer Vienna 118/10(2011-10-01), 1469-1475 0300-9564 118:10<1469 2011 118 702 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer