Pedunculopontine Nucleus Deep Brain Stimulation Improves Gait Disorder in Parkinson’s Disease: A Systematic Review and Meta-analysis
Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been proposed as a treatment strategy for gait disorder in patients with Parkinson’s disease (PD). We thus performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials to assess the effect of...
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| Veröffentlicht in: | Neurochemical research 2020-04, Vol.45 (4), p.709-719 |
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| creator | Lin, Fabin Wu, Dihang Lin, Chenxin Cai, Huihui Chen, Lina Cai, Guofa Ye, Qinyong Cai, Guoen |
| description | Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been proposed as a treatment strategy for gait disorder in patients with Parkinson’s disease (PD). We thus performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials to assess the effect of this treatment on gait disorder in patients with PD. We systematically searched PubMed, Cochrane, Web of Knowledge, Wan Fang and WIP for randomized and nonrandomized controlled trials (published before July 29, 2014; no language restrictions) comparing PPN–DBS with other treatments. We assessed pooled data using a random effects model and a fixed effects model. Of 130 identified studies, 14 were eligible and were included in our analysis (N = 82 participants). Compared to those presurgery, the Unified Parkinson Disease Rating Scale (UPDRS) 27–30 scores for patients were lowered by PPN–DBS [3.94 (95% confidence interval, CI = 1.23 to 6.65)]. The UPDRS 13 and 14 scores did not improve with levodopa treatment [0.43 (− 0.35 to 1.20); 0.35 (− 0.50 to 1.19)], whereas the UPDRS 27–30 scores could be improved by the therapy [1.42 (95% CI 0.34 to 2.51)]. The Gait and Falls Questionnaire and UPDRS 13 and 14 scores showed significant improvements after PPN–DBS under the medication-off (MED-OFF) status [15.44 (95% CI = 8.44 to 22.45); 1.57 (95% CI = 0.84 to 2.30); 1.34 (95% CI = 0.84 to 1.84)]. PPN–DBS is a potential therapeutic target that could improve gait and fall disorders in patients with PD. Our findings will help improve the clinical application of DBS in PD patients with gait disorder. |
| doi_str_mv | 10.1007/s11064-020-02962-y |
| format | Article |
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We thus performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials to assess the effect of this treatment on gait disorder in patients with PD. We systematically searched PubMed, Cochrane, Web of Knowledge, Wan Fang and WIP for randomized and nonrandomized controlled trials (published before July 29, 2014; no language restrictions) comparing PPN–DBS with other treatments. We assessed pooled data using a random effects model and a fixed effects model. Of 130 identified studies, 14 were eligible and were included in our analysis (N = 82 participants). Compared to those presurgery, the Unified Parkinson Disease Rating Scale (UPDRS) 27–30 scores for patients were lowered by PPN–DBS [3.94 (95% confidence interval, CI = 1.23 to 6.65)]. The UPDRS 13 and 14 scores did not improve with levodopa treatment [0.43 (− 0.35 to 1.20); 0.35 (− 0.50 to 1.19)], whereas the UPDRS 27–30 scores could be improved by the therapy [1.42 (95% CI 0.34 to 2.51)]. The Gait and Falls Questionnaire and UPDRS 13 and 14 scores showed significant improvements after PPN–DBS under the medication-off (MED-OFF) status [15.44 (95% CI = 8.44 to 22.45); 1.57 (95% CI = 0.84 to 2.30); 1.34 (95% CI = 0.84 to 1.84)]. PPN–DBS is a potential therapeutic target that could improve gait and fall disorders in patients with PD. Our findings will help improve the clinical application of DBS in PD patients with gait disorder.</description><identifier>ISSN: 0364-3190</identifier><identifier>EISSN: 1573-6903</identifier><identifier>DOI: 10.1007/s11064-020-02962-y</identifier><identifier>PMID: 31950450</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biochemistry ; Biomedical and Life Sciences ; Biomedicine ; Brain ; Cell Biology ; Clinical trials ; Clinical Trials as Topic ; Confidence intervals ; Deep brain stimulation ; Deep Brain Stimulation - methods ; Gait ; Gait Disorders, Neurologic - therapy ; Humans ; Levodopa ; Meta-analysis ; Movement disorders ; Neurochemistry ; Neurodegenerative diseases ; Neurology ; Neurosciences ; Parkinson Disease - therapy ; Parkinson's disease ; Patients ; Pedunculopontine tegmental nucleus ; Pedunculopontine Tegmental Nucleus - physiology ; Randomization ; Review ; Stimulation ; Systematic review ; Therapeutic applications</subject><ispartof>Neurochemical research, 2020-04, Vol.45 (4), p.709-719</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Neurochemical Research is a copyright of Springer, (2020). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-56e22bbca5c30fc5ea161b4fbc6fa40e0be9ac06ec633cc506b0057d2e6bdf8d3</citedby><cites>FETCH-LOGICAL-c375t-56e22bbca5c30fc5ea161b4fbc6fa40e0be9ac06ec633cc506b0057d2e6bdf8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11064-020-02962-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11064-020-02962-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31950450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Fabin</creatorcontrib><creatorcontrib>Wu, Dihang</creatorcontrib><creatorcontrib>Lin, Chenxin</creatorcontrib><creatorcontrib>Cai, Huihui</creatorcontrib><creatorcontrib>Chen, Lina</creatorcontrib><creatorcontrib>Cai, Guofa</creatorcontrib><creatorcontrib>Ye, Qinyong</creatorcontrib><creatorcontrib>Cai, Guoen</creatorcontrib><title>Pedunculopontine Nucleus Deep Brain Stimulation Improves Gait Disorder in Parkinson’s Disease: A Systematic Review and Meta-analysis</title><title>Neurochemical research</title><addtitle>Neurochem Res</addtitle><addtitle>Neurochem Res</addtitle><description>Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been proposed as a treatment strategy for gait disorder in patients with Parkinson’s disease (PD). We thus performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials to assess the effect of this treatment on gait disorder in patients with PD. We systematically searched PubMed, Cochrane, Web of Knowledge, Wan Fang and WIP for randomized and nonrandomized controlled trials (published before July 29, 2014; no language restrictions) comparing PPN–DBS with other treatments. We assessed pooled data using a random effects model and a fixed effects model. Of 130 identified studies, 14 were eligible and were included in our analysis (N = 82 participants). Compared to those presurgery, the Unified Parkinson Disease Rating Scale (UPDRS) 27–30 scores for patients were lowered by PPN–DBS [3.94 (95% confidence interval, CI = 1.23 to 6.65)]. The UPDRS 13 and 14 scores did not improve with levodopa treatment [0.43 (− 0.35 to 1.20); 0.35 (− 0.50 to 1.19)], whereas the UPDRS 27–30 scores could be improved by the therapy [1.42 (95% CI 0.34 to 2.51)]. The Gait and Falls Questionnaire and UPDRS 13 and 14 scores showed significant improvements after PPN–DBS under the medication-off (MED-OFF) status [15.44 (95% CI = 8.44 to 22.45); 1.57 (95% CI = 0.84 to 2.30); 1.34 (95% CI = 0.84 to 1.84)]. PPN–DBS is a potential therapeutic target that could improve gait and fall disorders in patients with PD. Our findings will help improve the clinical application of DBS in PD patients with gait disorder.</description><subject>Biochemistry</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Brain</subject><subject>Cell Biology</subject><subject>Clinical trials</subject><subject>Clinical Trials as Topic</subject><subject>Confidence intervals</subject><subject>Deep brain stimulation</subject><subject>Deep Brain Stimulation - methods</subject><subject>Gait</subject><subject>Gait Disorders, Neurologic - therapy</subject><subject>Humans</subject><subject>Levodopa</subject><subject>Meta-analysis</subject><subject>Movement disorders</subject><subject>Neurochemistry</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Parkinson Disease - therapy</subject><subject>Parkinson's disease</subject><subject>Patients</subject><subject>Pedunculopontine tegmental nucleus</subject><subject>Pedunculopontine Tegmental Nucleus - 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Academic</collection><jtitle>Neurochemical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Fabin</au><au>Wu, Dihang</au><au>Lin, Chenxin</au><au>Cai, Huihui</au><au>Chen, Lina</au><au>Cai, Guofa</au><au>Ye, Qinyong</au><au>Cai, Guoen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pedunculopontine Nucleus Deep Brain Stimulation Improves Gait Disorder in Parkinson’s Disease: A Systematic Review and Meta-analysis</atitle><jtitle>Neurochemical research</jtitle><stitle>Neurochem Res</stitle><addtitle>Neurochem Res</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>45</volume><issue>4</issue><spage>709</spage><epage>719</epage><pages>709-719</pages><issn>0364-3190</issn><eissn>1573-6903</eissn><abstract>Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been proposed as a treatment strategy for gait disorder in patients with Parkinson’s disease (PD). We thus performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials to assess the effect of this treatment on gait disorder in patients with PD. We systematically searched PubMed, Cochrane, Web of Knowledge, Wan Fang and WIP for randomized and nonrandomized controlled trials (published before July 29, 2014; no language restrictions) comparing PPN–DBS with other treatments. We assessed pooled data using a random effects model and a fixed effects model. Of 130 identified studies, 14 were eligible and were included in our analysis (N = 82 participants). Compared to those presurgery, the Unified Parkinson Disease Rating Scale (UPDRS) 27–30 scores for patients were lowered by PPN–DBS [3.94 (95% confidence interval, CI = 1.23 to 6.65)]. The UPDRS 13 and 14 scores did not improve with levodopa treatment [0.43 (− 0.35 to 1.20); 0.35 (− 0.50 to 1.19)], whereas the UPDRS 27–30 scores could be improved by the therapy [1.42 (95% CI 0.34 to 2.51)]. The Gait and Falls Questionnaire and UPDRS 13 and 14 scores showed significant improvements after PPN–DBS under the medication-off (MED-OFF) status [15.44 (95% CI = 8.44 to 22.45); 1.57 (95% CI = 0.84 to 2.30); 1.34 (95% CI = 0.84 to 1.84)]. PPN–DBS is a potential therapeutic target that could improve gait and fall disorders in patients with PD. Our findings will help improve the clinical application of DBS in PD patients with gait disorder.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31950450</pmid><doi>10.1007/s11064-020-02962-y</doi><tpages>11</tpages></addata></record> |
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| subjects | Biochemistry Biomedical and Life Sciences Biomedicine Brain Cell Biology Clinical trials Clinical Trials as Topic Confidence intervals Deep brain stimulation Deep Brain Stimulation - methods Gait Gait Disorders, Neurologic - therapy Humans Levodopa Meta-analysis Movement disorders Neurochemistry Neurodegenerative diseases Neurology Neurosciences Parkinson Disease - therapy Parkinson's disease Patients Pedunculopontine tegmental nucleus Pedunculopontine Tegmental Nucleus - physiology Randomization Review Stimulation Systematic review Therapeutic applications |
| title | Pedunculopontine Nucleus Deep Brain Stimulation Improves Gait Disorder in Parkinson’s Disease: A Systematic Review and Meta-analysis |
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