A block to pre-prepared movement in gait freezing, relieved by pedunculopontine nucleus stimulation

Thevathasan, Wesley, Pogosyan, Alek, Hyam, Jonathan A., Jenkinson, Ned, Bogdanovic, Marko, Coyne, Terry J., Silburn, Peter A., Aziz, Tipu Z. and Brown, Peter (2011) A block to pre-prepared movement in gait freezing, relieved by pedunculopontine nucleus stimulation. Brain, 134 7: 2085-2095. doi:10.1093/brain/awr131


Author Thevathasan, Wesley
Pogosyan, Alek
Hyam, Jonathan A.
Jenkinson, Ned
Bogdanovic, Marko
Coyne, Terry J.
Silburn, Peter A.
Aziz, Tipu Z.
Brown, Peter
Title A block to pre-prepared movement in gait freezing, relieved by pedunculopontine nucleus stimulation
Journal name Brain   Check publisher's open access policy
ISSN 0006-8950
1460-2156
Publication date 2011
Sub-type Article (original research)
DOI 10.1093/brain/awr131
Open Access Status
Volume 134
Issue 7
Start page 2085
End page 2095
Total pages 11
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Abstract Gait freezing and postural instability are disabling features of Parkinsonian disorders, treatable with pedunculopontine nucleus stimulation. Both features are considered deficits of proximal and axial musculature, innervated predominantly by reticulospinal pathways and tend to manifest when gait and posture require adjustment. Adjustments to gait and posture are amenable to pre-preparation and rapid triggered release. Experimentally, such accelerated release can be elicited by loud auditory stimuli - a phenomenon known as 'StartReact'. We observed StartReact in healthy and Parkinsonian controls. However, StartReact was absent in Parkinsonian patients with severe gait freezing and postural instability. Pedunculopontine nucleus stimulation restored StartReact proximally and proximal reaction times to loud stimuli correlated with gait and postural disturbance. These findings suggest a relative block to triggered, pre-prepared movement in gait freezing and postural instability, relieved by pedunculopontine nucleus stimulation.
Keyword Deep brain stimulation
Gait freezing
Parkinson's disease
Pedunculopontine nucleus
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: UQ Centre for Clinical Research Publications
 
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