Long‐term double‐blinded unilateral pedunculopontine area stimulation in Parkinson's disease

BACKGROUND: Gait-related symptoms are often refractory to current available treatment options with a significant reduction in quality of life in Parkinson's disease. OBJECTIVES: The objective of this study was to determine the long-term efficacy and safety of unilateral pedunculopontine area stimulation for refractory gait and balance impairment in Parkinson's disease. METHODS: This study used periodic randomized double-blinded assessments until 4 years postoperatively. The primary outcomes were gait-related items of the UPDRS part II and the MDS-UPDRS part III. RESULTS: At baseline, the median age and disease duration was 63 years (interquartile range: 62, 65) and 15 years (interquartile range: 11, 20). At 2 years, patient-reported freezing (UPDRS part II, off-time) was significantly better when compared with baseline (P =.028), with 62.5% of responders. At 4 years, there was no significant change in the used outcomes, but 66.7 % (n = 4 of 6) were responders for off-time patient-reported freezing and falling. CONCLUSIONS: Pedunculopontine area stimulation has an initial but not sustained benefit for gait-related symptoms.