Skip to Main content Skip to Navigation
Theses

EFFET DE LA STIMULATION DU NOYAU PEDONCULOPONTIN SUR LES TROUBLES DE LA MARCHE ET LE FREEZING DANS LA MALADIE DE PARKINSON : ETUDE CLINIQUE ET THERAPEUTIQUE

Abstract : Gait disorders in the healthy elderly are a major public health concern. We believed understanding Parkinson Disease (PD) typical gait disorders would bring some insights into the mechanisms of gait disorders in the elderly. In PD, their response to levodopa and to subthalamic nucleus stimulation is often heterogeneous, suggesting they are controlled at different levels of the CNS. In particular, there is convergent evidence of early alterations in cholinergic neurotransmission responsible for levodopa-resistant gait disorders in PD. An example comes from the observed link between executive dysfunction and the presence of levodopa-resistant freezing. Moreover, the relative preservation of executive functions in some patients suggests that other mechanisms may be involved in the development of levodopa-resistant freezing. The pedunculopontine nucleus area (PPNa) is a likely candidate. We report a beneficial effect of PPNa stimulation on freezing and falls related to freezing in some patients. However, our results are disappointing compared to the high levels of expectation raised by previous open label studies. Further controlled studies are needed to determine whether optimization of patient selection, targeting and setting of stimulation parameters might improve the outcome to a point that could transform this experimental approach to a treatment with a reasonable risk–benefit ratio.
Document type :
Theses
Complete list of metadatas

https://tel.archives-ouvertes.fr/tel-00489989
Contributor : Murielle Ferraye <>
Submitted on : Monday, June 7, 2010 - 3:32:38 PM
Last modification on : Friday, November 6, 2020 - 3:47:03 AM
Long-term archiving on: : Friday, September 17, 2010 - 1:12:16 PM

Identifiers

  • HAL Id : tel-00489989, version 1

Collections

UJF | U836 | UGA

Citation

Murielle Ferraye. EFFET DE LA STIMULATION DU NOYAU PEDONCULOPONTIN SUR LES TROUBLES DE LA MARCHE ET LE FREEZING DANS LA MALADIE DE PARKINSON : ETUDE CLINIQUE ET THERAPEUTIQUE. Neurosciences [q-bio.NC]. Université Joseph-Fourier - Grenoble I, 2010. Français. ⟨tel-00489989⟩

Share

Metrics

Record views

1031

Files downloads

1438