Is urinary incontinence a true consequence of deep brain stimulation of the pedunculopontine tegmental nucleus in Parkinson's disease?

摘要

The article by Aviles-Olmos et al. [3], published in Acta Neuro-chirurgica, is a further example of several single case reports that have recently appeared [1,5] concerning the deep brain stimulation (DBS) of the pedunculopontine tegmental nucleus (PPTg). After early uncertainty and misunderstanding of the position of stimulating electrodes, arising from our first series of patients [14], there has been growing interest among neurosurgeons concerning the PPTg as a possible new target for the treatment of movement disorders in drug-resistant patients. Such interest was particularly prompted by the need to search for alternative targets to the subthalamic nucleus (STN) in order to treat symptoms for which stimulation of this nucleus gave unsatisfactory results, such as those on gait freezing and postural instability [14, 15]. At present PPTg DBS still requires particular prudence because of the inconsistency of results obtained by different groups, which may limit the correct interpretation of the value of the PPTg as an innovative target.