Deep brain stimulation of the Cuneiform nucleus for levodopa-resistant freezing of gait in Parkinson’s disease: study protocol for a prospective pilot trial

摘要

Three-dimensional anatomy of the human MLR and expected side effects of DBS. Reconstructions were made using Lead-DBS and available MNI-space subcortical atlases [44]. A separate CnF (cyan) NIfTI object was created in relation to the PPN (dark purple) based on Olszewski and Baxter’s Atlas [45]. A Sagittal projection (5 mm lateral to midline) of the CnF (cyan) and PPN (dark purple) with overlay of active contacts from PPN DBS patients with poor (red), good (green), best (blue), and unevaluated (yellow) gait outcomes from Goetz et al. [43]. B Diagonal 3D view with right ML and STT absent to visualize the MLR, projected on to a transverse slice of the brain at the level of the pons. C Chart lists nearby structures, their relation to the CnF, and expected side effects of stimulation. CnF Cuneiform nucleus, CTT central tegmental tract, dSCP decussation of superior cerebellar peduncle, LC locus coeruleus, ML medial lemniscus, PPN Pedunculopontine nucleus, RN red nucleus, STT spinothalamic tract. Adapted from Fig. ​Fig.22 of [46] with permission