OBJECTIVES The pedunculopontine nucleus (PPN) is considered a promising target to alleviate gait disorders. We aimed to evaluate the effects of PPN stimulation on motor symptoms and gait disorders in patients with Parkinson's disease (PD) to help assess the potential role of PPN-DBS treatment in gait disorders. METHODS Studies were searched for low-frequency PPN stimulation to treat gait disorders and freezing of gait (FOG) in the PubMed, Embase, Cochrane Library, Web of Science, and ClinicalKey up to April 2020. Outcomes of Unified Parkinson's Disease Rating Scale (UPDRS) part III, subitems 27-30; UPDRS subitems 13 and 14; the Freezing of Gait Questionnaire (FOGQ), and the Gait and Falls Questionnaire (GFQ) were extracted and evaluated during PPN On-stimulation compared to preoperation or Off-stimulation in both Off- and On-medication states. RESULTS There was a significant improvement in subitems 27-30 with PPN On-stimulation versus Off-stimulation in Off-medication and On-medication states, but no improvement in UPDRS part III. The occurrence of FOG and falls also declined between PPN On-stimulation and presurgery, with a significant improvement in subitem 13 and subitem 14 in Off-medication and On-medication states, GFQ, and FQGQ. Heterogeneity in stimulation frequency, follow-up, electrode location, and unilateral or bilateral stimulation existed among the included studies. CONCLUSIONS In some conditions and in some selective PD patients, low-frequency PPN-DBS has beneficial effects on FOG and falls but no wider benefits on rigidity, resting tremor, or bradykinesia.

中文翻译：

---

脑桥脑深部刺激对帕金森病步态障碍的影响：文献荟萃分析

目的 桥脚核 (PPN) 被认为是缓解步态障碍的有希望的目标。我们旨在评估 PPN 刺激对帕金森病 (PD) 患者运动症状和步态障碍的影响，以帮助评估 PPN-DBS 治疗在步态障碍中的潜在作用。方法 在 PubMed、Embase、Cochrane 图书馆、Web of Science 和 ClinicalKey 中搜索低频 PPN 刺激治疗步态障碍和步态冻结 (FOG) 的研究，直至 2020 年 4 月。统一帕金森病评定量表 (UPDRS) 的结果) 第三部分，分项 27-30；UPDRS 分项 13 和 14；冻结步态问卷（FOGQ），步态和跌倒问卷 (GFQ) 在 PPN 刺激期间与术前或非刺激期间在药物关闭和药物治疗状态下进行提取和评估。结果 在停药和停药状态下，PPN 刺激与非刺激的子项 27-30 有显着改善，但 UPDRS 第 III 部分没有改善。PPN 刺激和术前 FOG 和跌倒的发生率也有所下降，子项 13 和子项 14 在非药物和药物治疗状态、GFQ 和 FQGQ 中显着改善。纳入的研究在刺激频率、随访、电极位置以及单侧或双侧刺激方面存在异质性。结论 在某些情况和某些选择性 PD 患者中，