Peduncolopontine nucleus stimulation in progressive supranuclear palsy: a randomised trial
Bibliographic record
Abstract
Axial signs and cognitive disorders are the major source of disability in progressive supranuclear palsy (PSP). Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN), a structure involved in locomotion and posture control, has showed to improve freezing and falls in patients with Parkinson’s disease (PD).1 In this pilot trial, we investigated the effectiveness and safety of unilateral PPN DBS on gait and balance in patients with Richardson’s syndrome (RS) phenotype of PSP. Between April 2006 and December 2010, eight patients with RS-PSP were enrolled at the Movement Disorders Center of the Toronto Western Hospital. The study was approved by the University Health Network, and the Toronto Rehab Research Ethics Boards. All patients gave their written consent to the study. Both the surgical procedure and the PPN DBS programming were similar to those already used in patients with PD.2 Patients were assessed at baseline, and at 6 and 12 months after surgery, when they were randomly assigned to be evaluated both in the OFF and in the ON stimulation condition, after being 1 week in each stimulation condition. Patients and raters were blinded to the stimulation conditions. All assessments were videotaped, and adverse events were recorded. Main outcome was the difference between the ON and OFF stimulation conditions at 6 and 12-month follow-up in gait, postural stability and fall subitems of the PSP Rating Scale (PSPRS). Secondary outcomes were differences in the total scores of the motor Unified Parkinson Disease Rating Scale (UPDRS) and PSPRS; the PSP Staging System (PSPSS) score; rigidity, bradykinesia, arising from a chair and posture UPDRS items; history, mental, bulbar examination, supranuclear ocular motor examination, limb examination and gait/midline examination subscores of the PSPRS; withdrawal, sleep difficulty, disorientation, bradyphrenia and emotional incontinence items of the PSPRS. …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".