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Journal of Neural Transmission

, Volume 123, Issue 7, pp 769–774 | Cite as

Understanding the human pedunculopontine nucleus in Parkinson’s disease

  • Anders Fytagoridis
  • Peter A. Silburn
  • Terry J. Coyne
  • Wesley Thevathasan
Neurology and Preclinical Neurological Studies - Original Article

Abstract

This paper presents the Brisbane experience of pedunculopontine nucleus (PPN) deep brain stimulation (DBS) in Parkinson’s disease (PD). Clinical outcomes along with studies of the mechanisms and neurophysiology of PPN in PD patients with severe freezing of gait (FoG) and postural imbalance (PI) are summarised and presented. Our results indicate that PPN DBS improves FoG and falls in the relatively uncommon group of PD patients who respond well to medication other than for continuing on time FoG and falls. Our studies indicate that bilateral DBS is more beneficial than unilateral DBS, and that the more caudal region of the PPN seems preferable for stimulation. There is evidence that rapid-release programs for initiation and correction of gait and posture are modulated by the PPN, possibly to some extent independently of the cerebral cortex. These functions were found to be impaired in PD patients with severe FoG/PI, but to some extent corrected by bilateral PPN DBS.

keywords

Freezing of gait Deep brain stimulation Pedunculopontine nucleus 

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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Anders Fytagoridis
    • 1
    • 2
    • 3
  • Peter A. Silburn
    • 1
    • 2
  • Terry J. Coyne
    • 1
    • 2
  • Wesley Thevathasan
    • 4
  1. 1.St. Andrews and Wesley HospitalsBrisbaneAustralia
  2. 2.Asia–Pacific Centre for NeuromodulationUniversity of QueenslandBrisbaneAustralia
  3. 3.Department of Clinical Neuroscience, NeurosurgeryKarolinska InstituteStockholmSweden
  4. 4.Melbourne Brain Centre, Department of Medicine, Royal Melbourne HospitalUniversity of Melbourne and the Bionics InstituteMelbourneAustralia

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