Does dominant pedunculopontine nucleus exist?

Lam, Susy; Moro, Elena; Poon, Yu‐Yan; Lozano, Andrés M.; Fasano, Alfonso

doi:10.1093/brain/awu225

Cited by 10 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[97][98][99] The effects of PPN implanted into the right side might have slightly better outcome, possibly suggesting the presence of a "dominant PPN." 100 However, the comparative efficacy of unilateral versus bilateral stimulation is far from resolved.…”

Section: Ppn: Potential For Treating Fogmentioning

confidence: 99%

Physiology of freezing of gait

Snijders

Takakusaki

Debû

et al. 2016

Annals of Neurology

Self Cite

166

157

View full text Add to dashboard Cite

Freezing of gait (FOG) is a common and debilitating, but largely mysterious, symptom of Parkinson disease. In this review, we will discuss the cerebral substrate of FOG focusing on brain physiology and animal models. Walking is a combination of automatic movement processes, afferent information processing, and intentional adjustments. Thus, normal gait requires a delicate balance between various interacting neuronal systems. To further understand gait control and specifically FOG, we will discuss the basic physiology of gait, animal models of gait disturbance including FOG, alternative etiologies of FOG, and functional magnetic resonance studies investigating FOG. The outcomes of these studies point to a dynamic network of cortical areas such as the supplementary motor area, as well as subcortical areas such as the striatum and the mesencephalic locomotor region including the pedunculopontine nucleus (PPN). Additionally, we will review PPN (area) stimulation as a possible treatment for FOG, and ponder whether PPN stimulation truly is the right step forward. Ann Neurol 2016;80:644-659.

show abstract

Section: Ppn: Potential For Treating Fogmentioning

confidence: 99%

Physiology of freezing of gait

Snijders

Takakusaki

Debû

et al. 2016

Annals of Neurology

Self Cite

166

157

View full text Add to dashboard Cite

show abstract

“…However, according to a recent review, only four further patients with combined PPN- and GPi-DBS have been reported in the literature, and electrophysiological data have been reported from only one patient so far [ 48 ]. Thus, the present analysis offers a useful contribution to recent discussions surrounding the existence of a ‘dominant’ PPN region and its clinical significance for future DBS therapies [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Pallidal Stimulation Modulates Pedunculopontine Nuclei in Parkinson’s Disease

et al. 2018

View full text Add to dashboard Cite

Background: In advanced Parkinson’s disease, the pedunculopontine nucleus region is thought to be abnormally inhibited by gamma-aminobutyric acid (GABA) ergic inputs from the over-active globus pallidus internus. Recent attempts to boost pedunculopontine nucleus function through deep brain stimulation are promising, but suffer from the incomplete understanding of the physiology of the pedunculopontine nucleus region. Methods: Local field potentials of the pedunculopontine nucleus region and the globus pallidus internus were recorded and quantitatively analyzed in a patient with Parkinson’s disease. In particular, we compared the local field potentials from the pedunculopontine nucleus region at rest and during deep brain stimulation of the globus pallidus internus. Results: At rest, the spectrum of local field potentials in the globus pallidus internus was mainly characterized by delta-theta and beta frequency activity whereas the spectrum of the pedunculopontine nucleus region was dominated by activity only in the delta and theta band. High-frequency deep brain stimulation of the globus pallidus internus led to increased theta activity in the pedunculopontine nucleus region and enabled information exchange between the left and right pedunculopontine nuclei. Therefore, Conclusions: When applying deep brain stimulation in the globus pallidus internus, its modulatory effect on pedunculopontine nucleus physiology should be taken into account.

show abstract

“…[ 48 51 70 ] Though L vs. R differences were not studied, L PPN-DBS yielded greater improvement in axial symptoms in a small sample. [ 44 ] The differential effects of R-sided, L-sided, and BL STN-DBS in the context of potentially lateralized axial motor circuits have not been systematically studied. In a recent pilot study of patients with PD who developed axial motor dysfunction after BL STN-DBS,[ 47 ] stride length improved by 5 cm more during R versus L STN-DBS and by 7 cm more during BL versus L STN-DBS.…”

Section: Neuromodulation Of Lateralized Motor Circuits In Parkinson'smentioning

confidence: 99%

Asymmetric neuromodulation of motor circuits in Parkinson's disease: The role of subthalamic deep brain stimulation

Lizárraga¹,

Luca²,

Salles³

et al. 2017

Surg Neurol Int

Self Cite

View full text Add to dashboard Cite

Whereas hemispheric dominance is well-established for appendicular motor control in humans, the evidence for dominance in axial motor control is still scarce. In Parkinson's disease (PD), unilateral (UL) onset of appendicular motor symptoms corresponds with asymmetric neurodegeneration predominantly affecting contralateral nigrostriatal circuits. Disease progression yields bilateral and axial motor symptoms but the initial appendicular asymmetry usually persists. Furthermore, there is evidence for hemispheric dominance for axial motor dysfunction in some of these patients. Dopaminergic medications improve appendicular symptoms but can also produce motor complications over time. Once these complications develop, bilateral (BL) deep brain stimulation (DBS) of the subthalamic nuclei (STN) can significantly improve appendicular symptoms while reducing medication doses and motor complications. Conversely, axial motor symptoms remain a significant source of disability, morbidity, and mortality for patients with PD. These axial symptoms do not necessarily improve with dopaminergic therapy, might not respond, and could even worsen after BL-DBS. In contrast to medications, DBS provides the opportunity to modify stimulation parameters for each cerebral hemisphere. Identical, BL-DBS of motor circuits with hemispheric dominance in PD might produce overstimulation on one side and/or understimulation on the other side, which could contribute to motor dysfunction. Several studies based on asymmetry of appendicular motor symptoms already support an initial UL rather than BL approach to DBS in some patients. The response of axial motor symptoms to UL versus BL-DBS remains unclear. Nonetheless, UL-DBS, staged BL-DBS, or asymmetric programming of BL-DBS could also be considered in patients with PD.

show abstract

Does dominant pedunculopontine nucleus exist?

Cited by 10 publications

References 9 publications

Physiology of freezing of gait

Physiology of freezing of gait

Pallidal Stimulation Modulates Pedunculopontine Nuclei in Parkinson’s Disease

Asymmetric neuromodulation of motor circuits in Parkinson's disease: The role of subthalamic deep brain stimulation

Contact Info

Product

Resources

About