Effects of pedunculopontine nucleus stimulation on human bladder function

Roy, Holly; Pond, Debbie; Roy, Christopher J.; Forrow, Beth; Foltynie, Thomas; Zrinzo, Ludvic; Akram, Harith; Aziz, Tipu Z.; FitzGerald, James J.; Green, Alexander L.

doi:10.1002/nau.23321

Cited by 16 publications

(13 citation statements)

References 25 publications

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“…Another study by Winge K (2012) revealed that nocturia was significantly improved after DBS, which differed from our study 20. The study by Roy HA (2018) found that DBS did slightly increase maximal capacity, and the study by Mock S (2016) revealed that there were notable improvements in QOL for LUTS post-DBS in the subthalamic nucleus target 21,22. Overall, the number of patients included in these studies was limited, and most of the research focused more on clinical results.…”

Section: Discussioncontrasting

confidence: 80%

<p>Clinical study of the effects of deep brain stimulation on urinary dysfunctions in patients with Parkinson’s disease</p>

Zong

Meng

Zhang

et al. 2019

CIA

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Purpose: To evaluate the effect of deep brain stimulation (DBS) on urinary dysfunctions in Parkinson’s patients. Patients and methods: A total of 416 patients, diagnosed with Parkinson’s disease (PD) based on the UK Parkinson’s Disease Society Brain Bank Diagnostic Criteria, were enrolled in the study, including 307 males and 109 females. The effects of DBS treatment on urinary functions during urination and bladder storage of these patients were evaluated using testing and assessment scales, such as the American Urological Association Symptom Index (AUA-SI), Overactive Bladder Symptom Scores (OAB-SS), Quality Of Life Scale (QOL), and urodynamic tests. The data were statistically analyzed with the chi-square test and both independent-samples t -test and paired-samples t -test were used in this study. Results: Symptoms of urinary dysfunctions, such as urinary frequency, urgency, and incontinence, in the patients with PD were notably relieved by DBS treatment ( P <0.05), and the OAB-SS and bladder storage problems were greatly improved as well ( P <0.05). Compared with those in male patients, DBS surgery significantly improved the AUA-SI, urinary symptom scores, and QOL in female PD patients ( P <0.05), as well as other functional indicators related to the urinary tract, including the maximum urinary flow rate, detrusor pressure at peak flow, and residual urine volume in female PD patients ( P <0.05). Conclusion: DBS surgery is effective in improving urinary functions in PD patients, as primarily reflected by the alleviation of urinary symptoms such as urinary frequency, urgency, and incontinence. Female PD patients displayed better urinary function outcomes from DBS treatment than did male patients.

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Section: Discussioncontrasting

confidence: 80%

<p>Clinical study of the effects of deep brain stimulation on urinary dysfunctions in patients with Parkinson’s disease</p>

Zong

Meng

Zhang

et al. 2019

CIA

View full text Add to dashboard Cite

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“…Urge incontinence attributed to stimulation of the pontine micturition centre was described in one patient (Aviles-Olmos et al, 2011). Further investigation into this phenomenon with urodynamic testing found no detrimental effects on urodynamic filling parameters and detrusor activity but a slight increase in maximal bladder capacity (Roy et al, 2017).…”

Section: Ppn-dbs Study Results In Humans: Side Effects and Non-motor mentioning

confidence: 91%

Pedunculopontine nucleus: An integrative view with implications on Deep Brain Stimulation

Nowacki

Galati

Ai-Schlaeppi

et al. 2019

Neurobiology of Disease

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The pedunculopontine nucleus (PPN) is a reticular nucleus located in the mesencephalic and upper pontine tegmentum. Initially, characterized by its predominant cholinergic projection neurons, it was associated with the "mesencephalic locomotor region" and "reticular activating system". Furthermore, based on histopathological studies, the PPN was hypothesized to play a role in the manifestation of symptoms in movement disorders such as Parkinson's disease (PD). Since axial symptoms represent unmet needs of PD treatments, a series of pioneering experiments in Parkinsonian monkeys promoted the idea of a potential new target for deep brain stimulation (DBS) and much clinical interest was generated in the following years leading to a number of trials analysing the role of PPN for gait disorders. This review summarizes the historical background and more recent findings about the anatomy and function of the PPN and its implications in the basal ganglia network of the normal as well as diseased brain. Classical views on PPN function shall be challenged by more recent findings. Additionally, the current role and future perspectives of PPN DBS in PD patients shall be outlined.

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“…Important areas identified by this approach included the frontal lobes in general (Maurice-Williams, 1974), and brainstem regions including the PAG (Yaguchi et al, 2004). More recently, alterations in bladder function have been reported following implantation of DBS electrodes within the thalamus (Kessler et al, 2008), subthalamic nucleus (STN; Seif et al, 2004; Herzog et al, 2006, 2008), internal globus pallidus (GPi) (Mordasini et al, 2014), PAG (Green et al, 2012) and pedunculopontine nucleus (PPN; Aviles-Olmos et al, 2011; Roy et al, 2018b), implicating all of these regions in some aspect of human urinary control. Finally, developments in functional brain imaging have facilitated a controlled, systematic, experimental whole-brain approach to investigate the neural control of the bladder in both healthy human subjects and those with bladder disorders.…”

Section: Supraspinal Organization Of Bladder Conrol and Overlap With mentioning

confidence: 99%

The Central Autonomic Network and Regulation of Bladder Function

Roy

Green

2019

Front. Neurosci.

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The autonomic nervous system (ANS) is involved in the regulation of physiologic and homeostatic parameters relating particularly to the visceral organs and the co-ordination of physiological responses to threat. Blood pressure and heart rate, respiration, pupillomotor reactivity, sexual function, gastrointestinal secretions and motility, and urine storage and micturition are all under a degree of ANS control. Furthermore, there is close integration between the ANS and other neural functions such as emotion and cognition, and thus brain regions that are known to be important for autonomic control are also implicated in emotional functions. In this review we explore the role of the central ANS in the control of the bladder, and the implications of this for bladder dysfunction in diseases of the ANS.

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Effects of pedunculopontine nucleus stimulation on human bladder function

Abstract: Bilateral PPN DBS did not have a detrimental effect on urodynamic filling parameters or produce detrusor overactivity, but did slightly increase maximal capacity. Possible mechanisms include long-range connectivity or local effects at the pontine micturition center.

Cited by 16 publications

References 25 publications

<p>Clinical study of the effects of deep brain stimulation on urinary dysfunctions in patients with Parkinson’s disease</p>

<p>Clinical study of the effects of deep brain stimulation on urinary dysfunctions in patients with Parkinson’s disease</p>

Pedunculopontine nucleus: An integrative view with implications on Deep Brain Stimulation

The Central Autonomic Network and Regulation of Bladder Function

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