The serendipity case of the pedunculopontine nucleus low-frequency brain stimulation: Chasing a gait response, finding sleep, and cognition improvement

Alessandro Stefani, Antonella Peppe, Salvatore Galati, Stampanoni Mario Bassi, Vincenza D'Angelo, Mariangela Pierantozzi

Research output: Contribution to journalArticlepeer-review

Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an efficacious therapy for Parkinson's disease (PD) but its effects on non-motor facets may be detrimental. The low-frequency stimulation (LFS) of the pedunculopontine nucleus (PPN or the nucleus tegmenti pedunculopontini-PPTg-) opened new perspectives. In our hands, PPTg-LFS revealed a modest influence on gait but increased sleep quality and degree of attentiveness. At odds with potential adverse events following STN-DBS, executive functions, under PPTg-ON, ameliorated. A recent study comparing both targets found that only PPTg-LFS improved night-time sleep and daytime sleepiness. Chances are that different neurosurgical groups influence either the PPN sub-portion identified as pars dissipata (more interconnected with GPi/STN) or the caudal PPN region known as pars compacta, preferentially targeting intralaminar and associative nucleus of the thalamus. Yet, the wide electrical field delivered affects a plethora of en passant circuits, and a fine distinction on the specific pathways involved is elusive. This review explores our angle of vision, by which PPTg-LFS activates cholinergic and glutamatergic ascending fibers, influencing non-motor behaviors.

Original languageEnglish
Article numberArticle 68
JournalFrontiers in Neurology
Volume4 JUN
DOIs
Publication statusPublished - 2013

Keywords

  • Deep brain stimulation
  • Executive function
  • Neuromodulation
  • Parkinson disease
  • Sleep structure

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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