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

Stefani A, Peppe A, Galati S, Bassi MS, D'Angelo V, Pierantozzi M - Front Neurol (2013)

Bottom Line: 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.Yet, the wide electrical field delivered affects a plethora of en passant circuits, and a fine distinction on the specific pathways involved is elusive.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience, "Tor Vergata" University , Rome , Italy ; IRCCS, Fondazione Santa Lucia , Rome , Italy.

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.

No MeSH data available.


Related in: MedlinePlus

Shown are mean results of Epworth sleepiness scale (ESS) in original PD patients implanted a long-time ago (2006–2007) in both STN and PPTg. Histograms refer to before surgery (T0), then 3 (T1), and 12 months (T2) following surgery completion. A modest but significant amelioration of diurnal drowsiness is detected when PPTg-ON is introduced (for details, see Peppe et al., 2012).
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Figure 2: Shown are mean results of Epworth sleepiness scale (ESS) in original PD patients implanted a long-time ago (2006–2007) in both STN and PPTg. Histograms refer to before surgery (T0), then 3 (T1), and 12 months (T2) following surgery completion. A modest but significant amelioration of diurnal drowsiness is detected when PPTg-ON is introduced (for details, see Peppe et al., 2012).

Mentions: Selected papers on PD patients implanted in the “PPN-area” (estimated 60 patients from Rome, Bristol, Oxford, Melbourne, Grenoble, Toronto).


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

Stefani A, Peppe A, Galati S, Bassi MS, D'Angelo V, Pierantozzi M - Front Neurol (2013)

Shown are mean results of Epworth sleepiness scale (ESS) in original PD patients implanted a long-time ago (2006–2007) in both STN and PPTg. Histograms refer to before surgery (T0), then 3 (T1), and 12 months (T2) following surgery completion. A modest but significant amelioration of diurnal drowsiness is detected when PPTg-ON is introduced (for details, see Peppe et al., 2012).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672779&req=5

Figure 2: Shown are mean results of Epworth sleepiness scale (ESS) in original PD patients implanted a long-time ago (2006–2007) in both STN and PPTg. Histograms refer to before surgery (T0), then 3 (T1), and 12 months (T2) following surgery completion. A modest but significant amelioration of diurnal drowsiness is detected when PPTg-ON is introduced (for details, see Peppe et al., 2012).
Mentions: Selected papers on PD patients implanted in the “PPN-area” (estimated 60 patients from Rome, Bristol, Oxford, Melbourne, Grenoble, Toronto).

Bottom Line: 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.Yet, the wide electrical field delivered affects a plethora of en passant circuits, and a fine distinction on the specific pathways involved is elusive.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience, "Tor Vergata" University , Rome , Italy ; IRCCS, Fondazione Santa Lucia , Rome , Italy.

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.

No MeSH data available.


Related in: MedlinePlus