title: Pedunculopontine nucleus deep brain stimulation changes spinal cord excitability in Parkinson's disease patients.
abstract: Bilateral peduncolopontine nucleus (PPN) and subthalamic nucleus (STN) deep brain stimulation (DBS) was performed in six-advanced Parkinson's disease (PD) patients. We report the effect of both PPN-DBS (25 Hz) and STN-DBS (185 Hz) on patient spinal reflex excitability by utilizing the soleus-Hoffman reflex (HR) threshold. Compared to controls (n = 9), patients showed an increase of HR-threshold, which was scarcely affected by levodopa, but significantly reduced by DBS. In particular, we found that PPN-DBS alone, or plus STN-DBS induced a complete recovery of HR-threshold up to control values. The HR-threshold changes, although do not allow to investigate the contribution of specific intraspinal pathways, suggest that PPN may play a key-role in modulating spinal excitability in PD possibly by improving the basal ganglia-brainstem descending system activity.
authors.affiliation: Department of Neuroscience, Tor Vergata University, Rome, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Pierantozzi
authors.forename: Maria Giuseppina
authors.initials: MG
authors.lastname: Palmieri
authors.forename: Salvatore
authors.initials: S
authors.lastname: Galati
authors.forename: Paolo
authors.initials: P
authors.lastname: Stanzione
authors.forename: Antonella
authors.initials: A
authors.lastname: Peppe
authors.forename: Domenicantonio
authors.initials: D
authors.lastname: Tropepi
authors.forename: Livia
authors.initials: L
authors.lastname: Brusa
authors.forename: Antonio
authors.initials: A
authors.lastname: Pisani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Moschella
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Marciani
authors.forename: Paolo
authors.initials: P
authors.lastname: Mazzone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stefani
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D046690:Deep Brain Stimulation / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006181:H-Reflex / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology* / Q000628:therapy*; D045042:Pedunculopontine Tegmental Nucleus / Q000502:physiology / Q000528:radiation effects*; D013116:Spinal Cord / Q000503:physiopathology*