title: Involvement of the human pedunculopontine nucleus region in voluntary movements.
abstract: OBJECTIVE
  The pedunculopontine nucleus region (PPNR) is being investigated as a target for deep brain stimulation (DBS) in Parkinson disease (PD), particularly for gait and postural impairment. A greater understanding of how PPNR activities and oscillations are modulated with voluntary movements is crucial to the development of neuromodulation strategies.
  
  
  METHODS
  We studied 7 patients with PD who underwent DBS electrode implantations in the PPNR. PPNR local field potential and EEG were recorded while patients performed self-paced wrist and ankle movements.
  
  
  RESULTS
  Back-averaging of the PPNR recording showed movement-related potentials before electromyography onset. Frequency analysis showed 2 discrete movement-related frequency bands in the theta (6- to 10-Hz) and beta (14- to 30-Hz) ranges. The PPNR theta band showed greater event-related desynchronization with movements in the ON than in the OFF medication state and was coupled with the sensorimotor cortices in the ON state only. Beta event-related desynchronization was observed in the PPNR during the premovement and movement execution phases in the OFF state. In contrast, premovement PPNR beta event-related synchronization occurred in the ON state. Moreover, beta band coherence between the PPNR and the midline prefrontal region was observed during movement preparation in the ON but not the OFF state.
  
  
  CONCLUSIONS
  Activities of PPNR change during movement preparation and execution in patients with PD. Dopaminergic medications modulate PPNR activities and promote the interactions between the cortex and PPNR. Beta oscillations may have different functions in the basal ganglia and PPNR, and may be prokinetic rather than antikinetic in the PPNR.
authors: Division of Brain Imaging & Behaviour Systems-Neuroscience, Toronto Western Hospital, McLaughlin Pavilion, Toronto, Ontario M5T 2S8, Canada.
authors: E W
authors: EW
authors: Tsang
authors: C
authors: C
authors: Hamani
authors: E
authors: E
authors: Moro
authors: F
authors: F
authors: Mazzella
authors: Y Y
authors: YY
authors: Poon
authors: A M
authors: AM
authors: Lozano
authors: R
authors: R
authors: Chen
mesh_terms: D000368:Aged; D001479:Basal Ganglia / Q000502:physiology; D003344:Cortical Synchronization; D003627:Data Interpretation, Statistical; D046690:Deep Brain Stimulation; D004567:Electrodes, Implanted; D004569:Electroencephalography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D009068:Movement / Q000502:physiology*; D009415:Nerve Net / Q000502:physiology; D010300:Parkinson Disease / Q000503:physiopathology / Q000601:surgery; D045042:Pedunculopontine Tegmental Nucleus / Q000502:physiology*; D013003:Somatosensory Cortex / Q000502:physiology; D020531:Subthalamic Nucleus / Q000502:physiology