title: Clinicopathological study in progressive supranuclear palsy with pedunculopontine stimulation.
abstract: BACKGROUND
  Pedunculopontine nucleus (PPN) DBS has emerged as a potential intervention for patients with gait and balance disorders. However, targeting this nucleus can be challenging. We report on the first neuropathological analyses after PPN-DBS surgery in advanced progressive supranuclear palsy (PSP).
  
  
  METHODS
  Two patients with PSP underwent unilateral PPN-DBS surgery and were clinically followed to autopsy. Both patients underwent postmortem neuropathological analysis, including choline acetyltransferase immunohistochemistry, to ascertain PPN boundaries and electrode location.
  
  
  RESULTS
  Both patients experienced partial improvement in some motor and nonmotor domains postintervention, but died shortly of other complications. Postmortem neuropathological analysis of each patient confirmed the electrode in a region of cholinergic neuronal loss corresponding to the PPN.
  
  
  CONCLUSIONS
  We provide histopathological evidence for the validity of our stereotactic approach to target the PPN and correlate electrode location with clinical outcomes.
authors.affiliation: Department of Pathology, University of Toronto, University Health Network, Toronto, Ontario, Canada. lilinaz.hazrati@utoronto.ca
authors.forename: Lili-Naz
authors.initials: LN
authors.lastname: Hazrati
authors.forename: Janice C
authors.initials: JC
authors.lastname: Wong
authors.forename: Clement
authors.initials: C
authors.lastname: Hamani
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
authors.forename: Yu-Yan
authors.initials: YY
authors.lastname: Poon
authors.forename: Jonathan O
authors.initials: JO
authors.lastname: Dostrovsky
authors.forename: William D
authors.initials: WD
authors.lastname: Hutchison
authors.forename: Cindy
authors.initials: C
authors.lastname: Zadikoff
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
mesh_terms: D001921:Brain / Q000378:metabolism / Q000473:pathology*; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000378:metabolism; D045042:Pedunculopontine Tegmental Nucleus / Q000502:physiology*; D013494:Supranuclear Palsy, Progressive / Q000473:pathology* / Q000628:therapy*
chemical_list: D009419:Nerve Tissue Proteins