title: Critical evaluation of the anatomical location of the Barrington nucleus: relevance for deep brain stimulation surgery of pedunculopontine tegmental nucleus.
abstract: Deep brain stimulation (DBS) has become the standard surgical procedure for advanced Parkinson's disease (PD). Recently, the pedunculopontine tegmental nucleus (PPN) has emerged as a potential target for DBS in patients whose quality of life is compromised by freezing of gait and falls. To date, only a few groups have published their long-term clinical experience with PPN stimulation. Bearing in mind that the Barrington (Bar) nucleus and some adjacent nuclei (also known as the micturition centre) are close to the PPN and may be affected by DBS, the aim of the present study was to review the anatomical location of this structure in human and other species. To this end, the Bar nucleus area was analysed in mouse, monkey and human tissues, paying particular attention to the anatomical position in humans, where it has been largely overlooked. Results confirm that anatomical location renders the Bar nucleus susceptible to influence by the PPN DBS lead or to diffusion of electrical current. This may have an undesirable impact on the quality of life of patients.
authors.affiliation: Clinical and Experimental Neuroscience, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, School of Medicine, University of Murcia, Campus de Espinardo, 30071 Murcia, Spain.
authors.forename: Lisette
authors.initials: L
authors.lastname: Blanco
authors.forename: Jose Enrique
authors.initials: JE
authors.lastname: Yuste
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Carrillo-de Sauvage
authors.forename: Aurora
authors.initials: A
authors.lastname: Gómez
authors.forename: Emiliano
authors.initials: E
authors.lastname: Fernández-Villalba
authors.forename: Itciar
authors.initials: I
authors.lastname: Avilés-Olmos
authors.forename: Patricia
authors.initials: P
authors.lastname: Limousin
authors.forename: Ludvic
authors.initials: L
authors.lastname: Zrinzo
authors.forename: María Trinidad
authors.initials: MT
authors.lastname: Herrero
mesh_terms: D000818:Animals; D046690:Deep Brain Stimulation / Q000379:methods / Q000592:standards*; D006801:Humans; D008252:Macaca fascicularis; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D045042:Pedunculopontine Tegmental Nucleus / Q000033:anatomy & histology* / Q000502:physiology / Q000601:surgery*; D013045:Species Specificity
keywords: Bar; Barrington nucleus; CRF; DBS; LC; LDTg; MRI; PBS; PD; PFA; PPN; Parkinson’s disease; TH; VAChT; corticotropin release factor; deep brain stimulation; laterodorsal tegmental nucleus; locus coeruleus; magnetic resonance imaging; micturition centre; paraformaldehyde; pedunculopontine nucleus; phosphate-buffered saline; tyrosine hydroxylase; vesicular acetylcholine transporter