Regional anatomy of the pedunculopontine nucleus: relevance for deep brain stimulation.
The pedunculopontine nucleus (PPN) is currently being investigated as a potential deep brain stimulation target to improve gait and posture in Parkinson's disease. This review examines the complex anatomy of the PPN region and suggests a functional mapping of the surrounding nuclei and fiber tracts that may serve as a guide to a more accurate placement of electrodes while avoiding potentially adverse effects. The relationships of the PPN were examined in different human brain atlases. Schematic representations of those structures in the vicinity of the PPN were generated and correlated with their potential stimulation effects. By providing a functional map and representative schematics of the PPN region, we hope to optimize the placement of deep brain stimulation electrodes, thereby maximizing safety and clinical efficacy.
Division of Neurosurgery, Hôpital Notre-Dame, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Marie-Pierre
MP
Fournier-Gosselin
Nir
N
Lipsman
Jean A
JA
Saint-Cyr
Clement
C
Hamani
Andres M
AM
Lozano
D046690:Deep Brain Stimulation / Q000379:methods*; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D009434:Neural Pathways / Q000033:anatomy & histology / Q000502:physiology; D010300:Parkinson Disease / Q000628:therapy; D045042:Pedunculopontine Tegmental Nucleus / Q000033:anatomy & histology* / Q000502:physiology*
Parkinson's disease; deep brain stimulation; gait; pedunculopontine nucleus; posture; stereotactic surgery