Functional Connectivity of the Pedunculopontine Nucleus and Surrounding Region in Parkinson's Disease.
Deep brain stimulation of the pedunculopontine nucleus and surrounding region (PPNR) is a novel treatment strategy for gait freezing in Parkinson's disease (PD). However, clinical results have been variable, in part because of the paucity of functional information that might help guide selection of the optimal surgical target. In this study, we use simultaneous magnetoencephalography and local field recordings from the PPNR in seven PD patients, to characterize functional connectivity with distant brain areas at rest. The PPNR was preferentially coupled to brainstem and cingulate regions in the alpha frequency (8-12 Hz) band and to the medial motor strip and neighboring areas in the beta (18-33 Hz) band. The distribution of coupling also depended on the vertical distance of the electrode from the pontomesencephalic line: most effects being greatest in the middle PPNR, which may correspond to the caudal pars dissipata of the pedunculopontine nucleus. These observations confirm the crucial position of the PPNR as a functional node between cortical areas such as the cingulate/ medial motor strip and other brainstem nuclei, particularly in the dorsal pons. In particular they suggest a special role for the middle PPNR as this has the greatest functional connectivity with other brain regions.
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.|Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK.
Ashwani
A
Jha
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.|Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK.
Vladimir
V
Litvak
I-LABS MEG Brain Imaging Center, University of Washington, Seattle, WA, USA.|Department of Physics, University of Washington, Seattle, WA, USA.
Samu
S
Taulu
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Wesley
W
Thevathasan
Unit of Functional Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK.
Jonathan A
JA
Hyam
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.|Unit of Functional Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK.
Tom
T
Foltynie
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.|Unit of Functional Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK.
Patricia
P
Limousin
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Marko
M
Bogdanovic
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.|Unit of Functional Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK.
Ludvic
L
Zrinzo
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Alexander L
AL
Green
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Tipu Z
TZ
Aziz
Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK.
Karl
K
Friston
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.|MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK.
Peter
P
Brown
D000368:Aged; D000513:Alpha Rhythm; D001611:Beta Rhythm; D001921:Brain / Q000503:physiopathology*; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009434:Neural Pathways / Q000503:physiopathology; D010300:Parkinson Disease / Q000503:physiopathology*; D045042:Pedunculopontine Tegmental Nucleus / Q000503:physiopathology*
coherence; deep brain stimulation (DBS); gait freezing; human; magnetoencephalography (MEG); oscillations; pedunculopontine nucleus