The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
N YousifB M Seemungal

Abstract

Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) reduces the number of falls in patients with Parkinson's disease (PD). It was hypothesized that enhanced sensory processing contributes to this PPN-mediated gait improvement. Four PD patients (and eight matched controls) with implanted bilateral PPN and subthalamic nucleus DBS electrodes were assessed on postural (with/without vision) and vestibular perceptual threshold tasks. Pedunculopontine nucleus ON stimulation (compared to OFF) lowered vestibular perceptual thresholds but there was a disproportionate increase in the normal sway increase on going from light to dark. The disproportionate increased sway with PPN stimulation in the dark may paradoxically improve balance function since mechanoreceptor signals rapidly adapt to continuous pressure stimulation from postural akinesia. Additionally, the PPN-mediated vestibular signal enhancement also improves the monitoring of postural sway. Overall, PPN stimulation may improve sensory feedback and hence balance performance.

References

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Citations

Oct 27, 2016·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Carolina de Oliveira SouzaErich Talamoni Fonoff
Nov 11, 2017·Frontiers in Neurology·Thomas CroninBarry M Seemungal
Oct 17, 2017·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A H V Schapira
May 18, 2018·Journal of Zhejiang University. Science. B·Nicole Peter, Tobias Kleinjung
Aug 31, 2018·Brain : a Journal of Neurology·Thushara PereraWesley Thevathasan
Jan 28, 2017·The Cerebellum·Aasef G ShaikhAntonella Palla
Sep 30, 2017·Movement Disorders : Official Journal of the Movement Disorder Society·Wesley ThevathasanUNKNOWN Movement Disorders Society PPN DBS Working Groupin collaboration with the World Society for Stereotactic and Functional Neur
Jan 9, 2019·Frontiers in Neurology·Paul F Smith
Jun 28, 2018·Frontiers in Neurology·Aasef G ShaikhFatema F Ghasia
Jan 16, 2020·The Cerebellum·Sinem Balta BeylergilAasef G Shaikh
Aug 2, 2019·Brain : a Journal of Neurology·Min XiangBarry M Seemungal
Jun 12, 2017·Journal of Neural Transmission·Thomas WichmannMahlon R DeLong
Oct 27, 2020·Movement Disorders : Official Journal of the Movement Disorder Society·Sinem Balta BeylergilAasef G Shaikh
May 19, 2021·Journal of Neurology·Sinem Balta BeylergilAasef G Shaikh

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