Deep brain stimulation of the subthalamic and pedunculopontine nucleus in a patient with Parkinson's disease

Huan-Guang Liu, Kai Zhang, An-Chao Yang, Jian-Guo Zhang, Huan-Guang Liu, Kai Zhang, An-Chao Yang, Jian-Guo Zhang

Abstract

Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) is a novel therapy developed to treat Parkinson's disease. We report a patient who underwent bilateral DBS of the PPN and subthalamic nucleus (STN). He suffered from freezing of gait (FOG), bradykinesia, rigidity and mild tremors. The patient underwent bilateral DBS of the PPN and STN. We compared the benefits of PPN-DBS and STN-DBS using motor and gait subscores. The PPN-DBS provided modest improvements in the gait disorder and freezing episodes, while the STN-DBS failed to improve the dominant problems. This special case suggests that PPN-DBS may have a unique role in ameliorating the locomotor symptoms and has the potential to provide improvement in FOG.

Keywords: Deep brain stimulation; Parkinson's disease; Pedunculopontine nucleus; Subthalamic nucleus.

Figures

Fig. 1. DBS electrodes were implanted bilaterally…
Fig. 1. DBS electrodes were implanted bilaterally into the STN and PPN. A and B : X-ray imaging. C and D : Transverse sections. E and F : Coronal sections. White arrows indicate PPN (C and E), black arrows indicate STN (D and F). DBS : deep brain stimulation, STN : subthalamic nucleus, PPN : pedunculopontine nucleus.

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