The Effect of Pedunculopontine Nucleus Deep Brain Stimulation on Postural Sway and Vestibular Perception

Overview

Journal Eur J Neurol

Publisher Wiley

Specialty Neurology

Date 2016 Jan 24

PMID 26800658

Citations 17

Authors

N Yousif

H Bhatt

P G Bain

D Nandi

B M Seemungal

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Citing Articles

A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies.

Hvingelby V, Carra R, Terkelsen M, Hamani C, Capato T, Kosutzka Z Mov Disord Clin Pract. 2024; 11(8):927-947.

PMID: 38899557 PMC: 11329578. DOI: 10.1002/mdc3.14143.

Vestibular dysfunction in Parkinson's disease: a neglected topic.

Gui M, Lv L, Qin L, Wang C Front Neurol. 2024; 15:1398764.

PMID: 38846039 PMC: 11153727. DOI: 10.3389/fneur.2024.1398764.

Does Vestibular Motion Perception Correlate with Axonal Pathways Stimulated by Subthalamic Deep Brain Stimulation in Parkinson's Disease?.

Beylergil S, Noecker A, Kilbane C, McIntyre C, Shaikh A Cerebellum. 2023; 23(2):554-569.

PMID: 37308757 DOI: 10.1007/s12311-023-01576-8.

Spinal cord stimulation therapy for patients with Parkinson's disease and gait problems (STEP-PD): study protocol for an exploratory, double-blind, randomised, placebo-controlled feasibility trial.

Hvingelby V, Terkelsen M, Johnsen E, Moller M, Danielsen E, Henriksen T BMJ Neurol Open. 2022; 4(2):e000333.

PMID: 36101543 PMC: 9413283. DOI: 10.1136/bmjno-2022-000333.

The Application of Deep Brain Stimulation for Progressive Supranuclear Palsy: A Systematic Review.

Wen Y, Jiao B, Zhou Y Front Neurol. 2022; 13:827472.

PMID: 35800081 PMC: 9253877. DOI: 10.3389/fneur.2022.827472.

References

Seemungal B, Gunaratne I, Fleming I, Gresty M, Bronstein A . Perceptual and nystagmic thresholds of vestibular function in yaw. J Vestib Res. 2005; 14(6):461-6. View

Kennedy P, Inglis J . Distribution and behaviour of glabrous cutaneous receptors in the human foot sole. J Physiol. 2002; 538(Pt 3):995-1002. PMC: 2290100. DOI: 10.1113/jphysiol.2001.013087. View

Maurer C, Mergner T, Bolha B, Hlavacka F . Human balance control during cutaneous stimulation of the plantar soles. Neurosci Lett. 2001; 302(1):45-8. DOI: 10.1016/s0304-3940(01)01655-x. View

St George R, Nutt J, Burchiel K, Horak F . A meta-regression of the long-term effects of deep brain stimulation on balance and gait in PD. Neurology. 2010; 75(14):1292-9. PMC: 3013496. DOI: 10.1212/WNL.0b013e3181f61329. View

Ferraye M, Debu B, Fraix V, Krack P, Charbardes S, Seigneuret E . Subthalamic nucleus versus pedunculopontine nucleus stimulation in Parkinson disease: synergy or antagonism?. J Neural Transm (Vienna). 2011; 118(10):1469-75. DOI: 10.1007/s00702-011-0673-y. View