Clinicopathological study in progressive supranuclear palsy with pedunculopontine stimulation

Background: Pedunculopontine nucleus (PPN) DBS has emerged as a potential intervention for patients with gait and balance disorders. However, targeting this nucleus can be challenging. We report on the first neuropathological analyses after PPN‐DBS surgery in advanced progressive supranuclear palsy...

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Published in:Movement disorders 2012-09, Vol.27 (10), p.1304-1307
Main Authors: Hazrati, Lili-Naz, Wong, Janice C., Hamani, Clement, Lozano, Andres M., Poon, Yu-Yan, Dostrovsky, Jonathan O., Hutchison, William D., Zadikoff, Cindy, Moro, Elena
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brain - metabolism
Brain - pathology
deep brain stimulation
Deep Brain Stimulation - methods
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
Humans
Male
Medical sciences
Middle Aged
Movement disorders
Nerve Tissue Proteins - metabolism
Neurology
neuropathology
pedunculopontine nucleus
Pedunculopontine Tegmental Nucleus - physiology
progressive supranuclear palsy
Supranuclear Palsy, Progressive - pathology
Supranuclear Palsy, Progressive - therapy
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Summary:Background: Pedunculopontine nucleus (PPN) DBS has emerged as a potential intervention for patients with gait and balance disorders. However, targeting this nucleus can be challenging. We report on the first neuropathological analyses after PPN‐DBS surgery in advanced progressive supranuclear palsy (PSP). Methods: Two patients with PSP underwent unilateral PPN‐DBS surgery and were clinically followed to autopsy. Both patients underwent postmortem neuropathological analysis, including choline acetyltransferase immunohistochemistry, to ascertain PPN boundaries and electrode location. Results: Both patients experienced partial improvement in some motor and nonmotor domains postintervention, but died shortly of other complications. Postmortem neuropathological analysis of each patient confirmed the electrode in a region of cholinergic neuronal loss corresponding to the PPN. Conclusions: We provide histopathological evidence for the validity of our stereotactic approach to target the PPN and correlate electrode location with clinical outcomes. © 2012 Movement Disorder Society
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.25123