Pedunculopontine nucleus deep brain stimulation changes spinal cord excitability in Parkinson's disease patients

J Neural Transm (Vienna). 2008 May;115(5):731-5. doi: 10.1007/s00702-007-0001-8. Epub 2008 Jan 15.

Abstract

Bilateral peduncolopontine nucleus (PPN) and subthalamic nucleus (STN) deep brain stimulation (DBS) was performed in six-advanced Parkinson's disease (PD) patients. We report the effect of both PPN-DBS (25 Hz) and STN-DBS (185 Hz) on patient spinal reflex excitability by utilizing the soleus-Hoffman reflex (HR) threshold. Compared to controls (n = 9), patients showed an increase of HR-threshold, which was scarcely affected by levodopa, but significantly reduced by DBS. In particular, we found that PPN-DBS alone, or plus STN-DBS induced a complete recovery of HR-threshold up to control values. The HR-threshold changes, although do not allow to investigate the contribution of specific intraspinal pathways, suggest that PPN may play a key-role in modulating spinal excitability in PD possibly by improving the basal ganglia-brainstem descending system activity.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Case-Control Studies
  • Deep Brain Stimulation / methods*
  • Dose-Response Relationship, Radiation
  • Female
  • H-Reflex / drug effects*
  • H-Reflex / physiology
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / pathology*
  • Parkinson Disease / therapy*
  • Pedunculopontine Tegmental Nucleus / physiology
  • Pedunculopontine Tegmental Nucleus / radiation effects*
  • Spinal Cord / physiopathology*