Connectivity of the human pedunculopontine nucleus region and diffusion tensor imaging in surgical targeting

• DOI: 10.3171/jns-07/10/0814
• Publication Date: 2007-12-13T15:49:17Z
• Authors: Kalai A. Muthusamy; Bhooma R. Aravamu...; Morten L. Kringel...; Ned Jenkinson; Natalie L. Voets; Heidi Johansen-Berg; John F. Stein; Tipu Z. Aziz
• Keywords: Pedunculopontine nucleus; Subthalamic Nucleus; Red nucleus

Object The pedunculopontine nucleus (PPN) region of the brainstem has become a new stimulation target for treatment gait freezing, akinesia, and postural instability in advanced Parkinson disease (PD). Because PD locomotor symptoms are probably caused by excessive γ-aminobutyric acidergic inhibition PPN, low-frequency PPN may overcome this improve symptoms. However, anatomical connections humans not known any detail. Methods Diffusion weighted magnetic resonance (MR) images were acquired at 1.5 teslas, probabilistic tractography was used to trace eight healthy volunteers. A single seed voxel (2 × 2 mm) chosen just lateral decussation superior cerebellar peduncle, Toolbox Oxford Centre Functional Magnetic Resonance Imaging Brain process MR images. each volunteer's analyzed using human brain imaging atlas. Results connected with cerebellum spinal cord below thalamus, pallidum, subthalamic nucleus, motor cortex above. regions primary that control trunk upper lower extremities had highest connectivity compared other parts cortex. Conclusions These findings suggest cortex, basal ganglia, cerebellum, play important roles regulation movement region. tensor be preoperatively optimize placement electrodes postoperatively it also useful reassess electrode positions.