Tractography patterns of pedunculopontine nucleus deep brain stimulation

• DOI: 10.1007/s00702-021-02327-x
• Publication Date: 2021-03-29T12:02:31Z
• Authors: Ashley L. B. Raghu; Tariq Parker; Amir P. Divanbeig...; Stephen Payne; Jesper Andersson; John Stein; Tipu Z. Aziz; Alexander L. Green
• Keywords: Pedunculopontine nucleus; Precentral gyrus

Abstract Deep brain stimulation of the pedunculopontine nucleus is a promising surgical procedure for treatment Parkinsonian gait and balance dysfunction. It has, however, produced mixed clinical results that are poorly understood. We used tractography with aim to rationalise this heterogeneity. A cohort eight patients postural instability disturbance (Parkinson’s disease subtype) underwent pre-operative structural diffusion MRI, then progressed deep targeting nucleus. Pre-operative follow-up assessments were carried out using Gait Falls Questionnaire, Freezing Questionnaire. Probabilistic tensor was between stimulating electrodes both cortical cerebellar regions priori interest. Cortical surface reconstructions measure thickness in relevant areas. Structural connectivity electrode precentral gyrus ( r = 0.81, p 0.01), Brodmann areas 1 0.78, 0.02) 2 0.76, 0.03) correlated improvement. negative correlation also observed superior peduncle −0.76, 0.03). Lower left parietal lobe bilateral premotor cortices associated greater severity symptoms. Both motor sensory stimulated target characterises benefit, or lack thereof, from surgery. In what challenging region brainstem effectively target, these provide insights into how can be better achieved. The mechanisms action likely have components, commensurate probable nature underlying