Focus on the pedunculopontine nucleus. Consensus review from the May 2018 brainstem society meeting in Washington, DC, USA
Edgar García‐Rilla b✉, Clifford B. Saperc, David B. Ryec, Markus Köflerd, Jorik H. Nonnekese, Andrés M. Lozanof, Josep Valls‐Solég, Mark Halletth
- aCenter for Translational Neuroscience, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA. Electronic address: garciarilledgar@uams.edu
- bCenter for Translational Neuroscience, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- cDepartment of Neurology, Division of Sleep Medicine and Program in Neuroscience, Harvard Medical School, Boston, MA, USA
- dDepartment of Neurology, Hochzirl Hospital, Zirl, Austria
- eRadboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, the Netherlands
- fDivision of Neurosurgery, University of Toronto and Krembil Neuroscience Centre, University Health Network, Toronto, Canada
- gNeurology Department, Hospital Clínic, University of Barcelona, IDIBAPS (Institut d'Investigació Biomèdica August Pi i Sunyer), Barcelona, Spain
- hHuman Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Abstract
The pedunculopontine nucleus (PPN) is located in the mesopontine tegmentum and is best delimited by a group of large cholinergic neurons adjacent to the decussation of the superior cerebellar peduncle. This part of the brain, populated by many other neuronal groups, is a crossroads for many important functions. Good evidence relates the PPN to control of reflex reactions, sleep-wake cycles, posture and gait. However, the precise role of the PPN in all these functions has been controversial and there still are uncertainties in the functional anatomy and physiology of the nucleus. It is difficult to grasp the extent of the influence of the PPN, not only because of its varied functions and projections, but also because of the controversies arising from them. One controversy is its relationship to the mesencephalic locomotor region (MLR). In this regard, the PPN has become a new target for deep brain stimulation (DBS) for the treatment of parkinsonian gait disorders, including freezing of gait. This review is intended to indicate what is currently known, shed some light on the controversies that have arisen, and to provide a framework for future research.
TL;DRThe pedunculopontine nucleus has become a new target for deep brain stimulation (DBS) for the treatment of parkinsonian gait disorders, including freezing of gait. (Semantic Scholar)