Deep Brain Stimulation of the Pedunculopontine Nucleus for Parkinson's Disease

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Deep brain stimulation (DBS) has become the most widely used surgical intervention for the treatment of PD. The two main targets of DBS for PD are the subthalamic nucleus (STN) and globus pallidus pars interna (GPi), both of which have shown similar efficacy in alleviating parkinsonian motor symptoms. Because of the severe impact that postural instability and gait disturbance have on patients' lives, there has been increased interest in identifying alternate targets for DBS, in an effort to treat these symptoms. The most promising target under investigation is the pedunculopontine nucleus (PPN). As investigations of the PPN as a therapeutic target have moved into clinical studies, results have continued to suggest that the site provides a means to address postural instability and gait dysfunction.