Clinicopathological study in progressive supranuclear palsy with pedunculopontine stimulation§


  • Funding agencies: CurePSP funded the trial of unilateral PPN-DBS in PSP patients. The work was supported, in part, by the Canadian Institutes of Health Research (grants to J.O.D. and W.D.H.; grant nos.: MOP-42505 and 98006).

  • Relevant conflict of interest/financial disclosures: Dr. Hamani is a consultant for St Jude Medical; Dr. Lozano is a consultant for St Jude Medical, Boston Scientific and Medtronic Inc. and holds intellectual property in the field of Deep Brain Stimulation; Dr. Hutchison has received consulting fee or honoraria from Medtronic Inc; Dr. Zadikoff has received payment for lectures from Tera and GSK; Dr. Moro has received honoraria from Medtronic Inc. for consulting services and lecturing, research support from St. Jude Medical, CurePSP, CIHR and educational grant support from Medtronic.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.



Pedunculopontine nucleus (PPN) DBS has emerged as a potential intervention for patients with gait and balance disorders. However, targeting this nucleus can be challenging. We report on the first neuropathological analyses after PPN-DBS surgery in advanced progressive supranuclear palsy (PSP).


Two patients with PSP underwent unilateral PPN-DBS surgery and were clinically followed to autopsy. Both patients underwent postmortem neuropathological analysis, including choline acetyltransferase immunohistochemistry, to ascertain PPN boundaries and electrode location.


Both patients experienced partial improvement in some motor and nonmotor domains postintervention, but died shortly of other complications. Postmortem neuropathological analysis of each patient confirmed the electrode in a region of cholinergic neuronal loss corresponding to the PPN.


We provide histopathological evidence for the validity of our stereotactic approach to target the PPN and correlate electrode location with clinical outcomes. © 2012 Movement Disorder Society