Clinicopathological study in progressive supranuclear palsy with pedunculopontine stimulation§

Authors


  • 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.

Abstract

Background:

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).

Methods:

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.

Results:

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.

Conclusions:

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

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