The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception

N Yousif; H Bhatt; P G Bain; D Nandi; B M Seemungal

doi:10.1111/ene.12947

The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception

N Yousif, H Bhatt, P G Bain, D Nandi, B M Seemungal

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Abstract

BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) reduces the number of falls in patients with Parkinson's disease (PD). It was hypothesized that enhanced sensory processing contributes to this PPN-mediated gait improvement.

METHODS: Four PD patients (and eight matched controls) with implanted bilateral PPN and subthalamic nucleus DBS electrodes were assessed on postural (with/without vision) and vestibular perceptual threshold tasks.

RESULTS: Pedunculopontine nucleus ON stimulation (compared to OFF) lowered vestibular perceptual thresholds but there was a disproportionate increase in the normal sway increase on going from light to dark.

CONCLUSIONS: The disproportionate increased sway with PPN stimulation in the dark may paradoxically improve balance function since mechanoreceptor signals rapidly adapt to continuous pressure stimulation from postural akinesia. Additionally, the PPN-mediated vestibular signal enhancement also improves the monitoring of postural sway. Overall, PPN stimulation may improve sensory feedback and hence balance performance.

Original language	English
Pages (from-to)	668-70
Number of pages	3
Journal	ISRN Neurology
Volume	23
Issue number	3
DOIs	https://doi.org/10.1111/ene.12947
Publication status	Published - 25 Feb 2016

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10.1111/ene.12947Licence: CC BY

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title = "The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception",

abstract = "BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) reduces the number of falls in patients with Parkinson's disease (PD). It was hypothesized that enhanced sensory processing contributes to this PPN-mediated gait improvement.METHODS: Four PD patients (and eight matched controls) with implanted bilateral PPN and subthalamic nucleus DBS electrodes were assessed on postural (with/without vision) and vestibular perceptual threshold tasks.RESULTS: Pedunculopontine nucleus ON stimulation (compared to OFF) lowered vestibular perceptual thresholds but there was a disproportionate increase in the normal sway increase on going from light to dark.CONCLUSIONS: The disproportionate increased sway with PPN stimulation in the dark may paradoxically improve balance function since mechanoreceptor signals rapidly adapt to continuous pressure stimulation from postural akinesia. Additionally, the PPN-mediated vestibular signal enhancement also improves the monitoring of postural sway. Overall, PPN stimulation may improve sensory feedback and hence balance performance.",

author = "N Yousif and H Bhatt and Bain, {P G} and D Nandi and Seemungal, {B M}",

note = "{\textcopyright} 2016 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of Europe an Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and re production in any medium, provided the original work is properly cited, see https://creativecommons.org/licenses/by/3.0/ ",

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T1 - The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception

AU - Yousif, N

AU - Bhatt, H

AU - Bain, P G

AU - Nandi, D

AU - Seemungal, B M

N1 - © 2016 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of Europe an Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and re production in any medium, provided the original work is properly cited, see https://creativecommons.org/licenses/by/3.0/

PY - 2016/2/25

Y1 - 2016/2/25

N2 - BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) reduces the number of falls in patients with Parkinson's disease (PD). It was hypothesized that enhanced sensory processing contributes to this PPN-mediated gait improvement.METHODS: Four PD patients (and eight matched controls) with implanted bilateral PPN and subthalamic nucleus DBS electrodes were assessed on postural (with/without vision) and vestibular perceptual threshold tasks.RESULTS: Pedunculopontine nucleus ON stimulation (compared to OFF) lowered vestibular perceptual thresholds but there was a disproportionate increase in the normal sway increase on going from light to dark.CONCLUSIONS: The disproportionate increased sway with PPN stimulation in the dark may paradoxically improve balance function since mechanoreceptor signals rapidly adapt to continuous pressure stimulation from postural akinesia. Additionally, the PPN-mediated vestibular signal enhancement also improves the monitoring of postural sway. Overall, PPN stimulation may improve sensory feedback and hence balance performance.

AB - BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) reduces the number of falls in patients with Parkinson's disease (PD). It was hypothesized that enhanced sensory processing contributes to this PPN-mediated gait improvement.METHODS: Four PD patients (and eight matched controls) with implanted bilateral PPN and subthalamic nucleus DBS electrodes were assessed on postural (with/without vision) and vestibular perceptual threshold tasks.RESULTS: Pedunculopontine nucleus ON stimulation (compared to OFF) lowered vestibular perceptual thresholds but there was a disproportionate increase in the normal sway increase on going from light to dark.CONCLUSIONS: The disproportionate increased sway with PPN stimulation in the dark may paradoxically improve balance function since mechanoreceptor signals rapidly adapt to continuous pressure stimulation from postural akinesia. Additionally, the PPN-mediated vestibular signal enhancement also improves the monitoring of postural sway. Overall, PPN stimulation may improve sensory feedback and hence balance performance.

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DO - 10.1111/ene.12947

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SP - 668

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JO - ISRN Neurology

JF - ISRN Neurology

IS - 3

ER -

The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception

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