Neuroreport
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The peduncolopontine nucleus modulates locomotor activity and dysfunction in this nucleus may be responsible for the gait and postural impairments seen in Parkinson's disease and other movement disorders. We report the first surgical exploration and implantation of deep brain stimulating electrodes of the peduncolopontine nucleus area in two Parkinson's disease patients to examine the safety and the potential benefit of chronic electrical stimulation at this site. Under local anesthesia, the peduncolopontine nucleus was approached from a coronal burr hole using a trajectory that was 78-80 degrees and 62-64 degrees on the coronal and sagittal planes. ⋯ These findings demonstrate that the stereotactic approach of peduncolopontine nucleus is safe. The target may reliably be identified by microrecordings. Low-frequency stimulation may produce acute improvements in motor function.
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Gait disturbance and postural instability are some the most disabling symptoms of idiopathic Parkinson's disease and in late stage disease can be resistant to both medical and surgical therapies. We implanted bilateral deep brain stimulation electrodes into the pedunculopontine nucleus in two patients with advanced Parkinson's disease. ⋯ No procedure or stimulation-related complications were observed. If these findings are replicated in a larger number of patients, pedunculopontine nucleus stimulation may provide the means to alleviate these disabling and otherwise treatment-resistant symptoms of advanced Parkinson's disease.