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Updated: May 25, 2026

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Pedunculopontine nucleus deep brain stimulation in Parkinson's disease
Tomasz Tykocki1, Tomasz Mandat, Paweł Nauman
1Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw, Poland.
Abstract:
Postural instability and gait difficulty (PIGD) are commonly observed in advanced Parkinson's disease. The neuronal mechanism of PIGD is not fully understood. Dysfunction of the pedunculopontine nucleus (PPN) might be a possible cause of these symptoms. The autopsy studies of subjects with PIGD revealed a neurodegenerative process involving mainly PPN cholinergic neurons. The PPN participates in the locomotion processes by initiation, modulation and execution of stereotyped patterns of movement. The standard neurosurgical treatment of PD is subthalamic deep brain stimulation (STN DBS). Clinical results revealed low efficiency of STN DBS on PIGD. Preliminary results of simultaneous PPN and STN DBS are very promising. Only a few reports have been published until now; a significant improvement of PIGD was observed in both ON and OFF L-dopa states.
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