Clinicopathological study in progressive supranuclear palsy with pedunculopontine stimulation

Mov Disord. 2012 Sep 1;27(10):1304-7. doi: 10.1002/mds.25123. Epub 2012 Aug 1.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / metabolism
  • Brain / pathology*
  • Deep Brain Stimulation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nerve Tissue Proteins / metabolism
  • Pedunculopontine Tegmental Nucleus / physiology*
  • Supranuclear Palsy, Progressive / pathology*
  • Supranuclear Palsy, Progressive / therapy*


  • Nerve Tissue Proteins