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

Clinicopathological study in progressive supranuclear palsy with pedunculopontine stimulation.

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  • 1Department of Pathology, University of Toronto, University Health Network, Toronto, Ontario, Canada.



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).


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.


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.


We provide histopathological evidence for the validity of our stereotactic approach to target the PPN and correlate electrode location with clinical outcomes.

Copyright © 2012 Movement Disorder Society.

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