This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
The pedunculopontine tegmental nucleus (PPN) is a neurochemically and functionally heterogeneous structure that occupies a strategic position in the dorsal tegmentum of the midbrain and upper pons. The PPN contains cholinergic, γ-aminobutyric acid (GABA)ergic, and glutamatergic neurons; it receives direct input from the cerebral cortex, is reciprocally connected with the basal ganglia, and provides inputs to the thalamus and motor areas of the brainstem and spinal cord. Via these connections, the PPN is involved in mechanisms of cortical arousal and behavioral state control and participates in control of locomotion and muscle tone. The PPN is affected in Parkinson disease (PD) and atypical parkinsonian syndromes such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). Involvement of the PPN may have an important role in gait impairment in these disorders. The development of PPN deep brain stimulation (DBS) for treatment of this disabling symptom has also provided some insight into the function of the PPN in humans. There have been several recent reviews on the PPN focused on its neurochemical organization and connectivity, physiology, involvement in parkinsonian syndromes, and as a target for DBS.1–12
GLOSSARY
- DBS=
- deep brain stimulation;
- GABA=
- γ-aminobutyric acid;
- GPi=
- globus pallidus internus;
- LDTg=
- laterodorsal tegmental nucleus;
- MLR=
- mesencephalic locomotor region;
- MSA=
- multiple system atrophy;
- PD=
- Parkinson disease;
- PPN=
- pedunculopontine nucleus;
- PPNc=
- pedunculopontine nucleus pars compacta;
- PSP=
- progressive supranuclear palsy;
- SMA=
- supplementary motor area;
- SNr=
- substantia nigra pars reticulata;
- SNc=
- substantia nigra pars compacta;
- STN=
- subthalamic nucleus
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the article.
- © 2013 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Disputes & Debates: Rapid online correspondence
NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.
- Stay timely. Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- 200 words maximum.
- 5 references maximum. Reference 1 must be the article on which you are commenting.
- 5 authors maximum. Exception: replies can include all original authors of the article.
- Submitted comments are subject to editing and editor review prior to posting.