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March 19, 2013; 80 (12) Clinical Implications of Neuroscience Research

Pedunculopontine nucleus

Functional organization and clinical implications

Eduardo E. Benarroch
First published March 18, 2013, DOI: https://doi.org/10.1212/WNL.0b013e3182886a76
Eduardo E. Benarroch
From the Department of Neurology, Mayo Clinic, Rochester, MN.
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Pedunculopontine nucleus
Functional organization and clinical implications
Eduardo E. Benarroch
Neurology Mar 2013, 80 (12) 1148-1155; DOI: 10.1212/WNL.0b013e3182886a76

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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

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  • 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
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  • Article
    • GLOSSARY
    • FUNCTIONAL ANATOMY OF THE PPN
    • PHYSIOLOGY
    • MOTOR FUNCTION OF THE PPN
    • PPN, CORTICAL AROUSAL, AND SLEEP CYCLE
    • CLINICAL CORRELATIONS
    • PERSPECTIVE
    • DISCLOSURE
    • Footnotes
    • REFERENCES
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