Open AccessThe pedunculopontine region and breathing in Parkinson's disease
Author(s) -
Hyam Jonathan A.,
Wang Shouyan,
Roy Holly,
Moosavi Shakeeb H.,
Martin Sean C.,
Brittain John Stuart,
Coyne Terry,
Silburn Peter,
Aziz Tipu Z.,
Green Alexander L.
Publication year - 2019
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.752
Subject(s) - medicine , stimulation , deep brain stimulation , local field potential , pedunculopontine nucleus , parkinson's disease , anesthesia , respiratory system , neuroscience , disease , psychology
Objective Respiratory abnormalities such as upper airway obstruction are common in Parkinson's disease ( PD ) and are an important cause of mortality and morbidity. We tested the effect of pedunculopontine region ( PPN r) stimulation on respiratory maneuvers in human participants with PD , and separately recorded PPN r neural activity reflected in the local field potential ( LFP ) during these maneuvers. Methods Nine patients with deep brain stimulation electrodes in PPN r, and seven in globus pallidus interna ( GP i) were studied during trials of maximal inspiration followed by forced expiration with stimulation OFF and ON . Local field potentials ( LFP s) were recorded in the unstimulated condition. Results PEFR increased from 6.41 ± 0.63 L/sec in the OFF stimulation state to 7.5 L ± 0.65 L/sec in the ON stimulation state ( z = −2.666, df = 8, P = 0.024). Percentage improvement in PEFR was strongly correlated with proximity of the stimulated electrode contact to the mesencephalic locomotor region in the rostral PPN ( r = 0.814, n = 9, P = 0.008). Mean PPN r LFP power increased within the alpha band (7–11 Hz) during forced respiratory maneuvers (1.63 ± 0.16 μ V 2 /Hz) compared to resting breathing (0.77 ± 0.16 μ V 2 /Hz; z = −2.197, df = 6, P = 0.028). No changes in alpha activity or spirometric indices were seen with GP i recording or stimulation. Percentage improvement in PEFR was strongly positively correlated with increase in alpha power ( r = 0.653, n = 14 (7 PPN r patients recorded bilaterally), P = 0.0096). Interpretation PPN r stimulation in PD improves indices of upper airway function. Increased alpha‐band activity is seen within the PPN r during forced respiratory maneuvers. Our findings suggest a link between the PPN r and respiratory performance in PD .