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The pedunculopontine region and breathing in Parkinson's disease

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 (PPNr) stimulation on respiratory maneuvers in human participants with PD, and sepa...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529926/
https://www.ncbi.nlm.nih.gov/pubmed/31139681
http://dx.doi.org/10.1002/acn3.752
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author 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.
author_facet 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.
author_sort Hyam, Jonathan A.
collection PubMed
description 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 (PPNr) stimulation on respiratory maneuvers in human participants with PD, and separately recorded PPNr neural activity reflected in the local field potential (LFP) during these maneuvers. METHODS: Nine patients with deep brain stimulation electrodes in PPNr, and seven in globus pallidus interna (GPi) were studied during trials of maximal inspiration followed by forced expiration with stimulation OFF and ON. Local field potentials (LFPs) 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 PPNr LFP power increased within the alpha band (7–11 Hz) during forced respiratory maneuvers (1.63 ± 0.16 μV(2)/Hz) compared to resting breathing (0.77 ± 0.16 μV(2)/Hz; z = −2.197, df = 6, P = 0.028). No changes in alpha activity or spirometric indices were seen with GPi recording or stimulation. Percentage improvement in PEFR was strongly positively correlated with increase in alpha power (r = 0.653, n = 14 (7 PPNr patients recorded bilaterally), P = 0.0096). INTERPRETATION: PPNr stimulation in PD improves indices of upper airway function. Increased alpha‐band activity is seen within the PPNr during forced respiratory maneuvers. Our findings suggest a link between the PPNr and respiratory performance in PD.
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spelling pubmed-65299262019-05-28 The pedunculopontine region and breathing in Parkinson's disease 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. Ann Clin Transl Neurol Research Articles 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 (PPNr) stimulation on respiratory maneuvers in human participants with PD, and separately recorded PPNr neural activity reflected in the local field potential (LFP) during these maneuvers. METHODS: Nine patients with deep brain stimulation electrodes in PPNr, and seven in globus pallidus interna (GPi) were studied during trials of maximal inspiration followed by forced expiration with stimulation OFF and ON. Local field potentials (LFPs) 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 PPNr LFP power increased within the alpha band (7–11 Hz) during forced respiratory maneuvers (1.63 ± 0.16 μV(2)/Hz) compared to resting breathing (0.77 ± 0.16 μV(2)/Hz; z = −2.197, df = 6, P = 0.028). No changes in alpha activity or spirometric indices were seen with GPi recording or stimulation. Percentage improvement in PEFR was strongly positively correlated with increase in alpha power (r = 0.653, n = 14 (7 PPNr patients recorded bilaterally), P = 0.0096). INTERPRETATION: PPNr stimulation in PD improves indices of upper airway function. Increased alpha‐band activity is seen within the PPNr during forced respiratory maneuvers. Our findings suggest a link between the PPNr and respiratory performance in PD. John Wiley and Sons Inc. 2019-05-01 /pmc/articles/PMC6529926/ /pubmed/31139681 http://dx.doi.org/10.1002/acn3.752 Text en © 2019 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
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.
The pedunculopontine region and breathing in Parkinson's disease
title The pedunculopontine region and breathing in Parkinson's disease
title_full The pedunculopontine region and breathing in Parkinson's disease
title_fullStr The pedunculopontine region and breathing in Parkinson's disease
title_full_unstemmed The pedunculopontine region and breathing in Parkinson's disease
title_short The pedunculopontine region and breathing in Parkinson's disease
title_sort pedunculopontine region and breathing in parkinson's disease
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529926/
https://www.ncbi.nlm.nih.gov/pubmed/31139681
http://dx.doi.org/10.1002/acn3.752
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