A block to pre-prepared movement in gait freezing, relieved by pedunculopontine nucleus stimulation

By W. Thevathasan, A. Pogosyan, JonathanA Hyam, N. Jenkinson, M. Bogdanovic, Terry J. Coyne, Peter A. Silburn, Tipu Z. Aziz, Tipu Z. Aziz, Peter Brown. 2011

178 citations recorded by the source corpus.

Gait freezing and postural instability are disabling features of Parkinsonian disorders, treatable with pedunculopontine nucleus stimulation. Both features are considered deficits of proximal and axial musculature, innervated predominantly by reticulospinal pathways and tend to manifest when gait and posture require adjustment. Adjustments to gait and posture are amenable to pre-preparation and rapid triggered release. Experimentally, such accelerated release can be elicited by loud auditory stimuli—a phenomenon known as ‘StartReact’. We observed StartReact in healthy and Parkinsonian controls. However, StartReact was absent in Parkinsonian patients with severe gait freezing and postural instability. Pedunculopontine nucleus stimulation restored StartReact proximally and proximal reaction times to loud stimuli correlated with gait and postural disturbance. These findings suggest a relative block to triggered, pre-prepared movement in gait freezing and postural instability, relieved by pedunculopontine nucleus stimulation.

Subfields: Neurology

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Citations in the corpus

• Numerosity, Abstraction, and the Emergence of Symbolic Thinking (2012, background): “Recent work by Geva et al. (2011), Lurito et al. (2000), and Owen, Borowsky, and Sarty (2004) implicates a far more complex relationship among the SMG, posterior brain areas, and Broca’s area in the production of inner speech.”
• The brain’s conversation with itself: neural substrates of dialogic inner speech (2015, background): “auditory imagery; Zatorre and Halpern, 2005) and in general it is preferable to include an objective test of inner speech use, such as paradigms that require participants to make rhyming judgements (Geva et al., 2011) or to assess metric stress (Aleman et al.”
• Mental imagery of speech: linking motor and perceptual systems through internal simulation and estimation (2012, background): “Lesions over the left pars opercularis (pOp) in the inferior frontal gyrus (IFG) as well as adjacent to the left supramarginal gyrus (SMG) in parietal cortex correlate with the ability to imagine speech; this demonstrates the possible neural implementation underlying the proposed simulation and (som”