Case report- PSP-P patient recvd DBS

This case report was published last year. It’s about an Italian patient diagnosed clinically with PSP-P (the parkinsonism form of PSP, not the dementia form of PSP) who received deep brain surgery, with an implant placed in an area of the brain called the nucleus tegmenti pedunculopontini (PPTg). This letter reports that the procedure was safe and the patient saw “modest benefits.”

“Gait was improved only in terms of a consistent amelioration of the primary gait ignition failure. On the other hand, the impact on postural stability and direction changes was absent. When evaluated with a specific questionnaire as the Giladi for FOG [freezing of gait] DBS-mediated effect were modest. DBS-related effect could be detected in non-motor domains (such as dysphagia and swallowing impairment). Neuropsychological tests did not reveal major cognitive changes apart from minimal improvement in verbal fluency.

The researchers considered this surgery based upon published data showing “some degree of gait impairment amelioration and cognitive benefits” to PD patients where an implant was placed in a similar part of the brain. In this PSP-P patient, the researchers saw no cognitive benefits and gait improvement only in terms of “consistent amelioration of the primary gait ignition failure.”

The researchers conclude: “Although this single case seems not to support the PPTg implantation as a critical therapeutic option for PSP-P patients, at least in advanced ones, it is possible that larger trials, centred either on PSP-P recruited at the disease onset or on PSP Richardson type, will verify further the potential of DBS-mediated stimulation to activate directly surviving fibres or even delay the disease evolution.”

I’ve copied the citation below.


Movement Disorders
Volume 24 Issue 13, Pages 2020 – 2022
Published Online: 11 Aug 2009

Letter to the Editor
Implantation of the Nucleus Tegmenti Pedunculopontini in a PSP-P Patient: Safe Procedure, Modest Benefits

Livia Brusa, MD, PhD 1, Cesare Iani, MD 1, Roberto Ceravolo, MD 2, Salvatore Galati, MD 3 4, Vincenzo Moschella, MD 2 4, Francesco Marzetti, MD 3 4, Paolo Stanzione, MD 3 4, Alessandro Stefani, MD 3 4

1 Ospedale S.Eugenio UOC Neurologia, Rome, Italy
2 Dipartimento di Neuroscienze, Clinica Neurologica, Università di Pisa, Pisa, Italy
3 Clinica Neurologica, Universita’ di Roma Tor Vergata, Rome, Italy
4 IRCCS Fondazione S. Lucia, Rome, Italy

Note: no abstract is available on PubMed. The PubMed ID# for this letter is #19672983.