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BACKGROUND: Pedunculopontine nucleus (PPN) stimulation is a novel therapy for Parkinson disease. However, controversies remain regarding the clinical application of this new therapy, including patient selection, electrode positioning, and how best to assess outcomes.

OBJECTIVE: To clarify the clinical application of PPN stimulation in Parkinson disease.

METHODS: Five consecutive patients with Parkinson disease complicated by severe gait freezing, postural instability, and frequent falls (all persisting even while the patient was on medication) received bilateral stimulation of the mid-lower PPN without costimulation of other brain targets. Outcomes were assessed prospectively over 2 years with gait-specific questionnaires and the Unified Parkinson Disease Rating Scale (part III).

RESULTS: The primary outcome, the Gait and Falls Questionnaire score, improved significantly with stimulation. Benefits were …