The periaqueductal grey area and control of blood pressure in neurodegeneration.

Journal article

The periaqueductal/periventricular grey area (PAG/PVG) is a midbrain nucleus with an important role in pain signalling and autonomic control. We present the case of an initially hypertensive man who developed a presumed neurodegenerative disorder over a decade, characterised by progressive right-sided chronic pain, extra-pyramidal symptoms and autonomic dysfunction including postural hypotension, sleep apnoea, and bladder instability. He underwent a variety of treatments for his symptoms, including deep brain stimulation (DBS) of the PAG/PVG. 24-h blood pressure monitoring was carried out 1 and 5 years after implantation. Although the DBS initially produced a significant reduction in blood pressure, the effect was significantly reversed when the same tests were repeated 5 years after surgery. This may imply a functional involvement of the PAG/PVG in the neurodegenerative process.

Authors: Sitsapesan, H; Green, A; Aziz, T; Pereira, E

• Publication status: Published
• Journal: Clinical autonomic research : official journal of the Clinical Autonomic Research Society
• Volume: 23
• Issue: 4
• Pages: 215-219
• Publication date: 2013-08-01
• DOI: 10.1007/s10286-013-0206-x
• EISSN: 1619-1560
• ISSN: 0959-9851
• Language: English
• Keywords: Neurosurgical Procedures; Neurodegenerative Diseases; Middle Aged; Blood Pressure; Multiple System Atrophy; Antiparkinson Agents; Humans; Treatment Outcome; Tremor; Periaqueductal Gray; Female; Blood Pressure Monitoring, Ambulatory; Electrodes, Implanted; Deep Brain Stimulation