[10] Projections from the MLR descend via the medullary and pontine reticulospinal tracts to act on spinal motor neurons supplying the trunk and proximal limb flexors and extensors.

[12] Results from animal and clinical studies suggest that cholinergic neurons in the PPN play a crucial role in modulating both the rhythm of locomotion and postural muscle tone.

[13][14] Glutamatergic and cholinergic inputs from the MLR may be responsible for regulating the excitability of reticulospinal neurons that in turn project to spinal central pattern generators to initiate stepping.

[22] Freezing of gait has also been associated with functional reorganization of supraspinal locomotor networks whereby altered connectivity and communication between the supplementary motor area and MLR were observed.

[24][25] Plaha and Gill reported significant improvements in gait dysfunction and postural instability in two patients with advanced Parkinson's disease who were treated using DBS electrodes implanted in the region of the PPN.