Movement Disorders via MedWorm.com

Influence of emotional instability on behavioral disorders in DYT11

Movement Disorders — Thu, 18 Mar 2010 00:00:00 +0100

No abstract (Source: Movement Disorders)

In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS

Movement Disorders — Thu, 11 Mar 2010 00:00:00 +0100

We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age-matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract-based spatial statistics, a hypothesis-free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (P < 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with ...

Kinematic study of whole body center of mass position during gait in Parkinson's disease patients with and without festination

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

Gait festination (FE) can cause serious disability in Parkinson's disease (PD) patients. It is argued that the center of pressure position (COP) and body center of mass (COM) are possibly implicated in FE pathogenesis. The relationship between them remains unclear. The goal of this study was to determine spatiotemporal relationships between COM and COP in PD and to explore whether FE arises as a consequence of lack of physiological link between COP and COM during step stride. Twenty patients with idiopathic PD, in OFF state and 17-age-matched control subjects completed a 10-m walking protocol. PD patients were divided in two groups: those with FE and those without (NF). COM position, excursion, and its relationship with COP, as well as other kinematic parameters were analyzed. COM displace...

Sepiapterin reductase deficiency: Two Indian siblings with unusual clinical features

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Tolerance to apomorphine develops and reverses rapidly

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Hereditary myoclonus dystonia (DYT11): A novel SGCE gene mutation with intrafamilial phenotypic heterogeneity

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Prescribing patterns of antiparkinsonian agents in Europe

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

In the 1990s, previous knowledge and randomized controlled trials supported the establishment of today's therapeutic recommendations in Parkinson's disease (PD). Scientific evidence allows different options for the treatment of PD. Patterns of use of antiparkinsonian agents (APA) across European countries may thus reflect these options. We wanted to describe patterns of use of APA in Europe and characterize the changes in prescription habits between 2003 and 2007. We investigated APA outpatient sales in 26 European countries where all commercially available APA were studied. Data for molecules and brand names were collected through IMS Health. Treatment per 1000 inhabitants daily (DID) was obtained from the WHO defined daily dose. Prescription pattern changes were evaluated by market share...

Catatonia during deep brain stimulator implantation complicated by intracranial hemorrhage

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Two Parkinson's disease patients with [alpha]-synuclein gene duplication and rapid cognitive decline

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Chorea in adults following pulmonary endarterectomy

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Cerebellar involvement in progressive supranuclear palsy

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Shoulder pain in Parkinson's disease: A case-control study

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Motor behavior abnormalities in drug-naïve patients with schizophrenia spectrum disorders

Movement Disorders — Wed, 10 Mar 2010 00:00:00 +0100

This study was aimed at examining the prevalence, syndromic structure, external correlates, and response to antipsychotic medication of a broad array of primary motor abnormalities. Two-hundred antipsychotic-naive patients with schizophrenia spectrum disorders were examined for motor abnormalities using the Modified Rogers Scale. Thirty-one motor signs were subjected to factor analysis, and the resulting factors examined for association with a number of risk factors, clinical and psychopathological variables. One-hundred and eighty-nine patients were reassessed for motor abnormalities after completing a 4-week trial with antipsychotic medication. Prevalence rates for at least one motor sign and syndrome at baseline were 66% and 40%, respectively. Motor signs clustered together into seven c...

Effects of chronic subthalamic stimulation on intractable akathisia in Parkinson's disease

Movement Disorders — Tue, 09 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Ancient representation of Meige's syndrome in the Moche culture in the pre-Columbian Peru

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

The Moches were a pre-Columbian culture from Peru, who had a fine ceramic technique and used to represent diseases. One example is the potter presented here which represents a man with a probable Meige's syndrome and may be the first artistic representation of this disease. © 2010 Movement Disorder Society. (Source: Movement Disorders)

Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS...

Real-time visualization of altered gastric motility by magnetic resonance imaging in patients with Parkinson's disease

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

Gastrointestinal motility is frequently affected in Parkinson's disease (PD) and has even been reported in early stages of PD. We hypothesized that gastric motility can be assessed in vivo by real-time magnetic resonance imaging (MRI), an established, noninvasive method. After an overnight fast and a standardized test meal, 10 patients with PD (six drug naïve, four treated) and 10 healthy volunteers underwent real-time MRI scanning of the stomach. Gastric motility was quantified by calculating the gastric motility indices (GMI) from transversal oblique und sagittal oblique MRI scans. There was a trend toward a decreased gastric motility in patients with PD compared with healthy controls (Mann-Whitney test, P 0.059). This difference in peristalsis was due to a significant reduction in the ...

Objective measurement of dyskinesia in Parkinson's disease using a force plate

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

Clinical investigation of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD) is limited because of lack of objective measurements and no consensus on use of a standard measuring tool. Currently, clinical trials use subject-completed diaries of dyskinesia throughout the day or investigator-administered clinical rating scales. An objective and valid method of measuring LID would reduce bias, variability, and decrease the time and number needed in trials of potential anti-dyskinetic agents. We have investigated using a force plate under standing subjects, which records movement of the center of pressure (CoP) to quantify LID over a levodopa (L-dopa) cycle. Twenty-two PD subjects (15 with LID, 7 without LID) admitted to an inpatient research facility had their PD meds withheld overn...

Gray matter correlations of cognition in incident Parkinson's disease

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

In conclusion, H&Y transition time is a useful measure of disease progression in PD and may be utilized in clinical studies evaluating therapeutic interventions and prognostic factors in PD. © 2010 Movement Disorder Society (Source: Movement Disorders)

Neuropathy as a potential complication of levodopa use in Parkinson's disease: A Pharmacological and Pharmacovigilance point of view

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Impulsive-compulsive spectrum behaviors in pathologically confirmed progressive supranuclear palsy

Movement Disorders — Mon, 08 Mar 2010 00:00:00 +0100

We present three cases of pathologically confirmed progressive supranuclear palsy who developed ICBs in association with dopamine agonist use. Pathological comparisons between these three cases and other case series of progressive supranuclear palsy are made. © 2010 Movement Disorder Society (Source: Movement Disorders)

Hyposmia in progressive supranuclear palsy

Movement Disorders — Sat, 06 Mar 2010 00:00:00 +0100

Previous studies suggested that olfaction is normal in progressive supranuclear palsy (PSP). We applied the University of Pennsylvania Smell Identification Test (UPSIT) to 36 patients with PSP who scored more than 18 on the Mini Mental State Examination (MMSE), 140 patients with nondemented Parkinson's disease (PD) and 126 controls. Mean UPSIT scores in PSP were lower than in controls (P < 0.001) but higher than in PD (P < 0.001) after adjusting for age, gender, and smoking history. For patients with PSP, UPSIT scores correlated with MMSE (r = 0.44, P = 0.006) but not disease duration (P = 0.6), motor subscale of the Unified Parkinson's Disease Rating Scale (P = 0.2), or Frontal Assessment Battery (P = 0.5). The brains of six of the patients with PSP were examined postmortem and all reveal...

Acute blepharospasm and torticollis associated with an ependymoma of the lateral ventricle

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Hyperintensity in the basis pontis: Atypical neuroradiological findings in a woman with FXTAS

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Rehabilitation in Parkinson's disease: Assessing the outcome using objective metabolic measurements

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

Objective measurements to assess the efficacy of rehabilitation treatment in Parkinson's disease, suitable to be carried out routinely in the clinical setting, are lacking. Metabolic parameters, reflecting the recruitment and co-ordination of muscle fibers, might be simple instrumental measurements suitable for use as outcome markers. Twenty parkinsonian patients underwent a 4-week rehabilitation treatment. Functional evaluation was based on Unified Parkinson's Disease Rating Scale Motor Section (UPDRS III), Berg's scale, 6-minute walking test (6MWT), and the metabolic data recorded during the 6MWT namely the active energy expenditure (AEE), the kinetics of the energy consumption curve, and the peak value of energy consumption. Both rating scales and gait improved significantly (UPDRS III ...

Carisbamate in essential tremor: Brief report of a proof of concept study

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

The efficacy and safety of carisbamate, an investigational neuromodulator currently in development for epilepsy, were examined in a multicenter, randomized, double-blind, cross-over, placebo-controlled study of essential tremor. Sixty-two patients (intent-to-treat analysis set; mean age 64 years; 66% men) received carisbamate 400 mg/day or matching placebo in a crossover study design with two 21-day treatment periods. The Fahn-Tolosa-Marín Tremor Rating Scale (TRS) was the primary assessment tool. Carisbamate and placebo treatment did not differ in their effect on the TRS (P = 0.94) or on measures of affect, mood, or quality of life. Carisbamate was generally well tolerated and had an adverse event profile comparable to that of placebo. © 2010 Movement Disorder Society (Source: Movement ...

Does age make a difference in caregiver strain? Comparison of young versus older caregivers in early-stage Parkinson's disease

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

This study compared the difference in negative aspects of strain and modulators of strain in young and older PD spouse caregivers. A series of hierarchical multiple regressions were used to examine the contribution of age on both positive and negative aspects of the care situation for 65 (37 young, 28 old) PD spouse caregivers. Negative variables included 3 dimensions of strain; strain from lack of personal resources, strain from worry, and global strain. Positive or protective variables included mutuality, preparedness, and rewards of meaning. Even in early stage disease before significant care is required, young spouses (40-55) were found to be at greater risk for negative consequences of the care situation reporting significantly more strain from lack of personal resources, and lower le...

Mortality in Parkinson's disease, a 20-year follow-up study

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Long-term antidyskinetic efficacy of amantadine in Parkinson's disease

Movement Disorders — Wed, 03 Mar 2010 00:00:00 +0100

Several randomized placebo-controlled trials have consistently shown antidyskinetic effects of amantadine in levodopa treated patients with advanced Parkinson's disease (PD). However, all of these were of short duration and there have been claims that the effect of amantadine on levodopa induced dyskinesias (LID's) wear off after about 9 months of treatment. This randomized placebo-controlled parallel-group study was performed to assess the long-term antidyskinetic effect of amantadine in 32 PD patients, who after having been on stable amantadine therapy for LID over at least one year- were switched in a double blind manner to amantadine or placebo and followed for 3 weeks. Dyskinesia duration and intensity were assessed by UPDRS IV items 32 and 33 as well as by patient's diaries. The prim...

Restless legs syndrome in a population of northern Tanzania: A community-based study

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

Restless legs syndrome (RLS) is a highly prevalent movement disorder. However, prevalences seem to vary amongst different ethnicities. To date, no community-based prevalence studies on RLS have been reported from the African continent. We have conducted a community-based, door-to-door study in northern Tanzania. Over a period of 16 months, 7,654 people aged 14 years and older were screened for the RLS Essential Diagnostic Criteria. Sampling was performed according to the method of "multistage cluster sampling." People who screened positive where reinterviewed and physically examined by a specialist neurologist. During the screening phase, 10 people answered "yes" to at least one of the screening questions. After reinterviewing those people, the result was confirmed in five people only. Aft...

Double-blind study of pardoprunox, a new partial dopamine agonist, in early Parkinson's disease

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

This study examined the efficacy and safety of the partial dopamine agonist, pardoprunox (SLV308), in the treatment of patients with early Parkinson's disease (PD). Patients were randomized to receive pardoprunox (n = 69) or placebo (n = 70). Pardoprunox was titrated to each patient's optimal dose (9-45 mg/d) over 2 to 6 weeks and then maintained at this dose for a further 3 weeks. Concomitant anti-Parkinson treatment was not permitted. In the primary analysis, Unified PD Rating Scale (UPDRS)-Motor score was improved in pardoprunox-treated patients (overall mean dose 23.8 mg/d; -7.3 points), as compared with placebo (-3.0 points; P = 0.0001), from baseline to end point. At end point, there were more responders ([ge]30% reduction in UPDRS-Motor score) in the pardoprunox group (50.7%) than i...

Discriminative power of different nonmotor signs in early Parkinson's disease. A case-control study

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

The objective of this study was to evaluate the discriminative power of different nonmotor signs for early diagnosis of Parkinson's disease (PD). Thirty patients with PD with [le]3 years of disease duration were compared with 30 healthy controls. Six deficit domains (DD) were defined: hyposmia, sleep abnormalities, dysautonomia, visual deficits, executive dysfunction, and depression. Plotting of Receiver operating characteristic (ROC) curves and exact conditional logistic modeling, followed by manual stepwise descending procedure were used to identify a model for nonmotor signs that detects early PD. Patients with PD and controls did not differ in terms of age, gender, and educational level. Several DD discriminated patients with PD from healthy controls. Visual deficits showed the largest...

Substantia nigra echogenicity in progressive supranuclear palsy

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

A normoechogenic substantia nigra (SN) is a typical finding in transcranial sonography in patients with progressive supranuclear palsy (PSP), whereas in patients with Parkinson's disease a hyperechogenic SN is characteristic. A recent classification scheme recommends the differentiation of PSP patients into those with Richardson's syndrome (RS) and those with PSP-Parkinsonism (PSP-P). We investigated 34 PSP patients (27 RS, 7 PSP-P) with ultrasound of the substantia nigra in search of differentiations in the two groups. We found that most of the PSP-P patients, according to recently published criteria, had a hyperechogenic SN (6 of 7): right (cm2) median 0.22, 25% percentile 0.21 and 75% percentile 0.36 (cm2); left (cm2) median 0.21, 25% percentile 0.20 and 75% percentile 0.30 and a normal...

Complex paroxysmal nocturnal behaviors in Parkinson's disease

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

Complex paroxysmal nocturnal motor behavioral disorders (CPNBs) are frequently reported in patients with Parkinson's disease (PD). REM sleep behavior disorder (RBD) is reported in at least a third of PD patients, although CPNB episodes can also occur on arousal from NREM sleep. It is important to establish the nature of CPNBs occurring in PD, as the different types have different neurobiological significance and clinical importance, and also different treatments. Ninety-six PD patients with and without CPNBs were submitted to overnight in-hospital video-polysomnography. Of these, 76 (47 men) were included in the study analysis: these were patients in whom it was possible to establish the presence or absence of CPNBs and to obtain a clear-cut diagnosis of the nature of the CPNBs reported. T...

Tyrosine hydroxylase deficiency in three Greek patients with a common ancestral mutation

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

We present the clinical, biochemical, and molecular findings of three Greek patients with tyrosine hydroxylase (TH) deficiency. All patients presented with a severe clinical phenotype characterized by prominent motor delay, infantile parkinsonism, oculogyric crises, and signs of autonomic dysfunction. Cerebrospinal fluid analysis disclosed reduced dopamine metabolites and normal pterins. Response to levodopa was favorable though not dramatic. All patients were homozygous for a previously reported mutation (p.L236P). SNP haplotype analysis was consistent with a common ancestral mutation, thus indicating a founder effect in Greek patients with TH deficiency. © 2010 Movement Disorder Society (Source: Movement Disorders)

The specific contributions of set-shifting to freezing of gait in Parkinson's disease

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

In this study, 31 patients with a range of self-reported FOG symptom severities were administered tests of executive functioning. The results demonstrate that FOG symptoms were selectively correlated with poorer performance on tasks of set-shifting, but not with a range of other executive tasks. This was apparent even after controlling for slowed processing speed, disease stage and depressive symptoms. The results support the recently proposed hypothesis for the pathophysiology underlying FOG in PD. © 2010 Movement Disorder Society (Source: Movement Disorders)

Characterization of Lewy body pathology in 12- and 16-year-old intrastriatal mesencephalic grafts surviving in a patient with Parkinson's disease

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

We previously reported the occurrence of Lewy bodies in grafted human fetal mesencephalic neurons in two patients with Parkinson's disease. Here, we have used immunohistochemistry and electron microscopy to characterize the development of Lewy bodies in one of these cases. This patient was operated in putamen on both sides at 12 or 16 years before death, respectively. We demonstrate that 2% of the 12-year-old and 5% of the 16-year-old grafted, presumed dopaminergic neurons contained Lewy bodies immunoreactive for [alpha]-synuclein. Based on morphological analysis, two forms of [alpha]-synuclein-positive aggregates were distinguished in the grafts, the first a classical and compact Lewy body, the other a loose meshwork aggregate. Lewy bodies in the grafts stained positively for ubiquitin an...

Rhabdomyolysis after low-dose quetiapine in a patient with Parkinson's disease with drug-induced psychosis: A case report

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

No Abstract. (Source: Movement Disorders)

Unilateral lower limb rest tremor is not necessarily a presenting symptom of Parkinson's disease

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

Lower leg rest tremor is an uncommon symptom of neurological disease. Review of the files of 16 patients who presented with lower leg tremor (average age 58 ± 16 years; average disease duration 6.8 ± 8.5 years) yielded a diagnosis of Parkinson's disease (PD) in 5 and probable multiple system atrophy (MSA) in 3. In 4 patients with an indeterminate diagnosis, cardiac MIBG SPECT was positive in 3, indicating PD, and negative in one, suggesting MSA. Two patients each had psychogenic tremor and drug-induced parkinsonism. Although lower leg tremor is considered an unusual presentation of PD, it should raise suspicions of MSA and other neurodegenerative disorders. © 2010 Movement Disorder Society (Source: Movement Disorders)

A two-year follow-up study of executive dysfunctions in Parkinsonian patients with freezing of gait at on-state

Movement Disorders — Tue, 02 Mar 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

An early image of hemifacial spasm: Édouard Brissaud contribution

Movement Disorders — Sat, 20 Feb 2010 00:00:00 +0100

Édouard Brissaud (1852-1909) was a French neuropsychiatrist of the Charcot school who provided in 1893 the first picture of a patient suffering from hemifacial spasm. Brissaud already suggested several possible etiologies for the involuntary movements of his patient, including the possibility of arterial malformations compressing the origin of the facial nerve. We also discuss the role of other early European authors (Schültze, Gowers, Babinski, and Negro) who contributed to the definition of hemifacial spasm in the late 19th and early 20th centuries. © 2010 Movement Disorder Society (Source: Movement Disorders)

Agrypnia with nocturnal confusional behaviors in dementia with Lewy bodies: Immediate efficacy of rivastigmine

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Self-rated health status in spinocerebellar ataxia - Results from a European multicenter study

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

Patient-based measures of subjective health status are increasingly used as outcome measures in interventional trials. We aimed to determine the variability and predictors of subjective health ratings in a possible target group for future interventions: the spinocerebellar ataxias (SCAs). A consecutive sample of 526 patients with otherwise unexplained progressive ataxia and genetic diagnoses of SCA1 (117), SCA2 (163), SCA3 (139), and SCA6 (107) were enrolled at 18 European referral centers. Subjective health status was assessed with a generic measure of health related quality of life, the EQ-5D (Euroqol) questionnaire. In addition, we performed a neurological examination and a screening questionnaire for affective disorders (patient health questionnaire). Patient-reported health status was...

How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

Essential tremor (ET) is among the more prevalent neurological disorders, yet prevalence estimates have varied enormously, making it difficult to establish prevalence with precision. We: (1) reviewed the worldwide prevalence of ET in population-based epidemiological studies, (2) derived as precisely as possible an estimate of disease prevalence, and (3) examined trends and important differences across studies. We identified 28 population-based prevalence studies (19 countries). In a meta-analysis, pooled prevalence (all ages) = 0.9%, with statistically significant heterogeneity across studies (I2 = 99%, P < 0.001). In additional descriptive analyses, crude prevalence (all ages) = 0.4%. Prevalence increased markedly with age, and especially with advanced age. In the meta-analysis, prevalenc...

Frontal and associative visual areas related to visual hallucinations in dementia with Lewy bodies and Parkinson's disease with dementia

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

In conclusion, DLB and PDD patients with VH had more frontal gray matter atrophy than non-hallucinators, the impairment being greater in the DLB group. The patterns of structural and functional correlations were different in both pathologies. © 2010 Movement Disorder Society (Source: Movement Disorders)

Frontotemporal dementia: Pathology of gait?

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

The main diagnostic criteria of the behavioural variant of frontotemporal degeneration (bvFTD) include neurobehavioral and dysexecutive syndromes, but not specific gait characteristics although strong relationship between gait and prefrontal functions are increasingly recognized. Accordingly, we tested the hypothesis that patients with bvFTD would have more gait changes than older healthy controls and demented patients with Alzheimer's disease (AD). Sixty subjects were included in the study: 19 with bvFTD, 19 with AD and 22 healthy controls. Mean values and coefficients of variation (CV) of stride time while just walking (i.e., single tasking) and while walking with backward counting (i.e., dual tasking) were measured using the SMTEC®-footswitch system. Stride time, mean value, and CV wer...

A new case of Uner Tan syndrome - With late childhood quadrupedalism

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Incidental Lewy body disease: Clinical comparison to a control cohort

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

Limited clinical information has been published on cases pathologically diagnosed with incidental Lewy body disease (ILBD). Standardized, longitudinal movement and cognitive data was collected on a cohort of subjects enrolled in the Sun Health Research Institute Brain and Body Donation Program. Of 277 autopsied subjects who had antemortem clinical evaluations within the previous 3 years, 76 did not have Parkinson's disease, a related disorder, or dementia of which 15 (20%) had ILBD. Minor extrapyramidal signs were common in subjects with and without ILBD. Cognitive testing revealed an abnormality in the ILBD group in the Trails B test only. ILBD cases had olfactory dysfunction; however, sample size was very small. This preliminary report revealed ILBD cases have movement and cognitive find...

The effect of cueing therapy on single and dual-task gait in a drug naïve population of people with Parkinson's disease in northern Tanzania

Movement Disorders — Fri, 19 Feb 2010 00:00:00 +0100

This study aimed to evaluate a nonpharmacological approach using cueing therapy to improve gait in drug-naïve PD and the feasibility of delivering rehabilitation in northern Tanzania. In this study, twenty-one people with PD aged 76.4 years (12.9 SD) with varying disease severity participated. They received 9 × 30 min sessions of cueing therapy for gait problems over 3 weeks from a trained therapist delivered in their home environment. Cueing therapy consisted of walking in time to a metronome beat to correct step amplitude and step frequency during a range of functional activities. Gait was recorded on video before and after therapy, and videos were analyzed in the UK by an assessor not involved in data collection. Disease severity (UPDRS) and balance were also measured. Patients were a...

Ropinirole diminishes myoclonus and improves writing and postural balance in an ULD patient

Movement Disorders — Sat, 13 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Plasma cholesterol and Parkinson's disease: Is the puzzle only apparent?

Movement Disorders — Fri, 12 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Neurochemical biomarkers in the differential diagnosis of movement disorders

Movement Disorders — Fri, 12 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

PDD-Short Screen: A brief cognitive test for screening dementia in Parkinson's disease

Movement Disorders — Fri, 12 Feb 2010 00:00:00 +0100

The diagnosis of Parkinson's disease with dementia (PDD) is currently based on clinical criteria (DSM-IV, MDS-Task Force). In daily practice and research studies, these criteria still depend on the subjective impression of the examiner. Brief screening tests (BST) are helpful in identifying patients with PD with dementia, which can be difficult in patients with advanced PD. We aimed to develop a BST for PD, the PDD-Short Screen (PDD-SS), to accurately and quickly screen for PDD. In this prospective study, 70 patients with nondemented (age 73.8 ± 4.4) and 32 demented (age 73.8 ± 4.4) PD regularly attending a Movement Disorders Clinic were included. Diagnosis of dementia was based on DSM-IV criteria, CDR score [ge]1, and PD-CRS total score [le]64. The PDD-SS, Mattis Dementia Rating Scale (...

Reply: Neuropathy as a potential complication of levodopa use in Parkinson's disease: A pharmacological and pharmacovigilance point of view

Movement Disorders — Fri, 12 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Myorhythmia associated with listerial rhombencephalitis

Movement Disorders — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Movement Disorders)

Levodopa-aggravated lateral flexion of the neck and trunk as a delayed phenomenon of unilateral pallidotomy

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

GPi-pallidal stimulation to treat generalized dystonia in Cockayne syndrome

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Spasticity treatment facilitates direct care delivery for adults with profound intellectual disability

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

This study shows comprehensive spasticity management provides meaningful improvement in ADL care for patients with ID, which may improve quality of life and reduce caregiver burden. © 2010 Movement Disorder Society (Source: Movement Disorders)

Impact of belief in neuroprotection on therapeutic intervention in Parkinson's disease

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

We explored the hypotheses that an investigator's belief in a putative neuroprotective agent might influence the timing of symptomatic intervention and the assessment of signs and symptoms of patients with Parkinson's disease with the Unified Parkinson's Disease Rating Scale (UPDRS). These hypotheses were tested with Cox and general linear modeling, using data from a previously published double-blind placebo-controlled futility trial of coenzyme Q10 and GPI-1485. We found the investigators' level of confidence in these agents had no effect on the time to symptomatic therapy or on the change in UPDRS during 12 months of treatment. © 2010 Movement Disorder Society (Source: Movement Disorders)

Prevalence and cost of medication nonadherence in Parkinson's disease: Evidence from administrative claims data

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

We estimated the prevalence of medication nonadherence in Parkinson's disease (PD) and the association between treatment nonadherence and healthcare costs. Insurance claims from over 30 US health plans were analyzed. Inclusion criteria were as follows: PD diagnosis, [ge]1 PD-related prescription between 1/1/1997 and 12/31/2004, continuous health plan enrollment for [ge]6 months before and [ge]12 months after first PD prescription. Adherence, all-cause healthcare utilization, and all-cause costs were evaluated over 12 months post-treatment initiation. Adherence was measured using the medication possession ratio (MPR), with MPR < 0.8 defining nonadherence. Among patients identified for inclusion (N = 3,119), 58% were male and mean age was 69 years. Mean MPR was 0.58 and 61% of patients were ...

Cardiac sympathetic degeneration correlates with olfactory function in Parkinson's disease

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

Autonomic and olfactory dysfunctions are considered markers for preclinical diagnosis in Parkinson's disease (PD), because pathological changes in these systems can start before motor symptoms develop. We investigated whether cardiac sympathetic function and olfactory function are associated in PD. Participants comprised 40 nondemented patients with idiopathic PD, and age-matched controls. Cardiac sympathetic function was evaluated by 123 I-metaiodobenzylguanidine (MIBG) uptake, in terms of the heart to mediastinum (H/M) ratio in both early and delayed images, and the washout rate (WR). Olfactory function was evaluated using the Odor Stick Identification Test for Japanese, which evaluates the detection of 12 odorants familiar to Japanese participants. Smell identification scores were signi...

Descriptions of Cervical Dystonia by Sir Charles Bell

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

In this report, Bell's depictions of patients presenting with a syndrome consistent with cervical dystonia will be discussed, including the identification of many of the different clinical features we currently use for the diagnosis of this disorder and his thoughts about its pathogenesis. © 2010 Movement Disorder Society (Source: Movement Disorders)

Background scenery visual hallucinations in a depressed patient with Parkinson's disease

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson's disease

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

People with Parkinson's disease (PD) often have a posture characterized by lateral trunk flexion poorly responsive to antiparkinsonian drugs. To examine the effects of a rehabilitation programme (daily individual 90-minute-sessions, 5-days-a-week for 4-consecutive weeks) on lateral trunk flexion and mobility, 22 PD patients with mild to severe lateral trunk flexion, and 22 PD patients without trunk flexion were studied. Patients were evaluated using the Unified Parkinson's Disease Rating Scale motor subscale (UPDRS-III) score, and the kinematic behavior of the trunk was recorded by means of an optoelectronic system to determine: a) trunk flexion, inclination and rotation values in the erect standing posture; b) ranges of trunk flexion and inclination during trunk movements. After the treat...

Narcolepsy with cataplexy associated with holoprosencephaly misdiagnosed as epileptic drop attacks

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Glucocerebrosidase Gene L444P mutation is a risk factor for Parkinson's disease in Chinese population

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

An association between mutations in the glucocerebrosidase (GBA) gene and Parkinson's disease (PD) has been reported in several populations. We searched for four common GBA mutations (L444P, F213I, R353W, and N370S) in 402 Chinese PD patients and 413 age- and sex-matched controls. In the PD cohort, 11 patients were found carrying a heterozygous GBA mutation and all of them had the L444P mutation. Heterozygous GBA mutations were detected none in controls. The GBA gene L444P mutation was detected at a significantly higher frequency among PD patients (11/402 = 2.74%), when compared with the control group (0/413): P = 0.0007. To evaluate the possible role of the GBA gene L444P mutation in PD in Ashkenazi Jewish and non-Jewish populations, we conducted a meta-analysis on the topic. In the Chine...

A case-control study on restless legs syndrome in nondialyzed patients with chronic renal failure

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

Restless legs syndrome (RLS) is a possible consequence of end-stage renal disease. However, conclusive data on the association between RLS and chronic renal failure (CRF) in nondialyzed patients are still lacking. The aims of this study were: (1) to look for an association between RLS and CRF in nondialyzed patients; (2) to analyze the characteristics of RLS and its consequences on nocturnal rest in nondialyzed patients with CRF; (3) to identify possible predictors of RLS occurrence in nondialyzed patients with CRF. We recruited 138 nondialyzed patients with CRF (mean age: 69.8 ± 11.7 years; male: 61.6%) and 151 controls (mean age: 60.2 ± 18.6 years; male: 42.4%). An expert in sleep medicine investigated the presence of RLS by means of a face-to-face interview. Fifteen nondialyzed CRF pa...

Adult-onset dystonia in Aicardi-Goutières syndrome

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No Abstract. (Source: Movement Disorders)

Excessive hoarding in Parkinson's disease

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

This study investigates hoarding tendency amongst patients with PD, and its association with impulsive-compulsive spectrum behaviors (ICBs). We compare clinical features, measures of hoarding, impulse buying, self-control, obsessive-compulsive symptoms, depression, and anxiety in 39 patients with PD with ICBs (PD + ICB), 61 patients with PD without ICBs (PD - ICB), and 50 healthy controls. A much higher proportion of PD + ICB (27.8%) than PD - ICB (3.5%) were hoarders (P = 0.001). 6% of healthy controls were hoarders. Compulsive shoppers scored higher than other varieties of ICB on excessive acquisition measures. Hoarding correlated positively with impulsive buying, obsessive-compulsive symptoms, PD duration, and negatively with self-control measures. Using multivariate regression analyzes...

Feeling-of-knowing in episodic memory in patients with Parkinson's disease with various motor symptoms

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

The aim of this study was to examine metamemory in patients with Parkinson's disease (PD) with different dominant motor symptoms. This is a prospective case-control study. Fifty-five PD patients [25 patients with tremor-dominant (TD) motor symptoms and 30 patients with akinetic and rigidity-dominant (ARD) motor symptoms] and 30 normal controls were studied. The two patient groups were similar in terms of age, level of education, disease duration, and disease severity. Metamemory was measured using the experimental metamemory task [feeling-of-knowing (FOK) paradigm]. In addition, memory and executive functions were determined using detailed cognitive tests. In comparison with normal subjects and TD patients, ARD patients exhibited impaired FOK accuracy (P = 0.007). Furthermore, correlation ...

Orthostatic Tremor in a left midbrain lesion

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No Abstract. (Source: Movement Disorders)

Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non-motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor-dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremo...

Higher-dose glutathione therapy for Parkinson's disease in Japan: Is it really safe?

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

No Abstract. (Source: Movement Disorders)

Clinical and dual-tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy

Movement Disorders — Wed, 03 Feb 2010 00:00:00 +0100

Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease with no sufficient therapeutic options to date. Falls are the most devastating feature. The causes of these falls are not well understood. To test the impact of PSP-associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers ([le] one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual-task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales "history," "mental," "bulbar," "supranuclear ocular motor," an...

Incidence of Parkinson's disease and Parkinsonism in northern Sweden: A population-based study

Movement Disorders — Thu, 28 Jan 2010 00:00:00 +0100

We present a prospective incidence cohort study of patients with idiopathic parkinsonian syndromes in the Umeå region in northern Sweden identified over a 4-year period. The clinical diagnoses were re-evaluated at follow-up visits at 12 months. We found 138 patients with parkinsonism: 112 PD, 12 multiple system atrophy with predominant parkinsonism (MSA-P), six progressive supranuclear palsy (PSP) and eight unclassifiable patients. The crude incidences for all age ranges per 100,000 were: PD 19.7 (95% confidence interval 16.1-23.3); MSA-P 2.1 (1.1-3.7); PSP 1.1 (0.4-2.4); idiopathic parkinsonism 24.3 (20.2-28.4). Age-standardized to the average Swedish population 2004-2007: PD 22.5 (18.3-26.7); MSA-P 2.4 (1.2-4.2); PSP 1.2 (0.4-2.6); idiopathic parkinsonism 27.5 (22.9-32.1). The crude ann...

A novel splice site mutation in the SPG7 gene causing widespread fiber damage in homozygous and heterozygous subjects

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Hereditary spastic paraplegias (HSP) are genetically and clinically heterogeneous neurodegenerative disorders. The purpose of this study was to assess the genotype and phenotype in a family with a complicated form of autosomal recessive hereditary spastic paraplegia (ARHSP). Neurological and neuropsychological evaluation, neurophysiologic studies, fiberoptic endoscopic evaluation of swallowing (FEES), neuroimaging analysis including diffusion tensor imaging (DTI), and mutation analysis of SPG4 and SPG7 gene were performed. The index case (mother) was affected by an adult-onset form of complicated ARHSP due to the homozygous splice site mutation c.1552+1 G>T in the SPG7 gene. This mutation leads to an abnormally spliced mRNA lacking exon 11. Additional clinical features were bilateral ptosi...

The effects of physical activity on psychogenic movement disorders

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

This study provides preliminary evidence for regular low-medium intensity exercise as a safe, adequate, and pleasing intervention for PMD. Furthermore, well-designed studies appear justified to confirm these findings. © 2010 Movement Disorder Society (Source: Movement Disorders)

Reply: Effect of movement frequency on repetitive finger movements in patients with Parkinson's disease

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Pramipexole combined with levodopa improves motor function but reduces dyskinesia in MPTP-treated common marmosets

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Reduced expression of dyskinesia is observed in levodopa-primed MPTP-treated common marmosets when dopamine agonists are used to replace levodopa. We now investigate whether a combination of the D-2/D-3 agonist pramipexole and levodopa also reduces dyskinesia intensity while maintaining the reversal of motor disability. Drug naïve, non-dyskinetic MPTP-treated common marmosets were treated daily for up to 62 days with levodopa (12.5 mg/kg plus carbidopa 12.5 mg/kg p.o. BID) or pramipexole (0.04-0.3 mg/kg BID) producing equivalent reversal of motor disability and increases in locomotor activity. Levodopa alone resulted in marked dyskinesia induction but little or no dyskinesia resulted from the administration of pramipexole. From day 36, some animals were treated with a combination of levod...

Pregabalin in the treatment of neuropathic tremor following a motor axonal form of Guillain-Barré syndrome

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Identification of a de novo mutation in SPG11

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Chorea induced by antihistamine drugs

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Table tennis dystonia

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

We describe the first four cases of FTSD related to table tennis (TT), two involving professional international competitors. We also systematically analyzed the literature for reports of sport-related dystonia including detailed clinical descriptions. We collected a total of 13 cases of sport-related dystonia, including our four TT players. Before onset, all the patients had trained for many years, for a large number of hours per week. Practice time had frequently increased significantly in the year preceding onset. As TT is characterized by highly skilled hand/forearm movements acquired through repetitive exercises, it may carry a higher risk of FTSD than other sports. Intensive training may result in maladaptive responses and overwhelm homeostatic mechanisms that regulate cortical plasti...

The measurement of anhedonia in Parkinson's disease: Psychometric properties of the Snaith-Hamilton Pleasure Scale (SHAPS) and the relevance to distinguish anticipatory and consummatory anhedonias

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Reply: The measurement of anhedonia in Parkinson's disease: Psychometric properties of the Snaith-Hamilton Pleasure Scale (SHAPS) and the relevance to distinguish anticipatory and consummatory anhedonias

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Topographical distribution of cerebral cortical thinning in patients with mild Parkinson's disease without dementia

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

The pathology of Parkinson's disease (PD) is not confined to the brainstem regions, but spreads to involve the neocortical areas. Using surface-based cortical thickness analysis, we studied the topographical distribution of cortical thinning in nondemented patients with mild PD. The high-resolution magnetic resonance imaging (MRI) studies were performed in 48 patients with PD without dementia and 56 age-matched healthy controls. Using the Freesurfer software, surface-based analysis was done to find changes in cerebral cortical thickness in patients with PD. Compared to the controls, patients with PD showed significant cortical thinning in the temporal, inferior parietal, rostral frontal, and orbitofrontal cortical areas. Thinning of the cerebral cortex occurs even in nondemented patients w...

GCH1 mutation and clinical study of Chinese patients with dopa-responsive dystonia

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Dopa-responsive dystonia (DRD) is typically caused by heterozygous mutations in GTP cyclohydrolase 1 gene (GCH1). Our aim was to investigate the clinical and genetic features of Chinese DRD patients. We analyzed a cohort of Chinese DRD patients' clinical data. Mutation of the GCH1 gene was screened by direct sequencing. Additionally, multiplex ligation-dependent probe amplification (MLPA) assay targeting the GCH1 and the TH gene to evaluate large exon deletion or duplicate mutation of the genes were performed in point mutation-negative patients. Ten sporadic DRD patients and two pedigrees including six patients were included in the study. The onset age ranged from 3 to 15 years old. All patients initially presented with walking problems due to lower limb dystonia. The delay between onset a...

Utility of the WHO-five well-being index as a screening tool for depression in Parkinson's disease

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Beck depression inventory (BDI-1A) is the gold standard screening tool for Parkinson's disease (PD) depression, but as a result of its complexity, it is of limited suitability as a quick and easy screening device. We, therefore, validate the 5-item WHO-Five Well-being Index (WHO-5) as a screening tool for PD depression. Two hundred thirteen of 215 recruited PD patients (99.1%) completed the WHO-5. Receiver operating characteristic plots were used to calculate sensitivity/specificity for all cut-off scores for the detection of depression and combined depression/dysthymia as assessed by an independent investigator using the Mini International Neuropsychiatric Interview (MINI). Internal consistency of the WHO-5 was good (Cronbach's [alpha] = 0.83). WHO-5 showed high validity with adequate det...

Mixed tremors with integrity of nigrostriatal system: A clinical and DAT-SPECT follow-up study

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

The phenomenology of the geste antagoniste in primary blepharospasm and cervical dystonia

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

The geste antagoniste (GA), a relatively common feature of adult-onset primary dystonia, has been systematically evaluated only in cervical dystonia, but it is still unclear whether its frequency and phenomenology differ among the various forms of focal dystonia. We analysed the frequency, phenomenology, effectiveness, and relationship of the GA with demographic/clinical features of dystonia in a representative clinical series of patients with the two most common forms of adult-onset primary dystonia, blepharospasm (BSP) and cervical dystonia (CD). Clinical data were gathered using a standardized questionnaire, which showed substantial test-retest reliability ([kappa] = 0.79, P < 0.00001). The frequency of GA was similar among patients with BSP (42/59, 71.2%) and patients with CD (27/32, 8...

The Montreal Cognitive Assessment as a screening tool for cognitive dysfunction in Huntington's disease

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

In this study, we compare the MoCA with the mini-mental state examination (MMSE) as a screening tool for cognitive dysfunction among 53 patients with HD. The mean MMSE score was 26 ± 2.4, and mean MoCA score was 21 ± 4.4. Twenty-one patients (81%) of those who scored [ge]26 on the MMSE had the MoCA score (Source: Movement Disorders)

Camptocormia in idiopathic Parkinson's disease: A focal myopathy of the paravertebral muscles

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

The objective of our study was to describe the clinical features of camptocormia, an involuntary, marked flexion of the thoracolumbar spine in idiopathic Parkinson's disease (PD) and to understand its etiology. In a prospective, cross-sectional study, we examined 15 patients with PD and camptocormia using laboratory parameters, EMG, muscle magnetic resonance imaging, and biopsy of the paravertebral muscles. The clinical data were compared with a matched control group of PD patients without camptocormia, and the biopsies were compared with muscles from age-matched autopsies. Almost all the patients (median age, 68.0 years; 7 women) with camptocormia suffered from advanced PD. Camptocormia occurred at a median of 9.0 years after the PD diagnosis. Compared with our clinical control group, bac...

Prolonged vastus lateralis denervation after botulinum toxin type a injection

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

We present evidence of prolonged denervation following BoNT injection of the vastus lateralis (VL) muscle to correct quadriceps muscle imbalance in patients with chronic anterior knee pain. Needle electromyography data were obtained from 10 subjects who had received a single BoNT treatment 5 to 19 months earlier as part of a clinical trial. Insertional and spontaneous activity, recruitment, and motor unit action potentials were examined. Clear differences between the injected and non-injected VL muscles, which correlated with the time since injection, were identified in all subjects. All 10 subjects studied with needle EMG showed evidence of persisting denervation in the BoNT-A injected VL muscle beyond the period of neuromotor recovery expected from animal experimental studies. © 2010 Mo...

The use of smell identification tests in the diagnosis of Parkinson's disease in Brazil

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Functional correlates of lower cognitive test scores in essential tremor

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Although motor features have been the defining element of essential tremor (ET), lower neurocognitive test scores are increasingly being recognized. However, the clinical correlates, if any, of these lower test scores remain largely unexplored. The aim of this study was to determine whether cognitive test scores in ET have any functional correlates. The Modified Mini Mental Status Examination (MMSE), Katz Activities of Daily Living (ADL) scale and Lawton Instrumental (I) ADL scale were administered to 95 cases. The Katz ADL score (rho = 0.26, P = 0.01) and Lawton IADL score (rho = 0.32, P = 0.001) were correlated with MMSE scores, such that poorer cognitive performance indicated greater dysfunction. Furthermore, cognitive test scores were a better predictor of functional disability than wa...

Incidence of Parkinson's disease and atypical Parkinsonism: Russian population-based study

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

The objective of this prospective population-based study was to determine the incidence of PD and APS in the Russian population. The study area was a large district of Moscow with a population of 1,237,900 inhabitants. Multiple sources of case ascertainment were used to identify incident cases of PD and APS between July 2006 and December 2008. All incident cases were examined by a specialist and followed up prospectively to confirm the diagnosis. The age-standardized incidence rates per 100,000/year were 9.03 [95% confidence interval (CI) 8.01-10.15] for PD, 0.11 (95% CI 0.03-0.23) for multiple system atrophy, 0.14 (95% CI 0.08-0.21) for progressive supranuclear palsy, and 0.02 (95% CI 0.01-0.12) for corticobasal degeneration. The age-standardized male-to-female ratio of PD was 0.87 for al...

What features improve the accuracy of the clinical diagnosis of progressive supranuclear palsy-parkinsonism (PSP-P)?

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Progressive supranuclear palsy-parkinsonism (PSP-P) is a primary tauopathy characterised by neurofibrillary degeneration, which is frequently mistaken for Parkinson's disease (PD), multiple system atrophy (MSA), and vascular parkinsonism (VP) at presentation. The aim of this study was to identify particular clinical features (green flags) that may be helpful in differentiating PSP-P from these other disorders. We identified 37 patients with PSP-P from 726 patients archived at the Queen Square Brain Bank. Using a retrospective case notes review the clinical features were compared between the PSP-P group and Lewy body associated parkinsonism (PD, n = 444 and dementia with Lewy bodies (DLB), n = 46), MSA (n = 90), and VP (n = 19), using the [chi]2-test for proportions for a two-by-two conting...

Cerebrotendinous xanthomatosis patients with and without parkinsonism: Clinical characteristics and neuroimaging findings

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

This report is on the clinical details of five genetically-proven CTX patients (two with and three without parkinsonism). Imaging findings using cranial magnetic resonance (MR) imaging and 99mTc-TRODAT-1 SPECT are also shown. Clinical correlation of neuroimaging findings and clinical presentations was made. A literature review of the clinical and neuroimaging features of eight CTX patients with parkinsonism reported in the English literature is also presented. The parkinsonian features of our two cases and the other eight reported cases occurred before the age of 50 years. The MR imaging study showed variable findings, in which, besides the common diffuse cerebral and cerebellar white matter lesions shown in CTX, several focal brain lesions were also noted. Of the focal lesions, substantia...

Thalamic single-unit and local field potential activity in Tourette syndrome

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

Psychiatric disorders in adult-onset focal dystonia: A case-control study

Movement Disorders — Wed, 27 Jan 2010 00:00:00 +0100

In a single-center, case-control study, we investigated the frequency and types of psychiatric disturbances in 89 consecutive patients with various primary focal dystonias (34 had cervical dystonia (CD), 28 blepharospasm (BPS), 16 laryngeal dystonia (LD), and 11 arm dystonia), 62 healthy control subjects and as controls for BPS, 26 patients with hemifacial spasm (HFS). Patients and controls underwent a full psychiatric evaluation. Diagnosis was based on the structured clinical interview for DSM-IV, obsessive-compulsive disorder (OCD) was assessed with the Yale-Brown Obsessive-Compulsive scale, anxiety with the Hamilton Rating Scale for Anxiety, the severity of depression with the Beck Depression Inventory. Of the 89 patients with focal dystonias studied, 51 patients (57.3%) had a diagnosis...

The baton is passed

Movement Disorders — Mon, 25 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Rhythmic pupillary oscillation in Creutzfeldt-Jakob disease associated with the Glu/Lys mutation of prion protein codon 200

Movement Disorders — Thu, 14 Jan 2010 00:00:00 +0100

We report two Creutzfeldt-Jakob disease (CJD) patients with rhythmic pupillary and palpebral oscillation who had a mutation of prion protein codon 200 that resulted in the substitution of lysine for glutamate (Glu/Lys). Alternating dilation and constriction of the pupils combined with elevation and descent of the eyelids occurred in correspondence with periodic sharp wave complexes (PSWCs) on the electroencephalogram and with myoclonus of the head, face, and extremities. The onset of pupillary dilation and palpebral elevation coincided with the PSWCs. Initiation of these rhythmic pupillary and palpebral movements may depend on sympathetic activity, but the site of the generator is unclear. Such rhythmic pupillary and palpebral oscillation may be a feature of rapidly progressive CJD with pr...

Genitourinary dysfunction in Parkinson's disease

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

Bladder dysfunction (urinary urgency/frequency) and sexual dysfunction (erectile dysfunction) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, genitourinary autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the genitourinary dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in diff...

The effect of peripheral enzyme inhibitors on levodopa concentrations in blood and CSF

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

Levodopa combined with a dopa-decarboxylase inhibitor, such as carbidopa, shifts the metabolism to the COMT pathway. Adding the peripheral acting COMT inhibitor entacapone provides improvement for patients with PD suffering from motor fluctuations. We studied the effects of the enzyme inhibitors entacapone and carbidopa on the levodopa concentrations in CSF and in blood. Five PD patients with wearing-off underwent lumbar drainage and intravenous microdialysis. Samples were taken 12 h daily for 3 days. Day 1; intravenous levodopa was given, day 2; additional oral entacapone 200 mg tid, day 3; additional oral entacapone 200 mg tid and carbidopa 25 mg bid. Levodopa in CSF and in dialysates was analysed. The AUC for levodopa increased both in blood and CSF when additional entacapone was given ...

Reckless generosity in Parkinson's disease

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

We describe another, potentially related phenomenon putatively associated with the use of dopamine agonists in 3 patients with PD, characterized by excessive and inappropriate philanthropy. © 2010 Movement Disorder Society (Source: Movement Disorders)

Reply: Plasma cholesterol and Parkinson's disease: Is the puzzle only apparent?

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Reply: A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Backpack treatment for camptocormia

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Kinematic and electromyographic tools for characterizing movement disorders in mice

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

Increasing interest in rodent models for movement disorders has led to an increasing need for more accurate and precise methods for both delineating the nature of abnormal movements and measuring their severity. These studies describe application of simultaneous high-speed video kinematics with multichannel electromyography (EMG) to characterize the movement disorder exhibited by tottering mutant mice. These mice provide a uniquely valuable model, because they exhibit paroxysmal dystonia superimposed on mild baseline ataxia, permitting the examination of these two different problems within the same animals. At baseline with mild ataxia, the mutants exhibited poorly coordinated movements with increased variation of stance and swing times, and slower spontaneous walking velocities. The corre...

Differentiating vascular parkinsonism from idiopathic Parkinson's disease: A systematic review

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

Vascular parkinsonism (VP) remains a loose constellation of various clinical features. We systematically reviewed studies comparing clinical, neuroimaging and other investigations that might distinguish VP from idiopathic Parkinson's disease (PD). Medline, Embase, Cinahl (R), and PsycINFO were searched by querying appropriate key words. Reports were included if the study population contained comparative findings between patients with VP and PD. Twenty-five articles fulfilled the selection criteria. Patients with VP were older, with a shorter duration of illness, presented with symmetrical gait difficulties, were less responsive to levodopa, and were more prone to postural instability, falls, and dementia. Pyramidal signs, pseudobulbar palsy, and incontinence were more common in VP. Tremor ...

Self-management rehabilitation and health-related quality of life in Parkinson's disease: A randomized controlled trial

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

The purpose of this randomized controlled trial was to determine whether increasing hours of self-management rehabilitation had increasing benefits for health-related quality of life (HRQOL) in Parkinson's disease beyond best medical treatment, whether effects persisted at 2 and 6 months of follow-up, and whether targeted compared with nontargeted HRQOL domains responded more to rehabilitation. Participants on best medication therapy were randomly assigned to one of three conditions for 6 weeks intervention: 0 hours of rehabilitation; 18 hours of clinic group rehabilitation plus 9 hours of attention control social sessions; and 27 hours of rehabilitation, with 18 in clinic group rehabilitation and 9 hours of rehabilitation designed to transfer clinic training into home and community routin...

Stiff person syndrome as the initial manifestation of systemic lupus erythematosus

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

We report a patient diagnosed with stiff person syndrome (SPS) as the first manifestation of systemic lupus erythematosus, discussing the possible interacting immune mechanisms involving the co-existence of both disorders. © 2010 Movement Disorder Society (Source: Movement Disorders)

Mild parkinsonian signs are associated with increased risk of dementia in a prospective, population-based study of elders

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

There is some evidence that mild parkinsonian signs (MPSs) are associated with increased risk of dementia, suggesting that MPS could be an early biomarker for dementia. Our aims, in a new cohort, were to determine whether (1) baseline MPS are a predictor of incident dementia and (2) there is an interaction between MPS and other baseline risk factors for dementia (i.e., the presence of both together greatly elevates the risk of dementia) was the objective. In a prospective, longitudinal study of community-dwelling elders in northern Manhattan, NY, Parkinsonian signs were rated with an abbreviated Unified Parkinson's Disease Rating Scale. Risk of incident dementia was assessed using Cox proportional hazards models. There were 1,851 participants (mean follow-up = 3.7 years). Participants with...

Progressive supranuclear palsy syndrome presenting as progressive nonfluent aphasia: A neuropsychological and neuroimaging analysis

Movement Disorders — Wed, 13 Jan 2010 00:00:00 +0100

There is currently considerable interest in the clinical spectrum of progressive nonfluent aphasia (PNFA) and progressive supranuclear palsy (PSP) and the intersection of these two entities. Here, we undertook a detailed prospective clinical, neuropsychological, and neuroimaging analysis of 14 consecutive patients presenting with PNFA to identify cases meeting clinical criteria for PSP. These patients had further detailed assessment of extrapyramidal and oculomotor functions. All patients had high-resolution MR brain volumetry and a cortical thickness analysis was undertaken on the brain images. Four patients presenting with PNFA subsequently developed features of a PSP syndrome, including a typical oculomotor palsy. The neuropsychological profile in these cases was similar to other patien...

Plasma [alpha]-synuclein in patients with Parkinson's disease with and without treatment

Movement Disorders — Sat, 09 Jan 2010 00:00:00 +0100

Long-term follow-up of DYT1 dystonia patients treated by deep brain stimulation: An open-label study

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Long-term efficacy of internal globus pallidus (GPi) deep-brain stimulation (DBS) in DYT1 dystonia and disease progression under DBS was studied. Twenty-six patients of this open-label study were divided into two groups: (A) with single bilateral GPi lead, (B) with a second bilateral GPi lead implanted owning to subsequent worsening of symptomatology. Dystonia was assessed with the Burke Scale. Appearance of new symptoms and distribution according to body region were recorded. In the whole cohort, significant decreases in motor and disability subscores (P < 0.0001) were observed at 1 year and maintained up to 10 years. Group B showed worsening of the symptoms. At 1 year, there were no significant differences between Groups A (without subsequent worsening) and B; at 5 years, a significant d...

The spectrum of movement disorders in Glut-1 deficiency

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

To assess the spectrum of movement disorders, we reviewed video recordings and charts of 57 patients with Glut-1 deficiency. Eighty-nine percent of patients with Glut-1 deficiency syndrome had a disturbance of gait. The most frequent gait abnormalities were ataxic-spastic and ataxic. Action limb dystonia was observed in 86% of cases and mild chorea in 75%. Cerebellar action tremor was seen in 70% of patients, myoclonus in 16%, and dyspraxia in 21%. Nonepileptic paroxysmal events occurred in 28% of patients, and included episodes of ataxia, weakness, Parkinsonism and nonkinesogenic dyskinesias. The 40 patients (70%) who were on the ketogenic diet had less severe gait disturbances but more dystonia, chorea, tremor, myoclonus, dyspraxia, and paroxysmal events compared with the 17 patients on ...

The relationship between uric acid levels and Huntington's disease progression

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Uric acid (UA) may be associated with the progression of Parkinson's disease and related neurodegenerative conditions; however, its association with Huntington's disease (HD) progression has not been explored. A secondary analysis of 347 subjects from the CARE-HD clinical trial was performed to examine the relationship between baseline UA levels and the level of functional decline in HD. Outcomes included change in scores at 30 months for the Unified Huntington's Disease Rating Scale components. There was less worsening of total functional capacity over time with increasing baseline UA levels (adjusted mean worsening in scores: 3.17, 2.99, 2.95, 2.28, 2.21, from lowest to highest UA quintile, P = 0.03). These data suggest a possible association between higher UA levels and slower HD progre...

The treatment of psychogenic movement disorders with suggestion is ethically justified

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Recent developments in our understanding of psychogenic movement disorders have not yet led to advances in treatment. A potentially beneficial treatment strategy is suggestion, the voluntary use by the physicians of techniques that introduce into the patient's mind a belief that he or she will be healed. Principalism, the dominant school of contemporary medical ethics, holds that the use of suggestion is not ethically justifiable because it undermines patient autonomy and degrades the doctor-patient relationship. However, evidence from a variety of sources (neuroimaging, anecdote, expert opinion, randomized controlled trials, and meta-analysis) supports the efficacy of suggestion as a treatment for psychogenic movement disorders. When issues of choice, consent, deceit, disclosure, and deci...

Measuring the rate of progression in Friedreich ataxia: Implications for clinical trial design

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

This study examines the rate of disease progression over one and two years in a cohort of 236 Friedreich ataxia patients using these scales and performance measure composites. The Friedreich Ataxia Rating Scale and performance-measure composites captured disease progression, with a greater sensitivity to change over 2 years than over 1 year. The measures differed in their sensitivity to change and in possible bias. These results help to establish norms for progression in FRDA that can be useful in measuring the long-term success of therapeutic agents and defining sample-size calculations for double-blind clinical trials. © 2009 Movement Disorder Society (Source: Movement Disorders)

Parkinsonism in patients with a history of amphetamine exposure

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

We recently found a higher rate of prolonged amphetamine exposure in patients diagnosed with Parkinson's disease (PD) than in spouse/caregiver controls. Since distinguishing features have been described in some patients with parkinsonism due to environment exposures (e.g., manganese), we sought to compare the clinical features of patients with PD with prolonged amphetamine exposure with unexposed patients with PD. Prolonged exposure was defined as a minimum of twice a week for [ge]3 months, or weekly use [ge]1 year. We reviewed the clinical records of patients with PD who had participated in a telephone survey of drug and environmental exposures and compared the clinical features of patients with a history of prolonged amphetamine exposure to patients who had no such exposure. Records were...

Visual hallucinations and altered visual information processing in Parkinson disease and dementia with Lewy bodies

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Visual hallucinations (VHs) are common in dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD), while auditory hallucinations are rare. To neurophysiologically investigate the pathophysiology of VHs in these disorders, we studied event-related potentials (ERPs) of DLB, PDD, and Alzheimer's disease (AD) patients. We compared visual and auditory ERP latencies among PDD patients with and without VHs (PDD-H: 11, PDD-N: 6), DLB patients (24), and AD patients (21). To elicit visual and auditory ERPs, a facial discrimination paradigm and a conventional auditory odd-ball paradigm, respectively, were used. The mean visual P3 latencies in the PDD-H and DLB groups were significantly longer than that in the AD group, while the mean auditory P3 latencies in all four patient group...

Orodispersible sublingual piribedil to abort OFF episodes: A single dose placebo-controlled, randomized, double-blind, cross-over study

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

S90049, a novel sublingual formulation of the non-ergoline D2-D3 agonist piribedil, has a pharmacokinetic profile promising to provide rapid relief on motor signs in Parkinson's disease (PD). We assessed the efficacy and safety of S90049 in aborting OFF episodes responding to subcutaneous apomorphine in PD patients with motor fluctuations. This was a single-dose double-blind double-placebo 3 × 3 cross-over study. Optimal tested doses were determined during a previous open-label titration phase (S90049 median dose: 60 mg, apomorphine: 5 mg). Primary endpoint was the maximal change versus baseline in UPDRS motor score ([Delta]UPDRS III) assessed after drug administration following an overnight withdrawal of antiparkinsonian medications. Thirty patients (age: 60 ± 8 years, PD duration: 12 �...

Trihexyphenidyl for acute life-threatening episodes due to a dystonic movement disorder in Rett syndrome

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

We describe three girls with RS who experienced ALTEs from an early age. These were long considered epileptic until video-EEG in Patients 1 and 3 revealed their non-epileptic nature. A primary dystonic mechanism was suspected and Patients 1 and 2 were treated with Trihexyphenidyl with significantly reduced frequency of the ALTEs. Patient 3 died before Trihexyphenidyl was tried. Trihexyphenidyl in RS patients with similar presentations can modify the dystonia and prevent ALTEs. © 2009 Movement Disorder Society (Source: Movement Disorders)

Fragile X-associated tremor/ataxia syndrome (FXTAS) with myoclonus

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Effect of movement frequency on repetitive finger movements in patients with Parkinson's disease

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Muscular pain in Parkinson's disease and nociceptive processing assessed with CO2 laser-evoked potentials

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Muscular pain is the most frequent kind of nondystonic pain associated with Parkinson's disease (PD). It might be related not only to peripheral factors but also to an abnormal nociceptive input processing in the central nervous system. To test this hypothesis, we recorded CO2 laser-evoked potentials (LEPs) in response to shoulder stimulation (skin over deltoid muscle) in 11 hemiparkinsonian PD patients complaining of muscular pain in the shoulder (ipsilateral to motor symptoms) and compared the results with those obtained in 12 pain-free PD patients with hemiparkinson and in 11 normal subjects. N2/P2 LEP, which is thought to originate from the cingulate cortex and insula, was significantly lower in amplitude in both groups of PD patients than in controls, regardless of the clinically affe...

Long-term deep brain stimulation for essential tremor: 12-year clinicopathologic follow-up

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

We describe the clinical course and postmortem pathological findings in a patient with essential tremor (ET) treated with deep brain stimulation (DBS) for 12 years. This 75 year old woman had a 13-year history of progressive ET prior to implantation of bilateral quadripolar DBS electrodes in the region of her ventral intermediate thalamic nuclei in 1996, producing immediate relief of arm tremor. Histopathological examination of the brain, performed 12 years after the initial implantation, demonstrated electrode catheter tracts rimmed by 20-25 micron fibrous sheaths, with multinucleated giant cells and reactive gliosis. Lymphocytic infiltration was seen by L26 immunoreactivity with CD3 (T cells) staining predominating over CD20 (B cells). Cerebellar axonal spheroids and Purkinje cell loss w...

Artistic profession: A potential risk factor for dopamine dysregulation syndrome in Parkinson's disease?

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

A small proportion of patients with Parkinson's disease (PD) develop a dopamine dysregulation syndrome (DDS). Management of such patients can be difficult; hence, early identification and careful monitoring of at-risk individuals are important. Based on four illustrative cases, we wish to draw attention to the risk of developing DDS in PD patients engaged in a creative and artistic profession, who compulsively abuse dopaminergic drugs to maintain or enhance their artistic creativity. Balancing the drug requirement for treating motor symptoms on one hand and improving creativity on the other hand has to be carefully evaluated and early neuropsychiatric intervention may be necessary. Apart from the known risk factors - young age at PD onset, male gender, heavy alcohol consumption, illegal dr...

Failure of cathodal direct current stimulation to improve fine motor control in musician's dystonia

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Musician's dystonia (MD) is a task-specific movement disorder with a loss of voluntary motor control in highly trained movements. Defective inhibition on different levels of the central nervous system is involved in its pathophysiology. Cathodal transcranial direct current stimulation (ctDCS) diminishes excitability of the motor cortex and improves performance in overlearned tasks in healthy subjects. The aim of this study was to investigate whether ctDCS improves fine motor control in MD. Professional guitarists (n = 10) with MD played exercises before, directly after ctDCS, and 60 min after ctDCS. ctDCS (2 mA, 20 min) was applied on the primary motor cortex contralateral to the affected hand. Guitar exercises were video-documented and symptoms were evaluated by three independent experts....

An exploration of the burden experienced by spousal caregivers of individuals with Parkinson's disease

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

This study used the repertory grid method to capture the full range of caregivers' subjective experience, quantify their perceptions, and to acquire information that might be useful in directing remediation attempts. Within this sample, caregivers reported far greater burden from "mental stress" (e.g., worrying about individual's safety) than from "physical stress" (e.g., lifting individual into bed). Specifically, caregivers were primarily concerned about spousal safety, as this requires continuous vigilance and constant worry. Caregivers also reported experiencing "little deaths" as the disease progresses, related to a loss of independence for the couple, and the steady diminishment of social networks. Increasing attention on the mental burden experienced by spousal caregivers promises t...

B cell depletion therapy for new-onset opsoclonus-myoclonus

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Twelve immunotherapy-naïve children with opsoclonus-myoclonus syndrome and CSF B cell expansion received rituximab, adrenocorticotropic hormone (ACTH), and IVIg. Motor severity lessened 73% by 6 mo and 81% at 1 yr (P < 0.0001). Opsoclonus and action myoclonus disappeared rapidly, whereas gait ataxia and some other motor components improved more slowly. ACTH dose was tapered by 87%. Reduction in total CSF B cells was profound at 6 mo (-93%). By study end, peripheral B cells returned to 53% of baseline and serum IgM levels to 63%. Overall clinical response trailed peripheral B cell and IgM depletion, but improvement continued after their levels recovered. All but one non-ambulatory subject became ambulatory without additional chemotherapy; two relapsed and remitted; four had rituximab-relat...

Skin cancer and Parkinson's disease

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

The report of an increased frequency of melanoma during the clinical development of rasagiline prompted a renewed interest in a possible association between skin cancer and Parkinson's disease (PD). The evaluation of this risk ended in a recommendation to perform a periodic dermatological examination as a follow-up measure of their treatment. The recognition of this safety concern lead to the need to clarify if the risk of skin cancer is indeed associated with PD and if levodopa or other anti-parkinsonian drugs might contribute to increase such risk. To answer these questions, we critically reviewed all clinical studies available concerning the association between skin cancer and PD. We found 26 studies on cancer occurrence in PD. The best data available suggest the risk of cancer is reduc...

Health-related quality of life in patients with Gilles de la Tourette's syndrome

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

To investigate the health-related quality of life (HrQoL) of adult patients with Gilles de la Tourette's syndrome (GTS) in Germany. HrQoL was evaluated in 200 adult patients with GTS (Mean age: 34.9 ± 11.8 years). Patients were recruited from three outpatient departments in Germany and completed a semi-structured, self-rating interview. HrQoL was measured using the EQ-5D. Depression was assessed using the Beck's depression inventory (BDI) and clinical symptoms using the Yale Tourette syndrome symptom list (TSSL) and the Shapiro Tourette-syndrome severity scale (STSSS). Multivariate regression analyses were performed to identify independent predictors of HrQoL. Patients with GTS proved to have a worse HrQoL than a sample from the general German population. The domains most affected were an...

Psychogenic chorea associated with family history of Huntington disease

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Modulatory effects of 5Hz rTMS over the primary somatosensory cortex in focal dystonia - An fMRI-TMS study

Movement Disorders — Fri, 08 Jan 2010 00:00:00 +0100

Dystonia is associated with impaired somatosensory ability. The electrophysiological method of repetitive transcranial magnetic stimulation (rTMS) can be used for noninvasive stimulation of the human cortex and can alter cortical excitability and associated behavior. Among others, rTMS can alter/improve somatosensory discrimation abilities, as shown in healthy controls. We applied 5Hz-rTMS over the left primary somatosensory cortex (S1) in 5 patients with right-sided writer's dystonia and 5 controls. We studied rTMS effects on tactile discrimination accuracy and concomitant rTMS-induced changes in hemodynamic activity measured by functional magnetic resonance imaging (fMRI). Before rTMS, patients performed worse on the discrimination task than controls even though fMRI showed greater task-...

Cognitive-nigrostriatal relationships in de novo, drug-naïve Parkinson's disease patients: A [I-123]FP-CIT SPECT study

Movement Disorders — Thu, 07 Jan 2010 00:00:00 +0100

To unveil cognitive-nigrostriatal correlations in Parkinson's disease (PD), 30 de novo, drug-naïve PD patients and 15 patients with essential tremor (Controls, CTR) underwent a neuropsychological (NPS) battery and brain SPECT with [I-123]Ioflupane, as a biomarker of nigrostriatal function. Automatic extraction of uptake at caudate and putamen level was conducted through the BasGan software, also allowing partial volume effect correction. Because of the multicollinearity among neuropsychological tests and among SPECT variables, factor analysis was applied to 16 neuropsychological scores; moreover, the four SPECT variables were merged into a mean SPECT value (mSPECT). Factor analysis identified four NPS factors: a dys-executive (NPS-EX), a visuospatial (NPS-VS), a verbal memory (NPS-VM), an...

External validation of abbreviated versions of the activities-specific balance confidence scale in Parkinson's disease

Movement Disorders — Sat, 12 Dec 2009 00:00:00 +0100

This study aimed to validate these abbreviated versions and to determine their correlations with measures of balance and functional capacity. Eighty-nine individuals with PD participated in the study. Using the 25th percentile, five items were identified as the lowest scoring items (i.e., lowest balance confidence), and thus a 5-item version of the questionnaire was created. Internal consistency and the relationship with the ABC-16 were good for all abbreviated versions (Cronbach [alpha] > 0.93; ICC > 0.91). All versions correlated significantly with most measures of balance and function, with no differences between versions. An abbreviation of the ABC-16, using only five items, may prove useful in busy clinical and research settings. © 2009 Movement Disorder Society (Source: Movement Dis...

Minocycline 1-year therapy in multiple-system-atrophy: Effect on clinical symptoms and [11C] (R)-PK11195 PET (MEMSA-trial)

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

The aim of the study was to investigate the efficacy of the antibiotic minocycline as a drug treatment in patients with Multiple-System-Atrophy Parkinson-type (MSA-P). Sixty-three patients were randomized to minocycline 200 mg/d (n = 32) or a matching placebo (n = 31). The primary outcome variable was the change in the value of the motor score of the Unified Multiple-System-Atrophy Rating-Scale (UMSARSII) from baseline to 48 weeks. Secondary outcome variables included subscores and individual Parkinsonian symptoms as determined by the UMSARS and the Unified-Parkinson's-Disease Rating-Scale (UPDRS). Health-related quality of life (HrQoL) was assessed using the EQ-5D and SF-12. "Progression rate" was assumed to be reflected in the change in motor function over 48 weeks. At 24 weeks and 48 we...

Clinical measures of dysarthria in Friedreich Ataxia

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

This study evaluated a series of performance measures for speech in 22 patients with genetically confirmed FA and 16 age-matched controls. Tests included the PATA examination, the PATAKA examination, the Oral Motor component of the Boston Aphasia examination, the Boston Cookie Theft description task, and the Assessment of Intelligibility of Dysarthric Speech. All measures, except the Cookie theft description task, demonstrated significantly lower scores for patients with FA when compared with controls and correlated with measures of disease progression. Thus, four of five measures capture speech dysfunction in FA and may provide feasible, inexpensive, quantitative testing for therapeutic monitoring in FA. © 2009 Movement Disorder Society (Source: Movement Disorders)

Baroreflex sensitivity and power spectral analysis during autonomic testing in different extrapyramidal syndromes

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

In conclusion, our approach allows the evaluation of autonomic variability during short and nonstationary periods of time and may constitute a useful advance in the assessment of autonomic function in both physiological and pathological conditions. © 2009 Movement Disorder Society (Source: Movement Disorders)

BDNF levels are not related with levodopa-induced dyskinesias in MPTP monkeys

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

Levodopa-induced dyskinesias (LIDs) are frequent in parkinsonian patients and may result from an aberrant plasticity. Brain-derived neurotrophic factor (BDNF) represents a likely candidate to subserve neuroadaptive processes encountered in LIDs. We compared striatal BDNF levels measured by ELISA in levodopa-treated 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) monkeys having developed LIDs compared with animals where LIDs were prevented by the addition of CI-1041 (NR1A/2B NMDA receptor antagonist) or low doses of cabergoline (dopamine D2 receptor agonist). We observed reduced striatal BDNF concentrations in levodopa-treated MPTP monkeys with or without LIDs, suggesting that levodopa treatment is associated with reduced striatal BDNF levels and is independent of dyskinesias. © 2009 M...

Novel PANK2 gene mutations in korean patient with pantothenate kinase-associated neurodegeneration presenting unilateral dystonic tremor

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Differential neuropsychological profiles in Parkinsonian patients with or without vascular lesions

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

The purpose of this study is to compare the neuropsychological profile of patients affected by parkinsonism and vascular lesions to that in patients with PD alone (PD) and to evaluate whether the brain vascular lesion load is associated with neuropsychological variables. Thirty-six nondemented patients with parkinsonism were divided into 3 groups of 12 patients each, according to both clinical history and the presence of brain vascular lesions and/or dopaminergic denervation as revealed by magnetic resonance and dopamine transporter imaging, respectively. The first group had vascular lesions without dopaminergic denervation (VP group); the second group had vascular lesions and dopaminergic denervation (DD) (VP+DD group); and the third group consisted of patients with dopaminergic denervati...

Motor laterality asymmetry and nonmotor symptoms in Parkinson's disease

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

Conclusions: These findings suggest that damage to left-hemisphere plays a disproportionately greater role in PD-related psychosis over time. In contrast, motor laterality does not consistently affect other NMS, suggesting that NMS are related to a more widespread brain disorder. © 2009 Movement Disorder Society (Source: Movement Disorders)

Deep brain stimulation in a patient with isolated mixed tremor

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

No abstract. (Source: Movement Disorders)

TremAn: A tool for measuring tremor frequency from video sequences

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

No abstract. (Source: Movement Disorders)

Psychogenic movement disorder after a venlafaxine-induced dystonia

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Movement Disorders)

Myopathy causing camptocormia in idiopathic Parkinson's disease: A multidisciplinary approach

Movement Disorders — Fri, 11 Dec 2009 00:00:00 +0100

This study aims to eludicate the etiology of PD-associated CC and HD via a multidisciplinary approach (clinical examination, electromyography, MRI, genetic analysis, muscle morphology) centering on the histology of the paraspinal muscles. We studied 17 patients with the clinical diagnosis of PD and CC or head drop syndrome and six controls. We performed muscle biopsies of paraspinal muscles and deep neck extensor muscles. Mean age at onset of postural abnormality was 66 years and mean latency between onset of parkinsonian symptoms to first signs of CC or head drop was 7 years. The electromyogram of paraspinal muscles was abnormal in 13-14 patients. Histopathology revealed chronic myopathic changes in 14 of 17 biopsies, consisting of abnormal variation in fiber size, increase in internal nu...