Movement Disorders Clinical Practice最新文献

{"title":"Magnetic Susceptibility and Area in the Subthalamic Nucleus Measured by QSM for Diagnosis of Progressive Supranuclear Palsy.","authors":"Shotaro Haji, Wataru Sako, Kenta Hanada, Tomoyasu Matsubara, Yusuke Osaki, Yuki Matsumoto, Masafumi Harada, Yuishin Izumi","doi":"10.1002/mdc3.70153","DOIUrl":"https://doi.org/10.1002/mdc3.70153","url":null,"abstract":"<p><strong>Background: </strong>Iron deposition and atrophy of the subthalamic nucleus (STN) have been reported in progressive supranuclear palsy (PSP). Quantitative susceptibility mapping (QSM), an advanced MRI technique, enables noninvasive assessment of the magnetic susceptibility of biological tissue and has been reported to have good ability to delineate STN.</p><p><strong>Objective: </strong>The aim of this study is to evaluate the diagnostic accuracy of a model using magnetic susceptibility and area of the STN assessed by QSM to differentiate PSP from Parkinson's disease (PD).</p><p><strong>Methods: </strong>A total of 35 patients with PSP and 28 patients with PD were recruited. Magnetic susceptibility and area of the STN were measured by QSM. Axial and coronal scans were acquired to measure the STN magnetic susceptibility and area. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic accuracy for differentiating PSP from PD.</p><p><strong>Results: </strong>In the axial scan group, STN susceptibility was significantly higher in PSP than PD (p = 0.047), with no difference in the coronal scan group (p = 0.066). PSP patients had a smaller STN area than PD in both axial (p < 0.001) and coronal (p = 0.002) scan groups. The combination of these metrics showed high diagnostic accuracy (Axial, AUC = 0.87; Coronal, AUC = 1.00) and excellent performance (AUC = 0.98) in cases within 3 years of onset.</p><p><strong>Conclusions: </strong>A combination of magnetic susceptibility and area of the STN measured by QSM can be used to discriminate PSP from PD, even at early stages.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Safety and Efficacy of Repeat Treatments with DaxibotulinumtoxinA in Cervical Dystonia: Results from the ASPEN-Open-Label Study.","authors":"Peter McAllister, Atul T Patel, Marta Banach, Aaron Ellenbogen, Jaroslaw Slawek, Sebastian Paus, Hyder A Jinnah, Virgilio Evidente, Todd M Gross, Rashid Kazerooni, Conor J Gallagher, David A Hollander","doi":"10.1002/mdc3.70104","DOIUrl":"https://doi.org/10.1002/mdc3.70104","url":null,"abstract":"<p><strong>Background: </strong>DaxibotulinumtoxinA (DAXI), a novel botulinum neurotoxin (BoNT) formulation, was shown to be safe, effective, and long-lasting in the treatment of cervical dystonia (CD) over one treatment cycle in the phase 3, randomized, placebo-controlled ASPEN-1 trial.</p><p><strong>Objectives: </strong>To evaluate the safety, immunogenicity, and efficacy of repeat DAXI treatments for CD over 52 weeks in the phase 3, open-label ASPEN-OLS (NCT03617367).</p><p><strong>Methods: </strong>Adults with moderate-to-severe CD (Toronto Western Spasmodic Torticollis Rating Scale [TWSTRS] score ≥20) initially received DAXI 125U or 250U based on treatment history and investigator judgment. Retreatment could be titrated (50U-75U) each cycle (maximum 300U) for up to four cycles over 52 weeks. Assessments were conducted at Week 4, 6, 12, and every 4 weeks until retreatment.</p><p><strong>Results: </strong>In all, 357 subjects received ≥1 dose of DAXI; most subjects (68.9%) received 250U during Cycle 1. Subjects most commonly received three (47.3%) or two (26.6%) treatments over 52 weeks. The average dose increased with successive cycles (Cycle 2: 239U, Cycle 3: 256U, Cycle 4: 270U). Mean (SD) change in TWSTRS score from baseline increased from -15.4 (10.3) in Cycle 1 to -19.9 (13.6) in Cycle 4. Median duration of effect was 20.1 weeks (Cycle 1, 2). No trend was observed between exposure to DAXI and any safety signals or antibody events. The most frequently reported treatment-related adverse events per treatment were muscular weakness (4.9%), injection-site pain (4.2%), and dysphagia (3.9%).</p><p><strong>Conclusion: </strong>DAXI was safe and efficacious over repeated treatments in adults with CD. Adverse event rates were similar to or potentially lower compared with conventional BoNTs.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Phenotype and Neuroimaging Findings in Siblings with COX15 Deficiency: Case Report and Review of Previously Reported Cases.","authors":"Haya S AlFaris, Sangeetha Yoganathan, Marcus N Callister, Liali Aljouda, Vivek Pai, Pradeep Krishnan, Andrea LeBlanc-Millar, Christos Ganos, Carolina Gorodetsky","doi":"10.1002/mdc3.70135","DOIUrl":"https://doi.org/10.1002/mdc3.70135","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Plasma Neurofilament Light Chain Levels in Children with Infantile-Onset Ascending Hereditary Spastic Paralysis.","authors":"Umar Zubair, Nicole Battaglia, Julian E Alecu, Amy Tam, Joshua Rong, Vicente Quiroz, Kathryn Yang, Hyo-Min Kim, Kaitlyn Warren, Rebekah Mannix, Stefania Della Vecchia, Filippo Maria Santorelli, Darius Ebrahimi-Fakhari","doi":"10.1002/mdc3.70157","DOIUrl":"https://doi.org/10.1002/mdc3.70157","url":null,"abstract":"<p><strong>Background: </strong>Infantile-onset ascending hereditary spastic paralysis (IAHSP), caused by bi-allelic variants in ALS2, is an ultra-rare, neurodegenerative disorder characterized by progressive ascending spasticity and weakness with bulbar dysfunction.</p><p><strong>Objectives: </strong>To investigate baseline plasma neurofilament light chain (NfL) levels in children with IAHSP patients compared to age-matched controls.</p><p><strong>Methods: </strong>Five patients (age range: 6-11 years) with genetically confirmed IAHSP and 74 healthy controls were assessed. Plasma NfL was measured using a single-molecule array. Statistical analyses included non-parametric tests, age-matched comparisons, and effect size estimation.</p><p><strong>Results: </strong>Children with IAHSP had modestly but significantly elevated plasma NfL levels compared to controls (median: 17.5 vs. 4.78 pg/mL, p = 0.004). High NfL levels persisted across varying levels of clinical severity.</p><p><strong>Conclusions: </strong>Plasma NfL levels are elevated in IAHSP, suggesting axonal degeneration. These pilot findings highlight NfL as a potential marker for disease activity, warranting further investigation in larger cohorts and longitudinal studies.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Is the Main Predictor of Wearing-Off and Dyskinesia in Levodopa-Naïve Patients with Parkinson's Disease.","authors":"Maria Teresa Pellecchia, Marina Picillo, Maria Claudia Russillo, Marianna Amboni, Gennarina Arabia, Laura Avanzino, Margherita Canesi, Alessia Catania, Roberto Ceravolo, Calogero Edoardo Cicero, Roberto Cilia, Isabel Colangelo, Giovanna Dati, Rosa De Micco, Anna De Rosa, Alessio Di Fonzo, Roberto Eleopra, Vincenza Fetoni, Barbara Garavaglia, Augusta Giglio, Martina Giuntini, Federica Invernizzi, Giulia Lazzeri, Roberta Marchese, Alessandra Nicoletti, Claudio Pacchetti, Celeste Panteghini, Manuela Pilleri, Fabiana Radicati, Chiara Reale, Cesa Scaglione, Andrea Soricelli, Fabrizio Stocchi, Alessandro Tessitore, Laura Vacca, Maria Antonietta Volontè, Graziella Volpi, Roberta Zangaglia, Francesco Amato, Carlo Ricciardi, Michela Russo, Paolo Barone","doi":"10.1002/mdc3.70143","DOIUrl":"https://doi.org/10.1002/mdc3.70143","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that female gender represents a risk factor for the development of motor/nonmotor fluctuations and dyskinesia in Parkinson's disease (PD). So far, no prospective study has analyzed this aspect in relation to the introduction of levodopa treatment.</p><p><strong>Objective: </strong>This prospective multicenter study aims to assess the development of motor/nonmotor fluctuations and dyskinesia based on gender over a 2-year observation period in PD patients starting levodopa.</p><p><strong>Methods: </strong>Two hundred and eighty-nine PD patients requiring levodopa at baseline were enrolled at 17 Movement Disorders Centers and followed for 2 years. Gender differences in the development of fluctuations, defined as a score ≥2 in the 19-item Wearing-Off Questionnaire, and dyskinesia, defined by Movement Disorders Society Unified Parkinson's Disease Rating Scale Part IV (MDS-UPDRS-IV) score >0 on item 4.1 were assessed. Baseline predictors of such complications were evaluated by stepwise multivariate logistic regression analysis.</p><p><strong>Results: </strong>Two hundred and sixteen patients (139 men, 77 women) completed the follow-up (M24). By M24, 53,2% of men and 64.9% of women had fluctuations (P = 0.048), whereas 5% of men and 14.3% of women developed dyskinesia (P = 0.0185). Multivariate analysis showed that female gender significantly predicted wearing-off (Odds ratio [OR] = 1.930; P = 0.0333), whereas older age was a significant protective factor (for 5-year increase: OR = 0.712; P < 0.0001). Multivariate analysis showed that gender (OR = 3.405; P = 0.0228) and MDS-UPDRS Part III score (for a 5-unit increase: OR = 1.281; P = 0.0239) were significant predictors of dyskinesia at M24.</p><p><strong>Conclusions: </strong>Female gender was the strongest predictor of fluctuations and dyskinesia after 2-year intake of levodopa. This finding could have important implications for the development of gender-oriented therapeutic recommendations in early PD.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Electroacupuncture on Insomnia in Parkinson's Disease: A Multicentre, Randomized, Controlled Trial.","authors":"Si-Chun Gu, Ping Yin, Min Yang, Rong Shi, Qiang Li, Jun Liu, Yun-Cheng Wu, Yu Zhang, Chang-De Wang, Yun-Yun Zhang, Min-Jue Gu, Li-Min Xu, Chen Gao, Xiao-Lei Yuan, You Wu, Can-Xing Yuan, Qing Ye","doi":"10.1002/mdc3.70139","DOIUrl":"https://doi.org/10.1002/mdc3.70139","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances, particularly insomnia, are prevalent and debilitating non-motor symptoms of Parkinson's disease (PD), significantly impacting quality of life. Current treatment options are limited by side effects and accessibility. Electroacupuncture (EA), a non-pharmacological approach, has shown promise in insomnia, while its specific impact on insomnia in PD remains unexplored.</p><p><strong>Objectives: </strong>To determine the efficacy and safety of EA vs sham electroacupuncture (SA) on insomnia associated with PD.</p><p><strong>Methods: </strong>We conducted a multicenter, participant-and assessor-blinded, randomized, sham-controlled clinical trial from March 1, 2024, to October 28, 2024, across eight sites in China. A total of 136 PD patients with insomnia were assigned to receive EA or SA (68 per arm) over an 8-week treatment period followed by a 12-week follow-up period. The primary outcome was the change in Parkinson's Disease Sleep Scale (PDSS) scores at week 8. A range of subjective sleep-related metrics and objective sleep assessments derived from polysomnography were utilized as secondary outcomes.</p><p><strong>Results: </strong>Both groups showed significant improvements in PDSS scores, with the EA group demonstrating a greater effect (between-group difference, 13.50 [95%CI, 12.68 to 14.32]). Secondary outcomes, including Insomnia Severity Index, Epworth Sleepiness Scale, and polysomnography-derived parameters, also showed greater improvements in EA group. The effects were maintained during the 12-week follow-up with no severe adverse events. The blinding assessment confirmed successful blinding.</p><p><strong>Conclusions: </strong>EA was effective in improving insomnia and related sleep disturbances in PD. This study provided Class I evidence supporting the integration of EA into the treatment regimen for insomnia in PD.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Evaluation of Opicapone in Early Wearing-Off Symptoms of Parkinson's Disease: A Critical Review and Recommendations for Future Research.","authors":"Sheng Li, Xiaolong Guo, Zishan Zhao","doi":"10.1002/mdc3.14278","DOIUrl":"https://doi.org/10.1002/mdc3.14278","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and Emerging Therapeutic Targets for Essential Tremor: A Critical Appraisal of Recent Preclinical and Clinical Studies.","authors":"Adreesh Mukherjee, Sanjay Pandey","doi":"10.1002/mdc3.70147","DOIUrl":"https://doi.org/10.1002/mdc3.70147","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) is a common hyperkinetic movement disorder and causes significant disability. However, the response to the commonly used medications is often unsatisfactory. Hence, there is a requirement for improved treatment modalities involving novel therapeutic targets.</p><p><strong>Objective: </strong>To review the literature on the recent clinical and preclinical studies regarding the treatment of ET, to identify and discuss the emerging therapeutic targets.</p><p><strong>Methods: </strong>The authors conducted a literature search on PubMed and Scopus on March 25, 2025 using different search terms and included the relevant articles in the review. Ongoing clinical trials in ET were noted by searching https://clinicaltrials.gov/.</p><p><strong>Results: </strong>Evidence collected from preclinical studies has led to clinical trials on several pharmacological agents such as T-type calcium channel antagonists, GABA_A receptor modulators, SK channel modulators, and agents targeting glutamatergic neurotransmission. However, some promising clinical trials had negative results, and the outcomes of the other phase 2 and 3 studies are still pending. Preclinical studies have identified other pharmacological targets that have yet to be replicated in clinical studies. Regarding deep brain stimulation and magnetic resonance-guided focused ultrasound surgery, in addition to the thalamic ventralis intermedius nucleus, the posterior subthalamic area has also shown efficacy, possibly due to its proximity to the dentato-rubro-thalamic tract. Non-invasive brain, spinal cord, and peripheral stimulation techniques are the other potential treatment modalities investigated in ET.</p><p><strong>Conclusions: </strong>New therapeutic targets including pharmacological, surgical, and non-invasive stimulation techniques have shown promise in ET. Translating preclinical research into useful treatment strategies requires further clinical trials.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in the Clinical Provision of Deep Brain Stimulation: A Systematic Scoping Review and Grounded-Theory Qualitative Analysis.","authors":"Wellington Chang, Talia Ganz, Sara Kang, Kacey Hu, Catherine Mark, Adam Frank, Brian Lee, Darrin Lee, R Bernard Coley, Rachel Carmen Ceasar, Xenos Mason","doi":"10.1002/mdc3.70132","DOIUrl":"https://doi.org/10.1002/mdc3.70132","url":null,"abstract":"<p><strong>Background: </strong>Deep Brain Stimulation (DBS) has been an established treatment for movement disorders since its FDA approval in 1996. However, disparities in DBS care, particularly concerning race, gender, socioeconomic status, and geography, remain a significant concern globally.</p><p><strong>Objectives: </strong>This systematic scoping review and grounded theory qualitative analysis aimed to synthesize existing research on worldwide disparities in DBS provision and to develop theoretical solutions to enhance equity and improve the quality of research in DBS disparities.</p><p><strong>Methods: </strong>A systematic search identified 46 studies, which were critically appraised for quality and analyzed using grounded theory methods to extract core conceptual categories.</p><p><strong>Results: </strong>We characterized three principles of DBS disparities: intersectionality, reciprocal interactivity and influence of patients and providers, and the interposition of simultaneous barriers; together these highlight the role of individual, systemic, and structural factors in generating DBS disparities. Racial minorities, women, socioeconomically disadvantaged individuals, and patients in certain geographic regions were consistently found to have reduced access to DBS. Gaps in the research include a calcified research infrastructure, insufficient attention to cultural and societal contexts, and reliance on conjecture without empirical support.</p><p><strong>Conclusions: </strong>We propose a multi-level approach to address DBS disparities, including reciprocal education between patients and clinicians, enhanced screening and referral networks, and policy reforms at institutional and governmental levels. These findings will facilitate further hypothesis-driven research and foster more equitable access to DBS globally.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Supine Hypertension in Alpha-Synucleinopathies: A Systematic Review and Meta-Analysis.","authors":"Paulo Roberto Moss Lopes, Fernando Luiz Westphal Filho, Frederico De Sousa Marinho Mendes Filho, Caio Eduardo Rodrigues Falcão, Vitor Maia Arca, Jacy Bezerra Parmera","doi":"10.1002/mdc3.70142","DOIUrl":"https://doi.org/10.1002/mdc3.70142","url":null,"abstract":"<p><strong>Background: </strong>Alpha-synucleinopathies, including Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA), and Pure Autonomic Failure (PAF), are associated with autonomic dysfunctions such as orthostatic hypotension (OH) and supine hypertension (SH). SH, characterized by elevated supine blood pressure, carries significant cardiovascular and cognitive risks, yet its prevalence in α-synucleinopathies remains inadequately defined.</p><p><strong>Objectives: </strong>We aimed to conduct a systematic review and meta-analysis to assess the prevalence of SH in α-synucleinopathies.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Web of Science databases for studies reporting SH prevalence in patients with α-synucleinopathies. A random-effects model estimated prevalence, stratified by disease type, study design, SH definition, OH presence, and disease duration. Sensitivity analyses were applied to explore sources of variability.</p><p><strong>Results: </strong>Nineteen studies involving 4973 patients were included. The overall SH prevalence was 30.4% (95% CI: 26.4-34.7; I² = 87.6%). In PD, SH prevalence was 28.3% (95% CI: 24.0-32.9; I² = 86.4%), with OH significantly increasing prevalence (33.9% vs. 21.3%, P = 0.0341). In MSA, SH prevalence was 31.1% (95% CI: 25.9-36.9; I² = 30.5%), with OH similarly associated with higher SH prevalence (46.5% vs. 19.8%, P = 0.0023). In DLB, the pooled SH prevalence was 48.7% (95% CI: 39.5-58.1; I² = 11.9%). For PAF, a single study reported a prevalence of 48.4% (95% CI: 35.7-61.2).</p><p><strong>Conclusion: </strong>SH is highly prevalent across α-synucleinopathies, with variability by disease type and OH presence. Standardizing diagnostic criteria and investigating its clinical implications are essential to enhance management strategies.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}