Movement Disorders Clinical Practice最新文献

{"title":"Oromandibular Dystonia Associated with Long-Term Adalimumab Therapy.","authors":"Berna Günay, Aylin Küçükali, Kübra Neslihan Kurt Oktay, Duygu Geler Külcü","doi":"10.1002/mdc3.70670","DOIUrl":"https://doi.org/10.1002/mdc3.70670","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840270","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":"Sex Differences in Fall Frequency, Risk Factors, and Outcomes in Parkinson's Disease: A Cross-Sectional Analysis.","authors":"Joaquin A Vizcarra, Kat Hefter, David-Erick Lafontant, Michael Tran Duong, Ashkan Ertefaie, Brian Litt, Dani S Bassett, Andrew Siderowf","doi":"10.1002/mdc3.70664","DOIUrl":"https://doi.org/10.1002/mdc3.70664","url":null,"abstract":"<p><strong>Background: </strong>Female sex is an independent fall risk factor in Parkinson's disease (PD), yet sex-specific fall patterns remain unclear.</p><p><strong>Objectives: </strong>To compare sex-specific fall risk and outcomes across PD, prodromal alpha-synucleinopathy (PAS), and healthy controls (HC); estimate fall frequency across PD progression; and assess how sex modifies fall risk and outcomes.</p><p><strong>Methods: </strong>Fall outcomes were analyzed in the Parkinson's Progression Markers Initiative. Yearly rates of rare and frequent falls were estimated by time since diagnosis. PD participants were classified as never, rare, or frequent fallers. Clinical measures included motor, cognitive, behavioral, sleep, and autonomic domains. Outcomes included injuries and healthcare utilization. Regression models adjusted for age, sex, and disease duration with Benjamini-Hochberg correction.</p><p><strong>Results: </strong>Among 3100 participants (937 PD, 1926 PAS, 237 HC; 6977 visits), PD participants had higher odds of falling than PAS (OR 1.66, 95% CI 1.46-1.87) and HC (OR 4.03, 95% CI 3.14-5.23). In PD and PAS, females had higher odds of injuries (OR 1.50, 95% CI 1.20-1.88) and fractures (OR 1.62, 95% CI 1.15-2.29), including hip (OR 2.30, 95% CI 1.09-4.91) and upper-extremity fractures (OR 2.67, 95% CI 1.51-4.85). Within PD, falls increased with disease duration and were higher in females (7 years: 42% vs. 32%; 14 years: 88% vs. 61%) despite milder clinical profiles. Across the Neuronal Synuclein Disease-Integrated Staging System (NSD-ISS) stages, fall occurrence was higher in females.</p><p><strong>Conclusion: </strong>Falls increase with disease duration and NSD-ISS stage. Female PD participants are at greater risk despite milder symptoms, supporting sex-specific prevention strategies.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840257","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":"Daridorexant Treatment for Chronic Insomnia in Restless Legs Syndrome.","authors":"Luca Fernando, Mariana Fernandes, Anna Castelnuovo, Alessandro Colitta, Angelica Montini, Pietro Mattioli, Michelangelo Maestri Tassoni, Enrica Bonanni, Luigi Ferini-Strambi, Federica Provini, Dario Arnaldi, Claudio Liguori","doi":"10.1002/mdc3.70651","DOIUrl":"https://doi.org/10.1002/mdc3.70651","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is common in restless legs syndrome (RLS), significantly impairing quality of life. Dual orexin receptor antagonists (DORAs) have demonstrated efficacy in managing insomnia and RLS symptoms. Daridorexant is a recently approved DORA for insomnia disorder.</p><p><strong>Objectives: </strong>Evaluate the effectiveness of daridorexant 50 mg/night in treating insomnia in patients with RLS.</p><p><strong>Methods: </strong>This multicenter prospective observational study included 21 patients with RLS and insomnia, evaluated at baseline and after 3 months of treatment with daridorexant 50 mg/night using Insomnia Severity Index (ISI), International Restless Legs Syndrome Study Group Rating Scale (IRLS), Beck Depression Inventory-II (BDI-II), and a visual analogue scale for sleep quality.</p><p><strong>Results: </strong>Sixteen patients completed follow-up. Significant improvements were observed at follow-up in ISI (P = 0.001), IRLS (P = 0.001) and BDI-II scores (P = 0.001), and sleep quality (P < 0.001).</p><p><strong>Conclusions: </strong>Daridorexant 50 mg/night improved insomnia, RLS, depressive symptoms, and sleep quality in RLS patients, supporting its potential use in this population.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840158","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":"Homogenous Cell Transplantation Trials in Parkinson's Disease: A Systematic Review and Meta-Analysis.","authors":"Nolan Reinisch, Athena Mancini, Adham Elsherbini, Jason Yuen, Andres Lozano","doi":"10.1002/mdc3.70647","DOIUrl":"https://doi.org/10.1002/mdc3.70647","url":null,"abstract":"<p><strong>Background: </strong>The transplantation of homogenous cells has emerged as an investigational strategy for Parkinson's disease (PD), offering an alternative to symptomatic treatment.</p><p><strong>Objective: </strong>We performed a systematic review and meta-analysis to assess its clinical efficacy and safety.</p><p><strong>Methods: </strong>Electronic searches of MEDLINE, EMBASE, and Cochrane Library were performed on November 2025 to identify clinical trials of defined homogenous cell populations in PD. Eligible studies required validated outcome reporting and extractable data. Continuous measures were synthesized as mean differences (MD) under fixed- or random-effects models depending on heterogeneity. Risk of bias was appraised using Cochrane methodology.</p><p><strong>Results: </strong>Twenty studies including 374 patients met inclusion criteria, of which 14 contributed to pooled analyses. In the OFF state, homogenous cell transplantation demonstrated consistent, statistically significant improvements in total UPDRS at 3 months [Mean Difference (MD) 22.04, 95% CI 17.40-26.68], 6 months [27.09, 15.47-38.70], 12 months [29.13, 18.04-40.21], and 24 months [21.01, 3.97-38.06]; benefits attenuated beyond 36 months [9.93, -2.16-22.02]. Motor UPDRS III showed robust gains across all intervals, particularly in the OFF state at 3 months [14.34, 11.22-17.45] and 12 months [13.59, 10.22-16.97]. ON-state outcomes were less consistent, with modest improvements limited to 6 and 24 months. Subgroup analyses indicated beneficial responses with dopaminergic progenitor and retinal pigment epithelial grafts. Reported adverse events were generally mild, transient, and perioperative in nature.</p><p><strong>Conclusions: </strong>In these open label studies of PD patients, homogenous cell transplantation is associated with meaningful and durable motor improvements, particularly in the OFF state, and demonstrates a favorable safety profile.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817850","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":"Phenotype-Specific Screening Model for Deep Brain Stimulation in Parkinson's Disease.","authors":"Sohail R Daulat, Dara Farhadi, Lisa Goudman, Julie G Pilitsis","doi":"10.1002/mdc3.70663","DOIUrl":"https://doi.org/10.1002/mdc3.70663","url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease (PD), yet referral for formal DBS evaluation is absent or delayed for many eligible patients. Standard candidacy assessments rely on OFF-ON medication testing and neuropsychological evaluation, which are time-consuming and often unavailable in routine practice. Additionally, traditional UPDRS-based metrics may inadequately capture DBS candidacy across heterogeneous PD motor phenotypes.</p><p><strong>Objectives: </strong>The objective of this study is to evaluate a phenotype-specific, longitudinal screening approach to support earlier identification of PD patients who may receive a DBS referral.</p><p><strong>Methods: </strong>Retrospective longitudinal data from the Parkinson's Progression Markers Initiative was used to train supervised logistic regression models to estimate the probability of undergoing DBS during follow-up. Separate models were developed for bradykinesia/rigidity-predominant, tremor-predominant phenotypes, and the total cohort. Analyses were restricted to visits within a clinically plausible DBS screening window (age <75 years, Hoehn & Yahr stage 2-3, MoCA ≥26). Model performance was assessed using discrimination, threshold-based operating characteristics, calibration, and interpretability via SHAP values.</p><p><strong>Results: </strong>Across 1,227 patients, phenotype-specific and combined models demonstrated moderate discrimination for eventual DBS implantation (AUC 0.80-0.82). In bradykinesia/rigidity-predominant PD, greater functional impairment and daytime sleepiness consistently increased likelihood of DBS implantation, while higher motor severity reduced referral likelihood. However, in tremor-predominant disease, better cognition and higher motor severity were associated with increased referral likelihood, while impulse-control burden strongly decreased implantation likelihood.</p><p><strong>Conclusions: </strong>A phenotype-specific, longitudinal screening approach can stratify DBS referral likelihood in PD. This approach supports earlier and more appropriate DBS referrals while complementing gold-standard evaluation.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817883","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":"Reply to: \"GJA1R148Q Variant Independently Cause Spastic Paraparesis or Interact with Other Pathogenic Variants?\"","authors":"Paula Pérez-Torre, César Aguilera Vega, Jose Luis López-Sendon","doi":"10.1002/mdc3.70667","DOIUrl":"https://doi.org/10.1002/mdc3.70667","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817891","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":"Enteral Nutrition in Idiopathic Parkinson's Disease and Atypical Parkinsonism: A Systematic Review.","authors":"Bradley Lonergan, Matteo Ciocca, Anette Schrag, Yen Tai","doi":"10.1002/mdc3.70653","DOIUrl":"https://doi.org/10.1002/mdc3.70653","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia and malnutrition are common in advanced Parkinson's disease and atypical parkinsonism. There is a lack of evidence to guide the use of enteral nutrition in these situations, including whether it improves survival or reduces aspiration pneumonia.</p><p><strong>Objectives: </strong>To systematically review the impact of enteral nutrition in Parkinson's disease and atypical parkinsonism on survival and morbidity (including aspiration pneumonia).</p><p><strong>Methods: </strong>We followed PRISMA guidelines and conducted searches using PubMed and Scopus databases. ROBINS-I V2 (n = 2) and JBI Cohort Study (n = 14) checklists were used to assess risk of bias.</p><p><strong>Results: </strong>We identified 16 eligible studies. Risk of bias was moderate or high in all studies. Reported enteral feeding rates in parkinsonian disorders varied widely. The rate of aspiration pneumonia following enteral feeding was around 40% in those with parkinsonism. The weighted median survival following gastrostomy insertion in Parkinson's disease was 1.35 years (n = 83; 3 studies) and in atypical parkinsonism 1.49 years (n = 46; 2 studies). One study in atypical parkinsonism found improved survival with enteral feeding compared to at-risk feeding (24 vs. 12 months), whilst another in Parkinson's disease found no difference in mortality rates.</p><p><strong>Conclusions: </strong>There is a lack of high-quality evidence on the impact of enteral feeding on prognosis and morbidity. It is unclear whether enteral feeding improves survival compared to at-risk feeding. There is a need for more robust evidence such as through enteral feeding registries with standardized data collection.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817853","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":"Socio-Occupational Functioning after Subthalamic Deep Brain Stimulation in Parkinson's Disease.","authors":"Gabriele Imbalzano, Elisa Montanaro, Martina Giacchero, Claudia Ledda, Alberto Romagnolo, Mario Giorgio Rizzone, Leonardo Lopiano, Maurizio Zibetti","doi":"10.1002/mdc3.70661","DOIUrl":"https://doi.org/10.1002/mdc3.70661","url":null,"abstract":"<p><strong>Background: </strong>Socio-occupational functioning in patients with Parkinson's disease (PD) treated with subthalamic nucleus deep brain stimulation (STN-DBS) is not fully captured by standard motor and quality-of-life scales.</p><p><strong>Objectives: </strong>To characterize patient-reported socio-occupational functioning after STN-DBS and explore associated clinical and demographic factors.</p><p><strong>Methods: </strong>Thirty-four PD patients were assessed 9-18 months postoperatively using a semi-structured interview covering socio-occupational domains. A composite mean score (Q_mean) was computed as a descriptive index, with clinical associations explored using univariate screening and multivariate linear regression.</p><p><strong>Results: </strong>The Q_mean score following STN-DBS was 7.66 ± 0.86 (range 6.00-9.57). In exploratory multivariate analysis, female sex (n = 7) was associated with higher functioning (P = 0.003), whereas GBA variants (n = 5) with lower functioning (P = 0.007).</p><p><strong>Discussion: </strong>Perceived socio-occupational functioning was overall satisfactory at postoperative assessment, with limited association with conventional motor/neuropsychiatric measures, and greater association with individual factors such as sex and genetic background. These exploratory findings support inclusion of socio-occupational perspectives in DBS outcome evaluation.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817841","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":"GJA1^R148Q Variant Independently Cause Spastic Paraparesis or Interact with Other Pathogenic Variants?","authors":"Yanqing Shi, Tongfei Liu, Min Zhong","doi":"10.1002/mdc3.70668","DOIUrl":"https://doi.org/10.1002/mdc3.70668","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817824","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":"Early Deep Brain Stimulation for Parkinson's Disease: A Systematic Review and Meta-Analysis.","authors":"Jose P Araya, Honglin Zhu, William Anderson, Martín Merenzon, Camila F Castillo, Paloma A Escalante, Rosita L Gutierrez","doi":"10.1002/mdc3.70666","DOIUrl":"https://doi.org/10.1002/mdc3.70666","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) causes progressive motor and non-motor disability. Although pharmacotherapy is first-line, responses diminish over time. Deep brain stimulation (DBS) effectively treats advanced PD, and recent data suggest benefits when applied earlier.</p><p><strong>Objectives: </strong>To systematically review studies and meta-analyze randomized controlled trials comparing subthalamic DBS plus best medical therapy (BMT) with BMT alone in early PD.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis according to PRISMA, with a protocol registered in PROSPERO (CRD420251014105). MEDLINE, Embase, and the Cochrane Library (2002-2025) were searched for studies comparing early DBS with BMT in \"early\" PD. \"Early\" was variably defined, commonly disease duration 4-8 years or onset of motor complications without significant disability. We included RCTs, secondary analyses, observational studies, and unpublished trials; meta-analyses were restricted to randomized comparisons of early DBS plus BMT versus BMT alone.</p><p><strong>Results: </strong>Studies included younger patients with ≤8 years' PD duration and early motor complications. Pooled RCT data showed a consistent quality-of-life benefit, while motor and medication outcomes directionally favored early STN-DBS but remained heterogeneous and imprecise. Studies suggest safety is broadly comparable to standard-indication DBS.</p><p><strong>Conclusions: </strong>Offering DBS before advanced disability-particularly in patients <60 years, <10 years from diagnosis, Hoehn-Yahr stage ≤3, early motor complications, and no dementia-may help delay loss of quality of life versus BMT alone. Given few trials and substantial heterogeneity, further large-scale randomized studies are needed to confirm safety, define optimal timing in early PD, and clarify which subgroups benefit most.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817878","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}