Movement Disorders Clinical Practice最新文献

{"title":"Cranial Tremors in Essential Tremor: Prevalence, Anatomic Distribution and Predictors of Occurrence.","authors":"Elan D Louis","doi":"10.1002/mdc3.14271","DOIUrl":"https://doi.org/10.1002/mdc3.14271","url":null,"abstract":"<p><strong>Background: </strong>There are few published data on the prevalence, pattern of anatomic distribution and predictors of various cranial tremors (eg, head, voice, jaw) in essential tremor (ET). Given the high levels of diagnostic misclassification in ET, data on observed clinical patterns would be valuable.</p><p><strong>Objectives: </strong>To assess the prevalence, pattern of anatomic distribution and predictors of occurrence of cranial tremors in ET.</p><p><strong>Methods: </strong>ET cases who enrolled in two studies (respective n's = 301 and 175, total n = 476) underwent a detailed clinical assessment, which included a videotaped neurological examination. A senior movement disorders neurologist reviewed the examination and coded a range of cranial tremors as present or absent.</p><p><strong>Results: </strong>The proportion of cases with any cranial tremor was 57.1% (Study 1) and 73.7% (Study 2). The following patterns emerged: (1) Head only and head + voice were the most commonly observed anatomical distribution of tremor. (2) Jaw tremors were rare, and face and tongue tremors, exceedingly rare. (3) There was a general layering-on of tremor from head to head + voice to head + voice + jaw in more advanced cases. (4) Women were more likely to have head tremors than men, although there was no sex predilection tremor in other locations. (5) The likelihood of cranial tremor increased with greater tremor severity and age but was unrelated to tremor duration.</p><p><strong>Conclusion: </strong>We observed and quantified several patterns in the expression of cranial tremors in ET. Data on such patterns may assist clinicians and researchers in assigning diagnoses.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604922","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":"Intersection of Sleep Disorders and Parkinson Disease: Unveiling the Bidirectional Relationship.","authors":"Elena Antelmi, Giuseppe Lanza, Maria Paola Mogavero, Gloria Pompea Mingolla, Giuseppe Plazzi, Luigi Ferini-Strambi, Raffaele Ferri, Michele Tinazzi","doi":"10.1002/mdc3.14254","DOIUrl":"https://doi.org/10.1002/mdc3.14254","url":null,"abstract":"<p><strong>Background: </strong>Patients with Parkinson's Disease (PD) frequently exhibit non-motor symptoms, particularly sleep disturbances. Sleep disorders in PD patients are intricately linked to the pathogenesis and progression of PD itself, exacerbating neurodegenerative processes and worsening patient quality of life.</p><p><strong>Objectives: </strong>This review underscores the significance of sleep disorders in PD, highlighting their prevalence, impact on disease progression, and the bidirectional relationship between sleep disruption and neurodegeneration. It aims to enhance clinician awareness for better diagnosis and management of sleep-related comorbidities in PD.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed and Scopus using key terms such as \"sleep disorders\", \"Parkinson's disease\", \"REM sleep behavior disorder\", \"restless legs syndrome\", \"insomnia\", \"obstructive sleep apnea\", \"excessive daytime sleepiness\", \"circadian rhythm disorders\", \"sleep and neurodegeneration\".</p><p><strong>Results: </strong>Sleep disorders are prevalent in PD affecting up to 90% of patients. Conditions such as insomnia, REM sleep behavior disorder, restless legs syndrome, obstructive sleep apnea, excessive daytime sleepiness, and circadian rhythm disorders are commonly reported. These disorders are linked to multifactorial biological mechanisms and are associated with more severe disease phenotypes. Of note, several evidence shows that sleep abnormalities may contribute to neuroinflammation and neurodegeneration, further accelerating the disease course.</p><p><strong>Conclusions: </strong>Sleep disturbances are critical non-motor symptoms in PD. Early diagnosis and tailored management of sleep disorders are essential for improving clinical outcomes and potentially offering neuroprotective benefits.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604901","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":"Differentiating Postural and Kinetic Tremor Responses to Deep Brain Stimulation in Essential Tremor.","authors":"Rebecca D Butler, Annemarie K Brinda, Madeline Blumenfeld, Marina N Bryants, Peter M Grund, Shivansh R Pandey, Chelsea K S Cornish, Disa Sullivan, Jordan Krieg, Matthew Umoh, Jerrold L Vitek, Leonardo Almeida, Tseganesh Orcutt, Scott E Cooper, Matthew D Johnson","doi":"10.1002/mdc3.14256","DOIUrl":"https://doi.org/10.1002/mdc3.14256","url":null,"abstract":"<p><strong>Background: </strong>While deep brain stimulation (DBS) targeting the ventral intermediate nucleus (VIM) of thalamus or posterior subthalamic area (PSA) can suppress forms of action tremor in people with Essential Tremor, previous studies have suggested postural tremor may respond more robustly than kinetic tremor to DBS.</p><p><strong>Objectives: </strong>In this study, we aimed to more precisely quantify the (1) onset/offset dynamics and (2) steady-state effects of VIM/PSA-DBS on postural and kinetic tremor.</p><p><strong>Methods: </strong>Tremor data from wireless inertial measurement units were collected from 11 participants with ET (20 unilaterally assessed DBS leads). Three postural hold tasks and one kinetic task were performed with stimulation turned off, in 2-min intervals after enabling unilateral DBS at the clinician-optimized DBS setting (15 min), and in 2-min intervals following cessation of DBS (5 min).</p><p><strong>Results: </strong>At baseline, kinetic tremor had significantly higher amplitudes, standard deviation, and frequency than postural tremor (P < 0.001). DBS had a more robust acute effect on postural tremors (54% decrease, P < 0.001), with near immediate tremor suppression in amplitude and standard deviation, but had non-significant improvement of kinetic tremor on the population-level across the wash-in period (34% decrease). Tremor response was not equivalent between wash-in and wash-out timepoints and involved substantial individual variability including task-specific rebound or long wash-out effects.</p><p><strong>Conclusions: </strong>Programming strategies for VIM/PSA-DBS should consider the individual temporal and effect size variability in postural versus kinetic tremor improvement. Improved targeting and programming strategies around VIM and PSA may be necessary to equivalently suppress both postural and kinetic tremors.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604883","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":"Identifying and Predicting Risk for Hospital Admission among Patients with Parkinsonism.","authors":"Emma Tenison, Anita McGrogan, Yoav Ben-Shlomo, Emily J Henderson","doi":"10.1002/mdc3.14257","DOIUrl":"10.1002/mdc3.14257","url":null,"abstract":"<p><strong>Background: </strong>Patients with parkinsonism are more likely than age-matched controls to be admitted to hospital. It may be possible to reduce the cost and negative impact by identifying patients at highest risk and intervening to reduce hospital-related costs. Predictive models have been developed in nonparkinsonism populations.</p><p><strong>Objectives: </strong>The aims were to (1) describe the reasons for admission, (2) describe the rates of hospital admission/emergency department attendance over time, and (3) use routine data to risk stratify unplanned hospital attendance in people with parkinsonism.</p><p><strong>Methods: </strong>This retrospective cohort study used Clinical Practice Research Datalink GOLD, a large UK primary care database, linked to hospital admission and emergency department attendance data. The primary diagnoses for nonelective admissions were categorized, and the frequencies were compared between parkinsonism cases and matched controls. Multilevel logistic and negative binomial regression models were used to estimate the risk of any and multiple admissions, respectively, for patients with parkinsonism.</p><p><strong>Results: </strong>There were 9189 patients with parkinsonism and 45,390 controls. The odds of emergency admission more than doubled from 2010 to 2019 (odds ratio [OR] 2.33; 95% confidence interval [CI] 1.96, 2.76; P-value for trend <0.001). Pneumonia was the most common reason for admission among cases, followed by urinary tract infection. Increasing age, multimorbidity, parkinsonism duration, deprivation, and care home residence increased the odds of admission. Rural location was associated with reduced OR for admission (OR 0.79; 95% CI 0.70, 0.89).</p><p><strong>Conclusions: </strong>Our risk stratification tool may enable empirical targeting of interventions to reduce admission risk for parkinsonism patients.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583875","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":"The \"Hedgehog-Halo Sign\" Is Associated with Gait Symptom Severity and Tap Response in Normal Pressure Hydrocephalus.","authors":"Jongmok Ha, Suin Lee, Seongmi Kim, Jun Seok Lee, Jong Hyeon Ahn, Jin Whan Cho, Alfonso Fasano, Jinyoung Youn","doi":"10.1002/mdc3.14255","DOIUrl":"10.1002/mdc3.14255","url":null,"abstract":"<p><strong>Background: </strong>Reduced cerebrospinal fluid (CSF) clearance may play a vital role in the pathogenesis of normal pressure hydrocephalus (NPH), but the radiologic marker is yet to be elucidated.</p><p><strong>Objectives: </strong>This open-label study presents two novel neuroimaging biomarkers based on enlarged perivascular spaces (ePVS) of the sub-insular territory: the Hedgehog and Hedgehog-Halo (H-H) sign, designed to predict gait symptom severity and tap response in NPH.</p><p><strong>Methods: </strong>We retrospectively reviewed 203 patients with possible NPH with baseline magnetic resonance imaging and gait analyses before and after lumbar puncture (LP). The Hedgehog/H-H sign was scored using T2-weighted images. The clinical severity at baseline and post-tap gait improvement was compared in patients with and without Hedgehog/H-H sign. The association between Hedgehog/H-H sign and post-tap gait outcomes was assessed using multivariate regression. The diagnostic performance of Hedgehog/H-H sign was compared with conventional radiological markers.</p><p><strong>Results: </strong>Patients with H-H showed higher global disability and more severe gait impairment than those without any signs. Following LP, patients with Hedgehog/H-H sign significantly improved in various gait parameters, unlike those with neither sign. Additionally, sub-insular ePVS was significantly associated with post-tap gait improvement after adjusting covariates. Finally, the Hedgehog/H-H sign showed a higher performance than conventional markers in predicting post-tap gait response.</p><p><strong>Conclusions: </strong>The Hedgehog/H-H sign is a useful neuroimaging biomarker related to the severity and tap response in NPH. This biomarker can be readily applied in clinical practice before undergoing LP, independent of conventional radiological signs. Further research is warranted to determine applicability in predicting post-shunt gait response.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583884","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":"Voice Tremor in VPS-16 Gene Mutation: Expanding the Clinical Spectrum.","authors":"Saranya B Gomathy, Animesh Das, Jasmine Parihar, Rajesh Kumar Singh, Deepti Vibha, Manjari Tripathi","doi":"10.1002/mdc3.14250","DOIUrl":"https://doi.org/10.1002/mdc3.14250","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583888","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":"Respiratory Dysfunction and Abnormal Hypoxic Ventilatory Response in Mild to Moderate Parkinson's Disease.","authors":"Jules M Janssen Daalen, Isabel R Straatsma, Jeroen W H van Hees, Amber Weevers, Veerle A van de Wetering-van Dongen, Maarten J Nijkrake, Marjan J Meinders, Frank H Bosch, Matthijs Kox, Philip N Ainslie, Bastiaan R Bloem, Dick H J Thijssen","doi":"10.1002/mdc3.14249","DOIUrl":"https://doi.org/10.1002/mdc3.14249","url":null,"abstract":"<p><strong>Background: </strong>Respiratory dysfunction is an important contributor to morbidity and mortality in advanced Parkinson's disease (PD), but it is unclear what parameters are sensitive to diagnose and monitor respiratory dysfunction across disease phases.</p><p><strong>Objectives: </strong>We aimed to characterize respiratory dysfunction in mild to moderate PD.</p><p><strong>Methods: </strong>In 20 individuals without cardiopulmonary comorbidity, pulmonary and inspiratory muscle function testing were performed ON-medication. Subsequently, the acute ventilatory response to hypoxia (HVR) was assessed by gradually decreasing F_IO₂ from 0.209 (room air) to 0.127, which was compared to eight age- and sex-matched healthy controls under arterial blood gas monitoring. Lastly, on different days, the same 20 individuals with PD underwent six blinded exposures to 45-min normobaric hypoxia at FiO2 0.163 and 0.127 or placebo OFF-medication to assess breathing responses.</p><p><strong>Results: </strong>At rest, individuals with greatest PD severity had a lower tidal volume (pairwise comparisons: 0.59 vs. 0.74, P = 0.038-0.050) and tended to have a higher breathing frequency (17.7 vs. 14.4, P = 0.076), despite normal pulmonary function. A 45-min exposure to hypoxia induced a significantly lower acute HVR in individuals with PD compared to controls (-0.0489 vs. 0.133 L.min/%, P = 0.0038). Acute HVR was reduced regardless of disease severity. Subacute HVR in individuals with milder disease tended to be higher compared to those with more advanced disease (P = 0.079).</p><p><strong>Conclusions: </strong>Respiratory dysfunction is present in individuals with PD, including those with relatively mild disease severity, and is characterized by altered breathing patterns at rest, as well as a lower HVR, despite normal pulmonary and inspiratory muscle function testing.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583882","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":"Editorial: \"Writing Is a Way of Thinking\" Gabriel Garcia Marquez El Olor de la Guayaba, 1982.","authors":"Marcelo Merello, Kailash P Bhatia","doi":"10.1002/mdc3.14259","DOIUrl":"https://doi.org/10.1002/mdc3.14259","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583872","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":"Predicting Post-Mortem α-Synuclein Pathology by the Combined Presence of Probable REM sleep behavior disorder and Hyposmia.","authors":"Cécilia Tremblay, Charles H Adler, Holly A Shill, Erika Driver-Dunckley, Shyamal Mehta, Parichita Choudhury, Christine Belden, David R Shprecher, Joyce K Lee-Iannotti, Alireza Atri, Geidy E Serrano, Thomas G Beach","doi":"10.1002/mdc3.14244","DOIUrl":"https://doi.org/10.1002/mdc3.14244","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic rapid eye movement sleep behavior disorder (RBD) is a strong known predictor of a final clinicopathological diagnosis of a Lewy type α-synucleinopathy (LTS). Olfactory dysfunction is an early symptom of synucleinopathies and has been repeatedly associated with the presence of post-mortem LTS.</p><p><strong>Objective: </strong>To assess the combined value of a clinician diagnosis of probable RBD (PRBD) and hyposmia in predicting the post-mortem presence of LTS in a broader, less-selected, volunteer elderly population.</p><p><strong>Methods: </strong>We studied 652 autopsied subjects from the Arizona Study of Aging and Neurodegenerative Disorders, which were evaluated for PRBD, had completed annual movement and cognitive assessments, and had at least one the University of Pennsylvania Smell Identification Test (UPSIT) olfactory test.</p><p><strong>Results: </strong>Histological evidence of LTS was significantly more frequent in those who had PRBD (112/152: 73.7%) than those without (177/494: 35.8%) (P < 0.001). LTS was more frequent in cases with PRBD and a low UPSIT score (90.8%) compared to cases with PRBD only (73.7%) (P < 0.001) or cases with a low UPSIT score only (69.4%) (P < 0.001). Sensitivity of PRBD diagnosis for predicting LTS was 38.8% and specificity 88.8%, whereas sensitivity of a low UPSIT score was 74.4% and specificity 73.4% (Youden's index = 0.276 for PRBD, 0.478 for UPSIT). When combining both measures, sensitivity was 34.3% and specificity increased to 97.2%.</p><p><strong>Conclusion: </strong>PRBD, diagnosed without sleep study confirmation, combined with a reduced olfactory performance is highly specific for predicting post-mortem presence of LTS. The combination of both measures may provide a cost-effective means of predicting LTS in a broader community.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583878","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":"Entrainment Characteristics of Functional Tremor.","authors":"Aditya Murgai, Svetlana Iskhakova","doi":"10.1002/mdc3.14258","DOIUrl":"https://doi.org/10.1002/mdc3.14258","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569309","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}