Movement Disorders Clinical Practice最新文献

{"title":"A Real-World Study on Unstable Parkinson's Disease: Levodopa Dosage Management and the Role of Nonmotor Symptoms.","authors":"Fabrizio Stocchi, Jaime Kulisevsky, Wolfgang H Jost","doi":"10.1002/mdc3.70188","DOIUrl":"https://doi.org/10.1002/mdc3.70188","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a neurodegenerative disorder associated with motor and nonmotor symptoms.</p><p><strong>Objectives: </strong>This study assesses levodopa dose management, the therapeutic goals of clinicians, the factors that influence clinicians' choice of therapy, and the role of nonmotor symptoms using real-world evidence from Germany, Italy, and Spain.</p><p><strong>Methods: </strong>To assess the management of unstable PD patients on levodopa-containing regimens, neurologists were asked to complete questionnaires (n = 181) and prospective electronic patient records (EPR) were collected (n = 2687). Neurologists were asked questions about their practice and approach to unstable PD patients. EPRs were completed by neurologists after each visit with patients, and the objectives of any changes to therapy were recorded.</p><p><strong>Results: </strong>Seventy-four percent of neurologists cited \"improving motor symptoms\" as the main objective for increasing daily levodopa dose. This was also the main objective when starting an add-on (50%) and the main reason for selecting a new add-on therapy (29%). In comparison, reducing nonmotor symptoms, depression, and pain was rarely cited as either the main or secondary objective for a therapy selection (15%, 9%, and 9%, respectively) even when over 60% of unstable patients had pain or depression and 29% had both. When the importance of add-on therapy features was rated, \"improve quality of life (QoL)\" had the highest average score. Improving nonmotor symptoms, pain, and depression was among the lowest-rated therapy feature.</p><p><strong>Conclusions: </strong>These findings suggest that improving motor symptoms is a key driver of therapeutic choice. In prioritizing motor symptoms, neurologists may unintentionally neglect nonmotor symptoms, despite most patients suffering from pain or depression.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369090","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":"From Inner Sense to Outer Action: Interoception and Impulsive Compulsive Behavior Disorders in Parkinson's Disease.","authors":"Chiara Baiano, Francesca Morgante, Diana Goeta, Chiara Giacobbe, Marianna Amboni, Carmine Vitale, Elena Makovac, Benedetta Demartini, Gabriella Santangelo, Lucia Ricciardi","doi":"10.1002/mdc3.70187","DOIUrl":"https://doi.org/10.1002/mdc3.70187","url":null,"abstract":"<p><strong>Background: </strong>Impulsive-compulsive behavior disorders (ICBDs) in Parkinson's disease (PD) include impulse control disorders (ICDs) and compulsive behaviors, often linked to dopaminergic treatment and altered reward processing. Interoception, the perception of internal bodily signals, plays a key role in emotional regulation and decision-making. Neuroimaging studies suggest that alterations in interoceptive and reward-related brain circuits may underlie ICDs in PD. However, the relationship between interoception and ICDs remains underexplored.</p><p><strong>Objective: </strong>To investigate the relationship between impulse control disorders (ICD) severity and interoceptive abilities-specifically interoceptive accuracy, insight, and self-reported interoception-in PD patients.</p><p><strong>Methods: </strong>Fifty-one participants were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale (QUIP-RS) alongside measures of interoceptive performance, anxiety, depression, and apathy.</p><p><strong>Results: </strong>Higher ICD severity predicted increased interoceptive insight and sensibility. No significant link was found between ICD severity and interoceptive accuracy. Additionally, higher Levodopa Equivalent Daily Dose (LEDD) was related to lower interoceptive insight, suggesting a potential modulatory effect of dopaminergic therapy on meta-cognitive interoception.</p><p><strong>Conclusions: </strong>These findings highlight the complex interplay between ICDs and interoception, suggesting that heightened self-reported interoception and interoceptive insight may reinforce impulsive behaviors in PD via enhanced bodily signal salience. This study contributes to understanding the characteristics of ICDs in PD, implicating reward-related circuits such as the insula and anterior cingulate cortex.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369091","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":"Functional Movement Disorder in Familial Ataxia: A Case Report of Monozygotic Twins.","authors":"Daniela Kern, Christian Windpassinger, Petra Schwingenschuh","doi":"10.1002/mdc3.70196","DOIUrl":"10.1002/mdc3.70196","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369092","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":"Constipation in a Large Online Cohort of Persons with Parkinson's Disease.","authors":"Adil E Bharucha, Mohammad Ghafouri, Revati Varma, Robert A Vierkant, Muhammad Abdul Rehman, Kent R Bailey, James H Bower, Rodolfo Savica","doi":"10.1002/mdc3.70168","DOIUrl":"10.1002/mdc3.70168","url":null,"abstract":"<p><strong>Background: </strong>Small studies suggest that constipation is a common symptom associated with a worse prognosis in patients with Parkinson's disease (PD).</p><p><strong>Objectives: </strong>The aim was to compare the association between constipation, motor, and other non-motor symptoms (NMS) in PD patients at baseline and in future.</p><p><strong>Methods: </strong>Using the Fox Insight database, we compared baseline characteristics, risk of progressive motor symptoms, and incidence of NMS between PD patients with versus without constipation.</p><p><strong>Results: </strong>Of 20,352 participants, 16,611 (82%) reported infrequent bowel movements and/or excessive straining, 15,594 (77%) had incomplete evacuation, and 14,165 (70%) reported both symptoms. Patients with constipation were generally older, white, women, had PD >5 years, and had higher NMS and comorbidity scores (P < 0.001). Constipation was significantly associated with worse motor symptoms and most NMS, especially fecal incontinence (odds ratio [OR] = 1.65; 95% confidence interval [CI], 1.49-1.82), dysphagia (OR = 1.20; 95% CI = 1.12-1.29), talking/moving during sleep (OR = 1.39; 95% CI = 1.30-1.48), and urinary urgency (OR = 1.23; 95% CI = 1.16-1.32). Constipation was associated with a small, but statistically significant increased risk of some progressive motor symptoms. At a mean median follow-up of 2.8 years, constipation was associated with an increased risk of incident gastrointestinal, autonomic, neuropsychiatric, sleep-related, sensory NMS, such as dysphagia (hazard ratio [HR] = 1.43; 95% CI = 1.35-1.51), fecal incontinence (HR = 1.87; 95% CI = 1.74-2.01), falls (HR = 1.44; 95% CI = 1.35-1.52), hallucinations (HR = 1.65; 95% CI = 1.52-1.79), cognitive impairment (HR = 1.38; 95% CI = 1.30-1.47), and talking/moving during sleep (HR = 1.65; 95% CI = 1.55-1.75).</p><p><strong>Conclusions: </strong>Constipation is a common symptom associated with severity of motor and other NMS and portends a worse prognosis in persons with PD.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333542","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":"Deep Brain Stimulation for Status Dyskineticus in ADCY5-Related Dyskinesia in a 60-Year-Old Woman.","authors":"Ana Moreno-Estébanez, Marta Ruiz-Lopez, Beatriz Tijero, Tamara Fernández-Valle, Miren Edurne Ruiz de Gopegui, Gaizka Bilbao, Imanol Lambarri, Miriam Sánchez-Horvath, Aida Lagüela, Claudio Catalli, Iñigo Garamendi-Ruiz, Juan Carlos Gomez-Esteban","doi":"10.1002/mdc3.70186","DOIUrl":"10.1002/mdc3.70186","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340275","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":"Enterovirus A-71 Associated Parainfectious Movement Disorders in Children.","authors":"Suus A M van Noort, Jan Willem J Elting, Thomas Foiadelli, Petra J J S Peters, Joost Nicolai, Marina A J Tijssen, Jelte Helfferich","doi":"10.1002/mdc3.70182","DOIUrl":"https://doi.org/10.1002/mdc3.70182","url":null,"abstract":"<p><strong>Background: </strong>Pediatric movement disorders can be challenging to characterize, given the phenotypic complexity and broad differential diagnosis. While genetic tests are often part of the diagnostic work-up, it is important to consider acquired causes, which may require specific investigations. Enterovirus A-71 (EV-A71) associated rhombencephalitis frequently presents with movement disorders. We aim to improve the recognition of these phenotypes.</p><p><strong>Cases: </strong>We describe four patients (aged 21 months-12 years) presenting with movement disorders and a confirmed EV-A71 infection. All patients had myoclonus, one suffered from ataxia. Both focal arm flexion myoclonus and generalized myoclonus were observed. Polymyography demonstrated a subcortical origin. The movement disorders subsided with infection improvement.</p><p><strong>Conclusions: </strong>Recognition of EV-A71 parainfectious movement disorders in childhood enables clinicians to obtain appropriate, cost-effective diagnostics. When an EV-A71 infection is suspected PCR-diagnostics in stool and nasopharynx material is required. Neuroimaging and polymyography can support the diagnosis.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326297","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":"How Do I Diagnose Multiple System Atrophy-A Videolibrary on Clinical and Imaging Features.","authors":"Victoria Sidoroff, Luca Baldelli, Nathaniel Bendahan, Giovanna Calandra-Buonaura, Nicole Campese, Gustavo Da Prat, Margherita Fabbri, Alessandra Fanciulli, Joaquim J Ferreira, Florin Gandor, Emilia Gatto, Gabriela S Gilmour, Sabrina Katzdobler, Horacio Kaufmann, Vladimir Kostic, Florian Krismer, Vikram Khurana, Anthony Lang, Johannes Levin, Patricio Millar Vernetti, Maria Teresa Pellecchia, Igor Petrovic, Werner Poewe, Cecilia Raccagni, Rita Moiron Simões, Wolfgang Singer, Michael Strupp, Thilo van Eimeren, Maria Stamelou, Günter Höglinger, Gregor Wenning, Iva Stankovic","doi":"10.1002/mdc3.70181","DOIUrl":"https://doi.org/10.1002/mdc3.70181","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326298","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":"Developing an Outpatient Transdisciplinary Functional Movement Disorder Program: 1-Year Experience.","authors":"Gabriela S Gilmour, Kayla Fritz, Joanne Stephen, Kate Kain, Monic Brunet, Mikhaila Fitzsimmons, Nora Krueger, Linette Lawlor-Savage, Kimberly McEachern, Leon Mitchell, Heather Squires, Patti Vaillant, Kim Walker, Megan Howlett, Kimberly G Williams","doi":"10.1002/mdc3.70183","DOIUrl":"https://doi.org/10.1002/mdc3.70183","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326296","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":"Cranial Myorhythmia as a Novel Clinical Manifestation in Contactin-Associated Protein-like 2 (CASPR2) Antibody Associated Encephalitis.","authors":"Selina Crippa, Georg Kägi, Florian Brugger","doi":"10.1002/mdc3.70167","DOIUrl":"https://doi.org/10.1002/mdc3.70167","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317515","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":"Levodopa-Responsive Dystonia Secondary to CTNNB1 Neurodevelopmental Disorder.","authors":"Hanin Algethami, Wei Kang Lim, David Chitayat, Ingrid Tein, Alfonso Fasano, Carolina Gorodetsky","doi":"10.1002/mdc3.70166","DOIUrl":"https://doi.org/10.1002/mdc3.70166","url":null,"abstract":"","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317516","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}