Movement Disorders最新文献

{"title":"Movement Disorders: Volume 41, Number 6, June 2026","authors":"","doi":"10.1002/mds.70399","DOIUrl":"https://doi.org/10.1002/mds.70399","url":null,"abstract":"","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical Morphometric Similarity Network Gradient in Parkinson's Disease and its Association with Gene Expression Profiles","authors":"Tianqi Xu MS,&nbsp;Yinhui Yu MS,&nbsp;Zhihuai Deng MS,&nbsp;Lianling Li MD,&nbsp;Shujie Wei MS,&nbsp;Xiayu Meng MS,&nbsp;Feiyi Duan MS,&nbsp;Xueyan Qin MS,&nbsp;Wenchao Duan MD,&nbsp;Fangang Meng MD, PhD,&nbsp;Yuchen Ji MD, PhD","doi":"10.1002/mds.70233","DOIUrl":"10.1002/mds.70233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent studies have shown that Parkinson's disease (PD) is accompanied by alterations in functional and structural network gradients. However, whether changes are present in the cortical morphometric similarity network (MSN) gradient, and the relationship between alterations of the gradient and gene expression, remain largely unknown. This study aimed to examine potential differences in the principal MSN gradient between patients with PD and healthy controls (HCs), and to explore how these differences relate to gene expression profiles and clinical phenomenology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The MSN was constructed in this study, and its gradient of the network was computed in 66 patients with PD and 100 HCs. Group comparisons were performed to assess alterations in the MSN gradient, and partial least squares regression was applied to explore the association between gene expression profiles and gradient-related changes in PD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In contrast to HCs, PD patients exhibited reconfiguration of the principal MSN gradient, with association cortices shifting upward, motor cortices shifting downward, and sensory cortices remaining low. These alterations showed uneven distribution across functional networks and a positive correlation with cognitive performance in the dorsal attention network. Additionally, case–control differences aligned spatially with cortical gene expression, with implicated genes enriched in neurobiological pathways related to synaptic function and ion transport.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings revealed alterations in the principal MSN gradient in PD and provide potential molecular insights into the structural changes underlying the neurobiological mechanisms of PD. © 2026 International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1445-1455"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Deep Brain Stimulation in Woodhouse–Sakati Syndrome","authors":"Hend Alhodaif MD,&nbsp;Yara Alkhodair MD,&nbsp;Faisal Alotaibi MD, FACS,&nbsp;Salma Alqahtani MD,&nbsp;Saeed Bohlega MD,&nbsp;Amaal Aldakheel MD","doi":"10.1002/mds.70266","DOIUrl":"10.1002/mds.70266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Woodhouse–Sakati syndrome (WSS) is a rare autosomal recessive disease with distinctive neuroendocrine manifestations, with dystonia being the most common. No clear guidelines are available for the treatment of dystonia in WSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim was to analyze the impact of deep brain stimulation (DBS) on WSS-associated dystonia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with genetically confirmed WSS who underwent globus pallidus internus (GPi) DBS for dystonia were analyzed retrospectively. The participants were assessed using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) and were videotaped pre- and post-surgery at multiple follow-up points. The primary outcome was the BFMDRS score at 1 year post-surgery, compared with baseline. The primary outcome was correlated with preoperative factors, including age at onset, disease duration at surgery, proportion of life lived with dystonia, and severity rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients with severe progressive generalized dystonia secondary to clinically and genetically confirmed WSS underwent bilateral GPi DBS from February 2011 through September 2023. The mean age at disease onset and at the time of DBS was 11.3 and 18.6, respectively. All patients' BFMDRS total scores improved from baseline to 12 months post-DBS. The mean pre-DBS BFMDRS score was 71.1, and the mean post-DBS BFMDRS score was 43.6. The percentage improvement in the BFMDRS mean score from pre- to post-DBS was approximately 39%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our case series showed clinical improvement in patients who underwent bilateral GPi DBS as an advanced therapy for generalized dystonia secondary to WSS. We recommend further research on DBS in a larger sample of WSS patients to obtain significant results. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1427-1433"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147524038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson's Disease in Times of War: Gaps in Knowledge and Emerging Controversies","authors":"Mehri Salari MD,&nbsp;Masoud Etemadifar MD,&nbsp;Sevim Soleimani MD","doi":"10.1002/mds.70272","DOIUrl":"10.1002/mds.70272","url":null,"abstract":"<p>Parkinson's disease (PD), the second most common neurodegenerative disorder, is influenced by genetic susceptibility and environmental exposures. Conditions of war, including traumatic brain injury, chronic stress, toxin exposure, malnutrition, and healthcare disruption, may significantly affect both PD risk and management. Studies have linked traumatic brain injury, post-traumatic stress disorder, and prolonged psychological stress to increased PD risk, while wartime deprivation may serve as a long-latency factor, with disease onset occurring decades later. Management of PD during conflict presents distinct challenges. Healthcare system collapse, medication shortages, and loss of follow-up care exacerbate motor and non-motor symptoms, often accelerating disability. Patients dependent on advanced therapies such as deep brain stimulation face particular risks given the reliance on specialist care and device maintenance. Ethical dilemmas also arise regarding the allocation of scarce dopaminergic medications, highlighting the need for triage frameworks in humanitarian contexts. Major gaps remain, including limited longitudinal data on PD progression in war-affected populations, a lack of tailored telemedicine approaches, and the absence of emergency guidelines for neurological care. Addressing these issues requires conflict-sensitive research, innovative care models, and the development of standardized humanitarian protocols. © 2026 International Parkinson and Movement Disorder Society.</p>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1362-1369"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Exposure to Air Pollution and Incidence of Parkinson's Disease: A Danish Nationwide Administrative Cohort Study","authors":"Thomas Cole-Hunter PhD,&nbsp;Sonja Antic MD, PhD,&nbsp;Youn-Hee Lim PhD,&nbsp;Jiawei Zhang MPH,&nbsp;Laust Hvas Mortensen PhD,&nbsp;Kees de Hoogh PhD,&nbsp;Steffen Loft DSc, PhD,&nbsp;George Maria Napolitano PhD,&nbsp;Stéphane Tuffier MD,&nbsp;Marie Laura Bergmann PhD,&nbsp;Bert Brunekreef PhD,&nbsp;Gerard Hoek PhD,&nbsp;Beate Ritz MD, PhD,&nbsp;Zorana Jovanovic Andersen PhD,&nbsp;Rina So PhD","doi":"10.1002/mds.70234","DOIUrl":"10.1002/mds.70234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Long-term exposure to air pollution has been linked to Parkinson's disease (PD) incidence, yet evidence is mixed, partly because of challenges with PD diagnosis and definition. We examined this association in a nationwide administrative cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We followed 3,280,190 Danish residents ≥30 years old from January 1, 2000 until December 31, 2018 for PD incidence, defined as either first hospital contact for primary PD or redeemed prescription of PD medication, as recorded in the Danish National Patient Registry or Prescription Registry, respectively. We assigned annual mean air pollution exposure concentrations at baseline residential address using the hybrid land-use regression model (fine particulate matter [PM_2.5], nitrogen dioxide [NO₂], ozone [warm-season, O₃w], black carbon [BC]) rendered at 0.1 × 0.1 km. We used Cox proportional hazard models adjusting for age, sex, individual-level, and area-level socioeconomic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean (standard deviation) follow-up of 15.7 (5.6) years, 36,665 participants developed PD. Median (interquartile range [IQR]) exposure levels of PM_2.5, NO₂, O₃w, and BC were 12.4 (2.0), 20.2 (7.9), 80.2 (4.3) μg/m³, and 1.01 (0.4) × 10⁻⁵/m, respectively. Hazard ratios (95% confidence intervals) for associations between air pollutants (per IQR) and PD incidence were: 1.05 (1.03, 1.07) for PM_2.5; 1.03 (1.01, 1.05) for NO₂; 0.98 (0.97, 1.00) for O₃w; and 1.04 (1.02, 1.06) for BC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a representative nationwide cohort, we find that long-term exposure to air pollution is associated with PD incidence. This unique study, with access to incidence data from administrative health registers, provides new evidence supporting air pollution as a PD risk factor. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1467-1478"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Dynamics of Parkinson's Disease Tremor: Clinical and Neuroimaging Insights","authors":"Melanie Suette MSc,&nbsp;Robert Matic MD,&nbsp;Marisa Koini PhD,&nbsp;Lukas Gattermeyer-Kell MD,&nbsp;Daniela Kern MD,&nbsp;Petra Katschnig-Winter MD, MSc,&nbsp;Mariella Koegl MD,&nbsp;Maximilian Sackl MSc,&nbsp;Christian Tinauer PhD,&nbsp;Birgit Helmlinger PhD,&nbsp;Manuel Leitner PhD,&nbsp;Stefan Ropele PhD,&nbsp;Daniela Pinter PhD,&nbsp;Christian Enzinger MD, MBA,&nbsp;Stephan Seiler MD, PhD,&nbsp;Petra Schwingenschuh MD","doi":"10.1002/mds.70268","DOIUrl":"10.1002/mds.70268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parkinson's disease (PD) is a progressive neurodegenerative disorder clinically defined by three cardinal motor symptoms: bradykinesia, rigidity, and tremor. Although the natural history of bradykinesia and rigidity is well described, the evolution of tremor as the disease progresses remains controversial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The goal was to clinically characterize long-term trajectories of rest, postural, and action tremor in PD and examine their neural network correlates using longitudinal resting-state functional magnetic resonance imaging (rs-fMRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective longitudinal cohort study, we analyzed 93 tremor-positive PD patients (mean disease duration: 3.6 years), each with up to six clinical assessments over 4.2 years. Linear mixed-effects models assessed temporal change in Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Fahn–Tolosa–Marín Tremor Rating Scale (FTM-TRS) scores. Rs-fMRI data from 30 tremor-affected patients (mean interval, 3.35 years) were analyzed for seed-to–whole-brain connectivity and connectivity between predefined brain regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bradykinesia (β = +0.09, <i>P</i> &lt; 0.001) and rigidity (β = +0.06, <i>P</i> &lt; 0.001) worsened, whereas total FTM-TRS scores declined by 0.49 points/year (<i>P</i> = 0.037), driven by reductions in postural (<i>P</i> &lt; 0.001) and action tremor (<i>P</i> = 0.033); resting tremor remained stable. Rs-fMRI revealed longitudinal changes in cerebellar- and thalamic-seed-to-whole-brain connectivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tremor in PD evolves along distinct clinical courses, often stabilizing or improving as other motor features worsen. These findings are consistent with partially adaptive reorganization within tremor-related networks and underscore the importance of identifying patient subtypes with divergent trajectories to inform prognosis and optimize therapy. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1456-1466"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual Oscillatory Signatures in Pallidal Circuits Underlie Symptom Complexity in Huntington's Disease Patients","authors":"Yichen Xu MD,&nbsp;Zixiao Yin MD, PhD,&nbsp;Houyou Fan MD,&nbsp;Yutong Bai MD, PhD,&nbsp;Qi An MD,&nbsp;Zehua Zhao MD,&nbsp;Yifei Gan MD,&nbsp;Yanwen Wang MD,&nbsp;Tianxue Hu MD,&nbsp;Hutao Xie MD, PhD,&nbsp;Yu Diao MD, PhD,&nbsp;Jinhui Yin MD, PhD,&nbsp;Yue Huang MD, PhD,&nbsp;Lin Shi MD, PhD,&nbsp;Guanyu Zhu MD, PhD,&nbsp;Yanjun Guo MD, PhD,&nbsp;Jean-Marc Burgunder MD,&nbsp;Jianguo Zhang MD, PhD,&nbsp;Anchao Yang MD, PhD","doi":"10.1002/mds.70290","DOIUrl":"10.1002/mds.70290","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Huntington's disease (HD) presents a unique clinical challenge with coexisting hyperkinetic and hypokinetic symptoms, yet the underlying neural oscillatory mechanisms remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to characterize pathological pallidal neural activity in HD and identify biomarkers for therapeutic optimization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated pallidal oscillatory patterns in 15 patients with HD undergoing deep brain stimulation, recording video-synchronized local field potentials during symptom fluctuations and comparing findings with patients with Parkinson's disease and dystonia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HD exhibited distinct pallidal oscillatory signatures that differed from PD and dystonia. Theta power (2–8 Hz) increased during hyperkinetic states, whereas high beta power (20–30 Hz) elevated during hypokinetic states, both correlating significantly with clinical symptom severity. These patterns were not modulated by voluntary movement. Electrophysiological connectivity analysis integrated with neuroimaging analysis showed that globus pallidum externus–globus pallidus internus theta coherence correlated with indirect pathway structural connectivity, whereas pallidal high beta power associated with direct pathway functional connectivity, reflecting HD's dual circuit pathology. Spatial mapping localized theta oscillations to the posterior globus pallidus, with fibers projecting to motor cortical areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We establish an electrophysiological framework explaining HD's complex symptomatology through dual oscillatory signatures. These findings provide circuit-specific biomarkers for disease monitoring and anatomical targets for optimizing deep brain stimulation in patients with HD. © 2026 International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1413-1426"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putamen Atrophy as a Predictive Factor of Efficacy of GPi-DBS in Dystonia-Dyskinesia Syndrome Secondary to Perinatal Anoxic Encephalopathy","authors":"Marylou Grasso,&nbsp;Pierre-Olivier Moser,&nbsp;Sidonie Sauvageot MD,&nbsp;Valérie Gil,&nbsp;Emilie Chan-Seng MD,&nbsp;Emily Sanrey,&nbsp;Philippe Coubes MD-PhD,&nbsp;Gaëtan Poulen MD, PhD","doi":"10.1002/mds.70275","DOIUrl":"10.1002/mds.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Perinatal hypoxic–ischemic encephalopathy (HIE) is a severe condition resulting from impaired oxygen delivery to the developing brain, often leading to both motor deficits and dystonia-dyskinetic syndromes (DDS). In selected cases, deep brain stimulation of the globus pallidus internus (GPi-DBS) may provide a therapeutic option. However, predicting outcomes remains challenging because of clinical heterogeneity and variable responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This retrospective study aims to identify preoperative imaging predictors of GPi-DBS efficacy in patients with DDS secondary to HIE, focusing on putaminal atrophy as a potential criterion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 73 patients with DDS secondary to HIE who underwent GPi-DBS at our institution from 2003 to 2023. Clinical outcomes were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and Barry-Albright Dystonia Scale (BADS) at baseline and up to 15 years post-surgery. Preoperative magnetic resonance imaging scans were qualitatively and quantitatively evaluated to assess putaminal atrophy. Statistical analyses explored the relationships between imaging findings, clinical severity, and DBS outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with severe putaminal atrophy exhibited significantly higher preoperative BFMDRS motor and disability scores, correlating with a limited response to DBS at 1-year follow-up (<i>P</i> &lt; 0.05). Volumetric analysis confirmed that greater putaminal atrophy was associated with poorer motor improvements post-surgery. The predictive value of putaminal volume for long-term outcomes remained significant at 5-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Putaminal atrophy is a key predictor of suboptimal outcomes following GPi-DBS in patients with HIE-related DDS. These findings highlight the importance of preoperative imaging in candidate selection and underscore the need for alternative strategies in patients with severe post-anoxic basal ganglia damage. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1402-1412"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147478083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Homunculus—SCAN-AMN as a Shared Action-Oriented Neural Substrate across Movement Disorders","authors":"Arjun Balachandar MD,&nbsp;Alvaro Hernandez-Guillen MD,&nbsp;Nico U.F. Dosenbach MD, PhD,&nbsp;Anthony E. Lang MD,&nbsp;Christos Ganos MD","doi":"10.1002/mds.70259","DOIUrl":"10.1002/mds.70259","url":null,"abstract":"&lt;p&gt;Movement disorders (MDs) present with strikingly distinct somatotopy and phenomenology. Some predominantly affect distal musculature, such as limb-onset tremor or cortical myoclonus,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; while others involve proximal or axial segments, such as craniocervical dystonia, akathisia, or restless legs syndrome (RLS). Certain MDs are accompanied by premonitory urges and partial volitional control—as in tics—whereas others lack such sensations entirely, like myoclonus. Despite decades of research into motor control, we lack a coherent, mechanistic framework explaining why different disorders show reproducible body-part selectivity while some are embedded in urge-related and action-monitoring experiences.&lt;/p&gt;&lt;p&gt;The motor homunculus established by Penfield has long structured understanding of motor control.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; This has informed studies on MDs with a corresponding somatotopic organization like cortical myoclonus, where face and hands are commonly affected.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; However, recent precision functional mapping studies provided a more granular view of the homunculus, possibly informing cardinal features of several MDs. Gordon et al&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; proposed an integrate-isolate model with two principal interconnected control systems governing movement: one mapping specific muscles or joints through “effector” primary motor cortex (M1) regions and another connecting to broader cognitive-motivational systems to incorporate movements into purposeful, goal-driven behavior with “inter-effector” M1 regions.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; This integrative action control system comprising the “somato-cognitive action network” (SCAN)—and the overarching action-mode network (AMN)&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;—underlies the coordination of whole-body axial-driven movements. Here, drawing on foundational and recent evidence, we argue that abnormal SCAN-AMN engagement underlies gross motor, axial-predominant symptoms across multiple MDs, informing neuromodulation targets.&lt;/p&gt;&lt;p&gt;The classic M1 homunculus depicts a distorted yet topographically organized representation, with disproportionately large areas including the hands, face, and mouth.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; This somatotopy extends to subcortical structures, with striatal activity topographically reflecting deep-layer cortical activity.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Although of relevance to distal limb movements in both normal actions and disorders, like cortical myoclonus,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; this effector-centric model presents limitations in explaining the overarching coordination of movements or when motor output is linked to internal states—such as premonitory urges or interoceptive discomfort—which often manifest with a predilection for proximal regions of the body. Moreover, urge-related disorders like tics, akathisia, and RLS commonly involve regions like the neck, shoulders, trunk, and lower limbs—less emphasized in classical models.&lt;/p&gt;&lt;p&gt;Within t","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1349-1354"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the Scale Drops: Pathways to Weight Loss in Parkinson's Disease and Future Directions","authors":"Ellie D. Gabriel MS,&nbsp;Robert S. Eisinger MD, PhD,&nbsp;Joyce M. Lee,&nbsp;Sarah Hamimi MS,&nbsp;Hope Kim BA,&nbsp;Susanna D. Howard MD,&nbsp;Casey H. Halpern MD","doi":"10.1002/mds.70258","DOIUrl":"10.1002/mds.70258","url":null,"abstract":"<p>Although Parkinson's disease (PD) is classically defined by its motor features, non-motor symptoms exert a substantial and often under-recognized influence on disease trajectory. Among these, weight loss has long been observed in PD and other neurodegenerative disorders, yet the mechanisms remain incompletely understood. This limited mechanistic insight has left few treatment options for weight loss in PD. Emerging research highlights the role of metabolic regulation, neuroendocrine signaling, pharmacologic treatment, cognitive decline, gastrointestinal dysfunction, and brain stimulation in shaping weight trajectories in PD. In this review, we synthesize current evidence surrounding weight in PD, beginning with an overview of epidemiologic trends and their implications for morbidity and mortality. The sections that follow examine proposed mechanisms, clinical and treatment-related factors associated with weight change, and insights derived from deep brain stimulation studies. Finally, we summarize cross-mechanism interactions, current knowledge gaps and discuss practical recommendations for translating these insights into therapeutic strategies. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 6","pages":"1337-1348"},"PeriodicalIF":7.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}