Movement Disorders最新文献

{"title":"Abnormal Brain Iron Metabolism is Linked to Altered Neural Function in Isolated Laryngeal Dystonia.","authors":"Giovanni Battistella,Laura de Lima Xavier,Alexander O Vortmeyer,Kristina Simonyan","doi":"10.1002/mds.30217","DOIUrl":"https://doi.org/10.1002/mds.30217","url":null,"abstract":"BACKGROUNDLaryngeal dystonia (LD) is an isolated focal dystonia causing involuntary spasms in the laryngeal muscles that selectively impair speech production. LD is characterized as a functional and structural neural network disorder; however, the mechanistic aspects of network dysfunction in dystonia remain unknown.OBJECTIVEWe hypothesized that iron-induced abnormal metabolic processes may underlie microstructural neuronal damage, contributing to altered neural activity within the dystonic network and, subsequently, the development of the dystonic state.METHODSWe used 7 Tesla magnetic resonance imaging (MRI) at ultra-high field resolution for quantitative susceptibility mapping (QSM) of iron content, multi-echo multi-band resting-state functional MRI (fMRI) of brain activity and functional connectivity, positron emission tomography with [11C]flumazenil radioligand of GABAA neuroreceptor availability, and immunohistochemistry of postmortem brain tissue to investigate iron metabolism in LD patients and healthy controls.RESULTSThe QSM analysis found increased iron content in primary sensorimotor and premotor cortices, inferior frontal, middle frontal, and middle temporal gyri, middle cingulate cortex, superior and inferior parietal lobules, insula, putamen, and cerebellum. Histopathology substantiated the neuroimaging findings by showing focal clusters of iron precipitates in these regions. Increased iron content in the supplementary motor area and middle cingulate cortex was associated with altered neural activity, while increased iron in the middle cingulate cortex, premotor cortex, and putamen had associations with GABAA receptor availability in LD patients.CONCLUSIONAbnormal iron accumulations are likely to contribute to the imbalance of excitatory and inhibitory signaling within the dystonic neural network, leading to altered network dynamics that ultimately contribute to LD development. © 2025 International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"53 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982453","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":"Development and Preliminary Validation of a Parkinsonism-Dystonia Scale for Infants and Young Children.","authors":"Roser Pons,Toni S Pearson,Belen Perez-Dueñas,Angels Garcia-Cazorla,Manju A Kurian,Zoi Dalivigka,Vasiliki Zouvelou,Chrysa Outsika,Eleftheria Kokkinou,Maria Sigatullina-Bondarenko,Alejandra Darling,Maria Del Mar O'Callaghan,Robert Spaull,Dora B D Steel,Evdokia Salamou,Maria João Forjaz,Carmen Rodriguez-Blazquez","doi":"10.1002/mds.30219","DOIUrl":"https://doi.org/10.1002/mds.30219","url":null,"abstract":"BACKGROUNDParkinsonism in infancy is rare and is highly correlated with the presence of dystonia. Advances in treating and characterizing developmental and infantile degenerative parkinsonism have highlighted the need for a specialized assessment scale.OBJECTIVEThe aim of this study was to design and validate a scale that effectively assesses parkinsonism-dystonia in early life.METHODSThe Infantile Parkinsonism-Dystonia Rating Scale (IPDRS) was designed to capture the key clinical features of parkinsonism-dystonia in early life. It consists of 28 items across three subscales: Non-motor symptoms, Motor symptoms, and Dyskinesias. Thirty-two patients with hypokinetic movement disorder were scored following a standardized protocol. Filmed motor examinations were analyzed independently by three pediatric movement disorders specialists to evaluate interrater reliability. Twenty additional patients with primary neurotransmitter disorders were scored, and nine of them were evaluated at baseline and after treatment. Psychometric validation was conducted.RESULTSA total of 52 patients were scored using the IPDRS. Mean age was 3.1 years (standard deviation [SD]: 2.0), and the mean IPDRS score was 40.8 (SD: 13.17). Internal consistency analysis demonstrated a Cronbach's α of 0.21 for Non-motor symptoms subscale, 0.84 for Motor symptoms subscale, and 0.95 for Dyskinesia subscale. Kappa indexes exceeded 0.70 in seven items. Correlation coefficients for dystonia items with the Barry-Albright-Dystonia Scale ranged from 0.46 to 0.64. After treatment, all IPDRS scores changed significantly, with an effect size of 2.42.CONCLUSIONSThe IPDRS appears to be a reliable and valid tool for assessing parkinsonism in early life. Further validation studies with a larger sample size are needed to confirm these findings and complete the validation process. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"2 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945247","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":"Nocebo Hypothesis Cognitive Behavioral Therapy for Functional Neurological Symptom Disorder (Motor Type): A Pilot Randomized Controlled Trial.","authors":"Matt Richardson,Maria Kleinstäuber,Dana Wong","doi":"10.1002/mds.30195","DOIUrl":"https://doi.org/10.1002/mds.30195","url":null,"abstract":"BACKGROUNDA previous case series showed that Nocebo Hypothesis Cognitive Behavioral Therapy (NH-CBT) is a promising treatment for Functional Neurological Symptom Disorder (FNSD).OBJECTIVESTo further evaluate the potential efficacy of NH-CBT in participants with FNSD (motor type).METHODSThis phase IIb pilot, randomized, parallel group trial compared the efficacy of NH-CBT (n = 20) with an active control condition (n = 19). Self-report scales of motor and other physical symptoms, psychological variables, and blinded assessor ratings of participants' mobility were administered at baseline, and at 8- and 16-week follow-ups. The primary outcome and endpoint of this trial was the Physical Functioning scale of the Short Form-36 Health Questionnaire (SF-36 PF) at the end of treatment.RESULTSRegarding the primary endpoint (SF-36 at the end of treatment), we did not identify a significant between-group effect (d = 0.21, 95% CI: -0.42-0.84). Significant between-group effects in favor of NH-CBT were identified for several secondary outcomes (motor symptoms: d = 0.67, 95% CI: 0.02-1.32; mobility: d = 0.70, 95% CI: 0.05-1.35; symptom perception \"concern\": d = 0.66, 95% CI: 0.01-1.31). Changes in outcomes within the NH-CBT group showed large effects (d > 0.80) for the primary outcome (SF-36 PF) and the majority of secondary measures post-treatment. A significantly greater proportion of NH-CBT (85%) than control participants (47%) showed full recovery of motor symptoms (P = 0.013).CONCLUSIONSNH-CBT resulted in large within-group effects on the primary outcome as well as the majority of secondary measures in the NH-CBT group and a greater proportion of fully recovered participants compared with an active control treatment. These promising findings warrant a definitive trial. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"37 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932874","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":"Neurophysiology of Atypical Parkinsonian Syndromes: A Study Group Position Paper.","authors":"Antonio Suppa,Francesco Asci,Nitish Kamble,Kai-Hsiang Chen,Giorgia Sciacca,Shabbir Hussain I Merchant,Marina A J Tijssen,Robert Chen,Mark Hallett,Pramod Kumar Pal","doi":"10.1002/mds.30225","DOIUrl":"https://doi.org/10.1002/mds.30225","url":null,"abstract":"Atypical parkinsonian syndromes (APs) are characterized by parkinsonian features combined with additional motor and non-motor signs and symptoms. Neurophysiological studies have contributed to clarifying differences and similarities between APs and idiopathic Parkinson's disease (PD) and to unravel specific pathophysiological features of APs. A comprehensive and updated evaluation of the potential clinical utility of the available neurophysiological tools in APs is, however, currently needed. The Neurophysiology Study Group of the International Parkinson and Movement Disorder Society reviewed previously published neurophysiological studies including those based on electromyography, electroencephalography, and evoked potentials, transcranial magnetic stimulation and kinematics, in most relevant APs, including progressive supranuclear palsy, multiple system atrophy, corticobasal syndrome, Lewy body dementia, fronto-temporal dementia, vascular parkinsonism, normal pressure hydrocephalus, and drug-induced parkinsonism. Following a critical narrative review of all the available information for each AP, the study group examined the most relevant pathophysiological advances achieved in the field owing to the application of specific neurophysiological tools. Furthermore, the review includes statements regarding the potential role in a research context (ie, pathophysiological investigation) as well as in the clinical setting (ie, clinical utility) of each neurophysiological technique, through an estimation of the corresponding levels of evidence, based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Finally, an example of a possible stepwise approach based on the sequential application of specific neurophysiological techniques for better supporting the clinical differential diagnosis of PD and APs is proposed. © 2025 International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"52 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945170","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":"Genetics Influences Telomere Length in Parkinson's Disease: A Study in Monozygotic Discordant Twins","authors":"Letizia Straniero, Valeria Rimoldi, Emanuele Cereda, Giulia Soldà, Daniela Calandrella, Stefano Duga, Samanta Mazzetti, Graziella Cappelletti, Ioannis U. Isaias, Gianni Pezzoli, Rosanna Asselta","doi":"10.1002/mds.30224","DOIUrl":"https://doi.org/10.1002/mds.30224","url":null,"abstract":"BackgroundParkinson's disease (PD) results from complex interactions among environmental, genetic, and aging factors. Telomeres, which ensure chromosome stability, naturally shorten with cell division, contributing to aging and cellular senescence. However, studies investigating telomere length (TL) in PD have produced inconsistent results.ObjectiveThis study aims to explore the relationship between TL and PD using a unique PD‐discordant monozygotic twin design, which minimizes confounding factors such as age, gender, and genetic background. We also examined the impact of PD‐related genetic mutations on TL.MethodsWe analyzed relative telomere length (RTL) in blood samples from 29 pairs of monozygotic twins discordant for PD. Data was stratified by disease duration, and we investigated the influence of genetic variants (<jats:italic>GBA1</jats:italic> and <jats:italic>LRRK2</jats:italic>) on RTL.ResultsNo significant difference in RTL was observed between PD‐affected twins and their healthy co‐twins overall. However, twins with longer disease duration (≥8 years) showed a significant decline in RTL (0.90 ± 0.18 vs. 1.07 ± 0.24; <jats:italic>P</jats:italic> = 0.046), which was more pronounced with a 10‐year disease duration cutoff (0.85 ± 0.18 vs. 1.06 ± 0.22; <jats:italic>P</jats:italic> = 0.015). <jats:italic>GBA1</jats:italic>‐mutated PD twins exhibited significantly longer RTL than non‐mutated twins, a result replicated in non‐twin <jats:italic>GBA1</jats:italic> carriers and extended to <jats:italic>LRRK2</jats:italic> carriers.ConclusionsOur findings suggest that aging and cellular senescence primarily drive sporadic PD, whereas genetic forms are linked to disruptions in cellular pathways, such as lysosomal or mitochondrial functions. These insights highlight the role of genetics in telomere dynamics in PD. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"7 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930631","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":"Phenotypic Heterogeneity in Genetic and Acquired Pediatric Cerebellar Disorders.","authors":"Katariina Granath,Sanna Huhtaniska,Juulia Ellonen,Tytti Pokka,Salla M Kangas,Jukka Moilanen,Heli Helander,Hanna Kallankari,Jonna Komulainen-Ebrahim,Päivi Vieira,Elisa Rahikkala,Renzo Guerrini,Minna Honkila,Terhi S Ruuska,Reetta Hinttala,Maria Suo-Palosaari,Jussi-Pekka Tolonen,Johanna Uusimaa","doi":"10.1002/mds.30210","DOIUrl":"https://doi.org/10.1002/mds.30210","url":null,"abstract":"BACKGROUNDThe genetic landscape of pediatric cerebellar disorders (PCDs) in Finland is undefined.OBJECTIVESThe objective was to define epidemiological, clinical, neuroradiological, and genetic characteristics of PCDs in Northern Finland.METHODSA longitudinal population-based cohort study of children with a movement disorder or a cerebellar malformation (diagnosis ≤16 years; study period 1970-2022) was performed in the tertiary catchment area of the Oulu University Hospital, Finland. The genotype-to-phenotype associations were compared with 1007 published cases with matching monogenic etiologies.RESULTSA total of 107 patients were included (cumulative incidence 21.9 per 100,000 live births). A defined genetic or non-genetic etiology was identified for 59 patients. These etiologies were monogenic (66%), chromosomal (12%), or non-genetic (22%). Ataxia was the most common movement disorder. Friedreich's ataxia was uncommon, whereas ataxias belonging to the Finnish Disease Heritage were overrepresented. Forty-eight cases remained undefined. The diagnostic yield (ie, pathogenic or likely pathogenic variants) of next-generation sequencing (NGS) in ataxia was 65%. Common features were ataxia, developmental delay, seizures, hypotonia, and abnormality in brain MRI, whereas hearing loss, sensory neuropathy, and microcephalia were associated with fewer etiologies.CONCLUSIONSPCDs are a heterogeneous disease group with a high proportion of genetic etiologies. Age of onset and certain clinical findings may help distinguish between different disease entities. The diagnostic yield of NGS has increased over time. Our dataset will support clinicians to recognize PCDs, their co-morbidities, and genetic etiologies. Further data on epidemiology, shared disease mechanisms, and the natural history of PCDs will be critical for the development of treatment approaches. © 2025 International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"2020 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914870","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":"Professor Tipu Aziz (1956–2024)","authors":"Alan Crossman BSc, PhD, DSc,&nbsp;Timmy Aziz BArch, MS, R.A., CPHC,&nbsp;John Stein MA, MSc, BM, BCh, FRCP, FMedSci","doi":"10.1002/mds.30201","DOIUrl":"10.1002/mds.30201","url":null,"abstract":"&lt;p&gt;Tipu Zahed Aziz, Professor of Neurosurgery at Oxford University (UK) was a wondrous amalgam of striking contrasts, complexities, clinical acumen, charisma, and bad luck. It is with great sadness that we report his death from esophageal cancer after a 3-year period confined to a wheelchair following a head injury.&lt;/p&gt;&lt;p&gt;Tipu was born in Dhaka (aka Dacca) in 1956, moving with his family to the United States in 1957, where he grew up until 1963, when his father took a position at the Medical Research Center, Lahore in Pakistan. It was in Lahore in 1965 that Tipu witnessed the war between India and Pakistan, taking shelter at a hospital when things came too close for comfort—otherwise, for entertainment with his siblings, watching dogfights between fighter planes. Soon after the conflict ended, Tipu moved back to Dhaka, then in East Pakistan, with his mother, two sisters, and younger brother, only to find himself in the midst of the horrors of civil war in the days after Liberation. It is likely that the atrocities that Tipu had witnessed led to his evolving, paradoxically, an almost saintly calm and resilient approach to violence and evil as sad facts of life. He found that he simply had to accept and assimilate them, as he said, “as a little brown person with no particular importance in life.” He adored his mother, whose strong social conscience he had inherited, and this added to his personality a powerful determination to somehow do some good in this world of sorrows.&lt;/p&gt;&lt;p&gt;In 1971, in the newly created country of Bangladesh, the educational system was in turmoil. Tipu's mother was advised by his teachers to take her children abroad for a proper education. In light of this advice and the traumatic experiences of her children, in 1973 she once again moved with the four children—this time to Oxford, UK, for a fresh start.&lt;/p&gt;&lt;p&gt;Tipu was very proud of his father, Dr. Mohammed Abdul Aziz, who carried out the first clinical trials that demonstrated that the drug ivermectin could cure river blindness (onchocerciasis). He would probably have been awarded the Nobel Prize for that discovery, which was awarded in 2015, had he not died young in 1987. Tipu particularly admired his father's devotion to properly organized scientific method. Generations of Tipu's students will have good reason to be thankful for Tipu's adoption of that principle.&lt;/p&gt;&lt;p&gt;In Oxford, Tipu devoted himself to science A-levels and then progressed to study Physiology at University College London, graduating with First Class Honors in 1978. Under the strong influence of Nobel Prize winners Bernard Katz and Andrew Huxley, both of whom he met personally, he decided that he wanted to be an electrophysiologist. He thus carried out a prizewinning dissertation on the neuromuscular junction of the barnacle. Characteristic of Tipu, he ever after sought out restaurants all over the world that served barnacles! But Tipu always had a wide range of interests, and he found the time, during the sa","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"40 5","pages":"773-775"},"PeriodicalIF":7.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.30201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915264","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":"Definition and Classification of Dystonia","authors":"Alberto Albanese, Kailash P. Bhatia, Victor S.C. Fung, Mark Hallett, Joseph Jankovic, Christine Klein, Joachim K. Krauss, Anthony E. Lang, Jonathan W. Mink, Sanjay Pandey, Jan K. Teller, Marina A.J. Tijssen, Marie Vidailhet, H.A. Jinnah","doi":"10.1002/mds.30220","DOIUrl":"https://doi.org/10.1002/mds.30220","url":null,"abstract":"Dystonia is a movement disorder with varied clinical features and diverse etiologies. Here we present a revision of the 2013 consensus definition and classification of dystonia in light of subsequent publications and experience with its application during the last decade. A panel of movement disorder specialists with expertise in dystonia reviewed the original document and proposed some revision. There was broad consensus to retain the definition of dystonia with only minor clarifications to the wording. Dystonia is defined as a movement disorder characterized by sustained or intermittent abnormal movements, postures, or both. Dystonic movements and postures are typically patterned and repetitive and may be tremulous or jerky. They are often initiated or worsened by voluntary action and frequently associated with overflow movements. The two‐axis structure for classification of the many different presentations of dystonia was also retained, with some revision. Axis I summarizes key clinical characteristics of dystonia, including age at onset, family history, body distribution, temporal dimensions, phenomenology, and whether dystonia is isolated or combined with other neurological or medical problems. Axis II organizes information regarding its etiological basis, including genetic, acquired, and anatomical, and common disease mechanisms. This consensus provides an update to the original definition and classification of dystonia with the aim of facilitating its clinical recognition and management. The revision retains the essence of the original proposal and aims particularly to provide a structure facilitating a uniform implementation. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"20 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915265","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":"Theta‐Gamma Subthalamic Stimulation for Verbal Fluency in Parkinson's Disease: A Randomized, Crossover Trial","authors":"Gabriele Imbalzano, Elisa Montanaro, Claudia Ledda, Francesca Donetto, Francesco D'Angelo, Corrado Campisi, Carlo Alberto Artusi, Alberto Romagnolo, Mario Giorgio Rizzone, Marco Bozzali, Leonardo Lopiano, Maurizio Zibetti","doi":"10.1002/mds.30218","DOIUrl":"https://doi.org/10.1002/mds.30218","url":null,"abstract":"BackgroundHigh‐frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves Parkinson's disease (PD) motor symptoms but may deteriorate verbal fluency (VF). Theta stimulation showed potential cognitive benefits associated with motor worsening.ObjectivesThis randomized, double‐blind, crossover study evaluated the efficacy and safety of combined theta‐gamma frequency stimulation on VF in PD patients with STN‐DBS.MethodsPatients were randomized 1:1 for standard or theta‐gamma stimulation. VF, motor, and non‐motor symptoms were assessed at baseline, 1 h, and 1 month after each period. Data were analyzed using a linear mixed‐effects model.ResultsTwelve patients completed the study. Non‐episodic (<jats:italic>P</jats:italic> = 0.038) and episodic VF (<jats:italic>P</jats:italic> = 0.030) improved after 1 month of theta‐gamma stimulation, while phonemic and switching fluency were unchanged. Motor and non‐motor outcomes were unaffected by the stimulation, with mild adverse events.ConclusionCombined theta‐gamma stimulation may enhance VF in PD patients with STN‐DBS without worsening motor symptoms or safety concerns. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"59 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905824","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":"Revisiting Coactivation (“Froment's Maneuver”) in Parkinson's Disease: A Physiological Approach","authors":"Mehmet Yücel, Thorsten Odorfer, Jens Volkmann, Daniel Zeller","doi":"10.1002/mds.30226","DOIUrl":"https://doi.org/10.1002/mds.30226","url":null,"abstract":"BackgroundIn the 1920s, Jules Froment extensively studied conditions that might exacerbate rigidity in persons with Parkinson's disease (PD).ObjectiveThis cross‐sectional, controlled study aimed at investigating the physiological basis, in particular motor cortical contribution to enhanced rigidity during contralateral extremity movements.MethodsMotor‐evoked potentials (MEPs) were recorded in 42 patients with PD and 42 age‐matched healthy control subjects. Resting and active motor thresholds, MEP latency and amplitude, contralateral (cCSP) and ipsilateral cortical silent period (iCSP), and transcallosal conduction time (TCT) were obtained without and during coactivation maneuver in the dopaminergic <jats:italic>on</jats:italic> state.ResultsAt baseline, MEP amplitudes, iCSP duration, and TCT were increased in patients with PD as compared with control subjects. During coactivation, motor thresholds and TCT increased, whereas cCSP showed a marked decrease in patients with PD.ConclusionsThe reduction of cCSP during coactivation points to a disinhibition of pyramidal output. Pyramidal disinhibition may most likely underlie the enhancement of rigidity during coactivation. © 2025 International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"36 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909697","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}