Movement disorders : official journal of the Movement Disorder Society最新文献

{"title":"Long-Duration Response to Levodopa in the PPMI-Cohort.","authors":"Nils Schnalke, Tim Feige, Tom Hähnel, Björn Falkenburger","doi":"10.1002/mds.70344","DOIUrl":"https://doi.org/10.1002/mds.70344","url":null,"abstract":"<p><strong>Background: </strong>Treatment of Parkinson's disease (PD) with levodopa results in a sustained reduction of symptoms. Although the plasma half-life of levodopa is short, it elicits a lasting effect, the long-duration levodopa response (LDR). A decrease in LDR as PD progresses has been linked to motor complications, but long-term data on the LDR and its clinical implications remain scarce.</p><p><strong>Objectives: </strong>The aim is to analyze the magnitude and impact of the LDR over time using data from the Parkinson's Disease Progression Marker Initiative (PPMI).</p><p><strong>Methods: </strong>First, therapy-naïve Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) scores were predicted using a mixed linear model (MLM) from n = 245 untreated people with PD (PwPD). This model yielded an increase of MDS-UPDRS III scores of 2.65 points per year. Using this model, we then calculated LDR and short-duration response in longitudinal data of 148 initially therapy-naïve PwPD. Symptom progression was analyzed using correlation analyses and MLMs.</p><p><strong>Results: </strong>In the 98 PwPD with observed LDR, the LDR accounted for approximately half of the total levodopa response. No significant change in LDR magnitude was observed over up to 10 years (analysis of variance, P = 0.14; generalized estimating equations, P = 0.26). The LDR magnitude was not associated with the onset of motor complications. PwPD with absent LDR (n = 50) progressed faster than PwPD with observed LDR in several motor and non-motor domains.</p><p><strong>Conclusions: </strong>The LDR is a stable component of the levodopa response and needs to be considered in clinical trials. These findings argue against a declining LDR as a major driver of motor fluctuations in PD. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qihuang Needle Therapy for Motor Symptoms in Parkinson's Disease: A Randomized Controlled Trial.","authors":"Wanqing Peng, Renhui Zhao, Ziting Huang, Jingpei Zhou, Yanning Liu, Zhijuan Liu, Xinyu Li, Jingjing Deng, Xubo Hong, Yanfang Chen, Nanbu Wang, Zhenhu Chen","doi":"10.1002/mds.70343","DOIUrl":"https://doi.org/10.1002/mds.70343","url":null,"abstract":"<p><strong>Background: </strong>Motor symptoms in Parkinson's disease (PD) often respond incompletely to medication, highlighting the need for effective adjunctive therapies. Acupuncture may offer benefits, but high-quality evidence for specialized techniques such as Qihuang needle therapy is lacking.</p><p><strong>Objective: </strong>Our goal was to evaluate the efficacy of Qihuang needle therapy for improving motor symptoms in PD patients.</p><p><strong>Methods: </strong>This single-center, randomized, single-blind, sham-controlled trial, enrolled 140 patients with idiopathic PD, who were assigned to either Qihuang needle therapy or sham acupuncture for nine sessions over 6 weeks, in addition to their stable medications. The primary outcome was the change in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score from baseline to week 6. Secondary outcomes included changes in the Non-Motor Symptoms Scale (NMSS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39).</p><p><strong>Results: </strong>Overall, 129 participants (92.1%) completed the trial. The Qihuang needle group showed significantly greater improvement in UPDRS-III at week 6 (between-group difference: 8.45 points; 95% confidence interval [CI], 5.49-11.42; P < 0.001), sustained at 10-week follow-up (10.88 points; 95% CI, 7.89-13.87; P < 0.001). Significant improvements were also noted in non-motor symptoms (NMSS) and quality of life (PDQ-39) at both time points (all P < 0.001). Greatest efficacy was observed in postural instability and gait disorder subtypes.</p><p><strong>Conclusions: </strong>Qihuang needle therapy significantly improved motor and non-motor symptoms and quality of life in PD patients compared with that via sham acupuncture, with benefits sustained for ≥1 month. These findings support Qihuang needle therapy as a safe and effective adjunctive treatment for PD. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroencephalography-Based Clustering Reveals Robust Neurophysiological Subtypes in Parkinson's Disease.","authors":"Daniel Vered, Zoya Katzir, Idan Daniel Grosbard, Avner Thaler, Inbal Maidan","doi":"10.1002/mds.70348","DOIUrl":"https://doi.org/10.1002/mds.70348","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is clinically heterogeneous, with substantial variability in motor and cognitive features. Conventional clinical scales provide limited insight into underlying neural mechanisms and show poor longitudinal stability. Scalp electroencephalography (EEG) offers a direct and scalable measure of brain activity that may support mechanistically informed stratification of PD, yet EEG-based subtyping remains largely unexplored.</p><p><strong>Objectives: </strong>To determine whether EEG-derived features can identify neurophysiological subtypes of PD and to examine their clinical and genetic correlates.</p><p><strong>Methods: </strong>EEG recordings were obtained from 116 PD patients and 30 healthy controls during resting state and treadmill walking. Spectral power (theta-gamma), aperiodic components, and temporal complexity measures were extracted across cortical regions. Multiple dimensionality reduction and unsupervised clustering approaches were evaluated, with internal validity and stability assessed using leave-one-out resampling. Clinical, cognitive, gait, and genetic features were compared across clusters.</p><p><strong>Results: </strong>A three-cluster solution demonstrated optimal separation and robustness across models. The clusters exhibited distinct neurophysiological profiles characterized by differences in spectral slowing, signal complexity, and aperiodic activity across both behavioral states. Clusters did not differ in motor severity, gait speed, or disease duration, but showed differences in cognitive performance and genetic composition. One cluster demonstrated preserved cognition and included more LRRK2-mutation carriers, whereas two cognitively impaired clusters displayed divergent electrophysiological signatures despite similar clinical profiles.</p><p><strong>Conclusions: </strong>EEG-based clustering reveals robust neurophysiological subtypes of PD that capture heterogeneity not reflected by standard clinical measures. These findings support EEG as a scalable tool for mechanism-based stratification, with implications for prognosis and precision clinical trials. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Motor Effectors to Action Networks: SCAN Reshapes Parkinson's Disease Pathophysiology.","authors":"Rubens Gisbert Cury, Nicola Pavese","doi":"10.1002/mds.70347","DOIUrl":"https://doi.org/10.1002/mds.70347","url":null,"abstract":"","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage-Dependent Dyslipidemia in Spinocerebellar Ataxia Type 3 Masked by Disease-Associated Low Body Mass Index.","authors":"Na Wan, Mengyuan Dong, Zhao Chen, Qinlin Huang, Zhe Long, Linlin Wan, Linliu Peng, Chunrong Wang, Zhuan Pei, Lang He, Yuting Shi, Rong Qiu, Beisha Tang, Hong Jiang","doi":"10.1002/mds.70353","DOIUrl":"https://doi.org/10.1002/mds.70353","url":null,"abstract":"<p><strong>Background: </strong>Central lipid dysregulation is implicated in spinocerebellar ataxia type 3 (SCA3), but peripheral lipid profiles remain poorly understood. Disease-associated low body mass index (BMI) may confound interpretation.</p><p><strong>Objective: </strong>The aim was to characterize peripheral lipid profiles across SCA3 disease stages and unmask intrinsic metabolic alterations.</p><p><strong>Methods: </strong>This cross-sectional study analyzed the lipid profiles of 37 preataxic carriers, 229 ataxic patients, and 316 controls using BMI-adjusted analysis of covariance (ANCOVA), mediation analysis, hierarchical regression, and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>After adjustment, ataxic patients exhibited elevated low-density lipoprotein cholesterol (LDL-C) and reduced high-density lipoprotein cholesterol (HDL-C). Mediation analysis revealed these alterations were substantially masked by BMI. HDL-C exhibited a stage-dependent pattern-elevated in preataxic carriers but depleted in ataxic patients. Lower HDL-C independently predicted higher Scale for the Assessment and Rating of Ataxia (SARA) (β = -2.881, P = 0.006). HDL-C improved ataxic-preataxic discrimination, achieving an area under the curve (AUC) of 0.837.</p><p><strong>Conclusions: </strong>SCA3 exhibits dyslipidemia with elevated LDL-C and reduced HDL-C, partially masked by BMI. HDL-C depletion accompanies phenoconversion and correlates with severity, representing a candidate peripheral biomarker. © 2026 International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nongenetic Factors Associated with Age at Onset and Disease Severity in Spinocerebellar Ataxia Type 3: A Cross-Sectional Cohort Study.","authors":"Jiawei He, Zhao Chen, Linyi Zeng, Linliu Peng, Jian Hu, Riwei Ouyang, Qi Deng, Hongyu Yuan, Na Wan, Yiqing Gong, Yan Tan, Siyu Ding, Cuiling Tang, Xiaokai Shen, Mengyuan Dong, Lijing Lei, Qi Wu, Jinzi Peng, Qinlin Huang, Lang He, Chunrong Wang, Linlin Wan, Zhe Long, Beisha Tang, Rong Qiu, Hong Jiang","doi":"10.1002/mds.70345","DOIUrl":"https://doi.org/10.1002/mds.70345","url":null,"abstract":"<p><strong>Background: </strong>Beyond genetic factors, demographic and environmental associations with onset and severity in spinocerebellar ataxia type 3 (SCA3) remain incompletely understood.</p><p><strong>Objective: </strong>The aim of this study was to identify the association of nongenetic factors with onset and severity of SCA3.</p><p><strong>Methods: </strong>Associations of nongenetic factors with age at onset (AAO) or Scale for the Assessment and Rating of Ataxia (SARA) scores were examined using generalized linear models.</p><p><strong>Results: </strong>In the cohort of 324 patients with SCA3, higher education level was associated with lower SARA scores but earlier AAO. Smoking was associated with earlier AAO. Tea consumption was inversely associated with SARA scores. Body mass index, coffee consumption, alcohol consumption, as well as other assessed variables, were not associated with AAO or SARA scores.</p><p><strong>Conclusions: </strong>These findings support the associations of nongenetic factors and onset or severity in SCA3, while highlighting the need for cautious interpretation given the observational design. © 2026 International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Alzheimer's Disease Co-Pathology on Shunt Outcomes in Idiopathic Normal Pressure Hydrocephalus: A Systematic Review and Meta-Analysis.","authors":"Ameya Patwardhan, Mojtaba Sharafkhah, Michael Borrie, Jaspreet Bhangu","doi":"10.1002/mds.70333","DOIUrl":"https://doi.org/10.1002/mds.70333","url":null,"abstract":"<p><p>Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible condition characterized by gait, cognitive, and urinary impairment and treated with cerebrospinal fluid shunting, yet post-shunt outcomes vary. Coexisting Alzheimer's disease (AD) pathology may contribute to this variability. This systematic review and meta-analysis investigated whether pre-shunt AD co-pathology influences post-shunt outcomes across distinct clinical domains and follow-up durations. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, PubMed, Embase, Scopus, and Web of Science were searched for studies assessing the impact of pre-shunt AD co-pathology on post-shunt outcomes in iNPH. Studies were included in the meta-analysis if they stratified patients by pre-shunt AD status (iNPH-AD vs. iNPH-nAD) and reported at least one post-shunt outcome compared between groups. Random-effects meta-analyses pooled standardized mean differences across short- (<12 months) and long-term (≥12 months) follow-up. Sixteen studies (n = 1825 patients) were included in the systematic review, with nine (n = 428) eligible for meta-analysis. Pre-shunt AD co-pathology prevalence ranged from 23.9% to 67.6%, and post-shunt follow-up duration ranged from 3 to 60 months. No short-term group differences were observed for cognitive outcomes; however, a significant long-term group effect indicated poorer cognitive recovery in the iNPH-AD group. Gait measures showed short-term group differences favoring the iNPH-nAD group, with no group effects at long-term follow-up, whereas urinary outcomes showed no group differences at any follow-up. AD pathology is not a contraindication to shunting; rather, AD biomarker assessment should be incorporated into the pre-shunt workup, as it can enhance outcome prediction and support tailored postoperative management. © 2026 International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Tic-Related Impairment in Children and Adults with Tourette Syndrome.","authors":"Wm Jeptha Davenport, Davide Martino, Christos Ganos, Christelle Nilles, Tamara Pringsheim","doi":"10.1002/mds.70342","DOIUrl":"https://doi.org/10.1002/mds.70342","url":null,"abstract":"<p><strong>Background: </strong>Tic-related impairment drives treatment decisions for Tourette syndrome and related tic disorders. The clinical features most strongly associated with impairment remain unclear.</p><p><strong>Objective: </strong>The aim of this analysis is to identify clinical predictors of tic-related impairment in children and adults with tic disorders in a prospective longitudinal study.</p><p><strong>Methods: </strong>Participants were drawn from the Calgary Tic Registries, undergoing prospective structured assessments. Baseline demographic and psychiatric data, psychotropic medication use, Yale Global Tic Severity Scale (YGTSS) dimension scores, and the number of different tics (NDT) were analyzed. Predictors of impairment were examined using Spearman's correlations, univariate associate screening with false discovery rate correction, least absolute shrinkage and selection operator (LASSO) regression with ordinary least squares refitting, and linear mixed-effects (LME) models to evaluate within-person changes over time.</p><p><strong>Results: </strong>The sample included 496 participants (848 total assessments). Motor tic interference showed the strongest correlation with impairment (ρ = 0.50), followed by motor tic intensity and frequency. The NDTs correlated with impairment more strongly than most individual YGTSS dimensions. In LASSO regression, seven predictors remained significant: motor tic interference, frequency and complexity, phonic tic interference, older age, female sex, and absence of autism. The LME models analyzed data from all participants with at least one follow-up visit. LME models showed that increases in total tic score predicted higher impairment and that impairment decreased modestly over time.</p><p><strong>Discussion: </strong>Motor tic interference is the most robust predictor of tic-related impairment. Older age and female sex further contribute to functional burden. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Mitochondrial Parkinson's Disease in the α-Synuclein Seed Amplification Assays Era.","authors":"Marco Percetti, Vidal Yahya, Alessio Di Fonzo, Edoardo Monfrini","doi":"10.1002/mds.70325","DOIUrl":"https://doi.org/10.1002/mds.70325","url":null,"abstract":"","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurology Under Fire: What About Parkinson's Disease in Wartime?","authors":"Margherita Fabbri, Olivier Rascol","doi":"10.1002/mds.70350","DOIUrl":"https://doi.org/10.1002/mds.70350","url":null,"abstract":"","PeriodicalId":520713,"journal":{"name":"Movement disorders : official journal of the Movement Disorder Society","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}