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Movement Disorders Clinical Practice

Christos Ganos, Davide Martino, Tamara Pringsheim
BACKGROUND: Primary tic disorders, notably Tourette syndrome, are very common movement disorders in childhood. However, the management of such patients still poses great therapeutic challenges to medical professionals. METHODS: Based on a synthesis of the available guidelines published in Europe, Canada, and the United States, coupled with more recent therapeutic developments, the authors provide a pragmatic guide to aid clinicians in deciding when and how to treat patients who have primary tic disorders...
March 2017: Movement Disorders Clinical Practice
Kory S Herrick, Randy Woltjer, Thao Pham, Megan Chalupsky, Amie L Hiller
Central hypoventilation, also known as Ondine's curse, results from an impairment of the autonomic respiratory drive. It is characterized by an attenuated or absent respiratory response to hypoxemia and hypercapnia with preservation of volitional respiratory function. RJ was a 75-year-old woman with a diagnosis of probably PSP who developed central hypoventilation approximately four years after her initial onset of symptoms. Brain MRI showed no evidence of medullary lesions, one of the more common causes of adult onset central hypoventilation...
January 2017: Movement Disorders Clinical Practice
Rwei-Ling Yu, Ruey-Meei Wu, Anne Y Y Chan, Vincent Mok, Yih-Ru Wu, Barbara C Tilley, Sheng Luo, Lu Wang, Nancy R LaPelle, Glenn T Stebbins, Christopher G Goetz
BACKGROUND: Given the importance of ethnic differences in the evaluation of various aspects of symptoms in patients with Parkinson's disease (PD), we present the formal procedure for completing the traditional Chinese translation of the International and Parkinson and Movement Disorder Society/UPDRS (MDS-UPDRS) and highlight the discrepancy in nonmotor symptoms (NMS) between patients in Eastern and Western countries. METHODS: A total of 350 native Chinese-speaking PD patients were recruited from multiple hospitals in Eastern countries; they completed the MDS-UPDRS...
January 2017: Movement Disorders Clinical Practice
Stuart Isaacson, Mark Lew, William Ondo, Jean Hubble, Thomas Clinch, Fernando Pagan
BACKGROUND: In patients with motor fluctuations complicating Parkinson's disease (PD), delays in time-to-ON with levodopa are common. This open-label study aimed to assess the effect of apomorphine on time-to-ON in PD patients with morning akinesia. METHODS: The safety population included 127 enrolled patients, and the full analysis set (FAS) included 88 patients. Patients completed a 7-day levodopa baseline period recording their time-to-ON following each morning dose of levodopa...
January 2017: Movement Disorders Clinical Practice
Aristide Merola, Alberto J Espay, Maurizio Zibetti, Alberto Romagnolo, Michela Rosso, Simona Maule, Leonardo Lopiano
No abstract text is available yet for this article.
January 2017: Movement Disorders Clinical Practice
Joerg Klepper, Baerbel Leiendecker, Christin Eltze, Nicole Heussinger
View Supplementary Video Movement disorders are a major feature of Glut1 deficiency. As recently identified in adults with paroxysmal exercise-induced dystonia, similar events were reported in pediatric Glut1 deficiency. In a case series, parent videos of regular motor state and paroxysmal events were requested from children with Glut1 deficiency on clinical follow-up. A questionnaire was sent out to 60 families. Videos of nonparoxysmal/paroxysmal states in 3 children illustrated the ataxic-dystonic, choreatiform, and dyskinetic-dystonic nature of paroxysmal events...
November 2016: Movement Disorders Clinical Practice
Nora Vanegas, Kareem Zaghloul, Mark Hallett, Codrin Lungu
No abstract text is available yet for this article.
September 2016: Movement Disorders Clinical Practice
David Okai, Sally Askey-Jones, Joel Mack, Anne Martin, Kallol Ray Chaudhuri, Michael Samuel, Anthony S David, Richard G Brown
BACKGROUND: Impulse-control behaviors (ICBs) are increasingly recognized in Parkinson's disease (PD) as drug-related effects of dopaminergic mediation that occur in 15% to 35% of patients with PD. The authors describe the design and evaluation of a new, clinician-rated severity scale for the assessment of syndromal and subsyndromal forms of impulse-control disorders (ICDs), simple (punding) and complex (hobbyism) repetitive behaviors, and compulsive overuse of medication (dopamine dysregulation syndrome)...
September 2016: Movement Disorders Clinical Practice
Tapan Thacker, Ashley R Wegele, Sarah Pirio Richardson
BACKGROUND: Recruitment for clinical trials is a major challenge. Movement disorders, which do not have associated diagnostic laboratory tests, may be especially prone to inaccuracy in coding. Our objective was to evaluate the accuracy of diagnostic codes such as cervical dystonia (CD) and PD in an electronic medical record. METHODS: Retrospective chart review was performed to confirm the ICD-9 diagnoses of PD, CD and diabetes mellitus type 2 (DM-2), using published clinical diagnostic criteria (PD, CD) and hemoglobin A1c ≥ 6...
September 2016: Movement Disorders Clinical Practice
Gian D Pal, Deborah Hall, Bichun Ouyang, Jessica Phelps, Roy Alcalay, Michael W Pauciulo, William C Nichols, Lorraine Clark, Helen Mejia-Santana, Lucia Blasucci, Christopher G Goetz, Cynthia Comella, Amy Colcher, Ziv Gan-Or, Guy A Rouleau, Karen Marder
OBJECTIVE: In a cohort of patients with young-onset Parkinson's disease (PD), the authors assessed (1) the prevalence of genetic mutations in those who enrolled in deep brain stimulation (DBS) programs compared with those who did not enroll DBS programs and (2) specific genetic and clinical predictors of DBS enrollment. METHODS: Subjects were participants from 3 sites (Columbia University, Rush University, and the University of Pennsylvania) in the Consortium on Risk for Early Onset Parkinson's Disease (CORE-PD) who had an age at onset < 51 years...
September 2016: Movement Disorders Clinical Practice
Leonardo Almeida, Pawan V Rawal, Benjamin Ditty, Bryan L Smelser, He Huang, Michael S Okun, Barton L Guthrie, Harrison C Walker
BACKGROUND: Deep brain stimulation is an effective treatment for movement disorders, but it is relatively complex, invasive, and costly. Little is known about whether stimulation mode alters pulse generator (battery) longevity in routine clinical care. OBJECTIVE: To compare battery longevity during monopolar versus bipolar stimulation in patients who underwent deep brain stimulation for movement disorders. METHODS: We evaluated 2,902 programming adjustments and calculated the average stimulator settings for 393 batteries in 200 unique patients with Parkinson's disease and essential tremor...
July 2016: Movement Disorders Clinical Practice
Chizoba C Umeh, Piyush Kalakoti, Michael K Greenberg, Silvio Notari, Yvonne Cohen, Pierluigi Gambetti, Adrian L Oblak, Bernardino Ghetti, Zoltan Mari
Parkinsonism-dystonia is rare in carriers of PRNP P102L mutation. Severity and distribution of prion protein (PrP) deposition may influence the clinical presentation. We present such clinic-pathological correlation in a 56-year-old male with a PRNP P102L mutation associated with a phenotype characterized by rapidly progressing parkinsonism-dystonia. The patient was studied clinically (videotaped exams, brain MRIs); molecular genetically (gene sequence analysis); and neuropathologically (histology, immunohistochemistry) during his 7-month disease course...
July 2016: Movement Disorders Clinical Practice
Rizwan S Akhtar, Sharon X Xie, Laura Brennan, Michael J Pontecorvo, Howard I Hurtig, John Q Trojanowski, Daniel Weintraub, Andrew D Siderowf
BACKGROUND: Neuronal loss and α-synuclein (α-syn) pathology are diagnostic of PD in the appropriate clinical context. However, some PD patients have co-morbid Alzheimer's disease (AD) pathology on autopsy, including amyloid-β (Aβ) plaques and neurofibrillary tangles. Florbetapir((18)F) is a PET ligand that detects Aβ pathology. We hypothesized that florbetapir((18)F) imaging could detect Aβ pathology in Parkinson disease dementia (PDD) patients prior to death. OBJECTIVE: To determine the utility of florbetapir((18)F) PET imaging in detecting Aβ pathology in patients with autopsy-confirmed PDD...
July 2016: Movement Disorders Clinical Practice
Vesper Fe Marie Llaneza Ramos, Elaine Considine, Barbara I Karp, Codrin Lungu, Katharine Alter, Mark Hallett
BACKGROUND: Diaphragmatic myoclonus is a rare disorder of repetitive diaphragmatic contractions, acknowledged to be a spectrum that includes psychogenic features. Electromyography has been the diagnostic tool most commonly used in the literature. METHODS: To test if we could perform a noninvasive technique to delineate the diaphragm as the source of abnormal movements and demonstrate distractibility and entrainability, we used B-mode ultrasound in a patient with diaphragmatic myoclonus...
May 2016: Movement Disorders Clinical Practice
Alexander Pantelyat, Candace Syres, Suzanne Reichwein, Allison Willis
BACKGROUND: Physical therapy can improve motor function in patients with PD. Music performance may be used to improve motor skills by rhythmic entrainment. Drumming has long been a part of traditional healing rituals worldwide, and is increasingly being utilized as a therapeutic strategy. METHODS: This pilot controlled prospective cohort trial assessed feasibility and effects of twice-weekly group West African drum circle classes for 6 weeks on PD patients' quality of life, symptoms, motor findings, cognition, and mood...
May 2016: Movement Disorders Clinical Practice
Jori E Fleisher, Krunal Shah, Whitney Fitts, Nabila A Dahodwala
BACKGROUND: Low health literacy (HL) indicates a limited ability to understand and use basic information to make appropriate healthcare decisions. While low HL is associated with higher morbidity, mortality, and healthcare costs in multiple chronic conditions, little is known about HL and its associations in Parkinson's disease (PD). METHODS: Cross-sectional study of non-demented adults with PD participating in the National Parkinson Foundation Parkinson's Outcomes Project at the University of Pennsylvania...
May 2016: Movement Disorders Clinical Practice
Eric S Molho, Mark Stacy, Patrick Gillard, David Charles, Charles H Adler, Joseph Jankovic, Marc Schwartz, Mitchell F Brin
BACKGROUND: Cervical dystonia is thought to result in high disease burden, but limited information exists on its impact on employment and work productivity. We utilized data from the Cervical Dystonia Patient Registry for the Observation of OnabotulinumtoxinA Efficacy ( identifier: NCT00836017) to assess the impact of cervical dystonia on employment and work productivity and examine the effect of onabotulinumtoxinA treatments on work productivity. METHODS: Subjects completed a questionnaire on employment status and work productivity at baseline and final visit...
March 2016: Movement Disorders Clinical Practice
Khashayar Dashtipour, Jack J Chen, Alberto J Espay, Zoltan Mari, William Ondo
OBJECTIVE: This systematic review was performed to elucidate dosing practices, dosing conversions, and related outcomes from randomized controlled trials that directly compared onabotulinumtoxinA (ONA) and abobotulinumtoxinA (ABO) at various dose conversion ratios for therapeutic use in movement disorders. METHODS: A systematic review of 3 medical literature databases (PubMed, the Cochrane Library, and EMBASE) was performed to identify relevant comparative clinical studies, systematic reviews, and meta-analyses published in the English language between January 1991 and January 2015...
March 2016: Movement Disorders Clinical Practice
Elan D Louis
BACKGROUND: A broad range of tremors occur in patients with essential tremor and Parkinson's disease; despite this, there are virtually no published data that focus on the patient perspective. The aims were to (1) assess the subjective experience of tremor, comparing essential tremor and Parkinson's disease patients, and (2) assess the clinical correlates of that experience (i.e., what specific clinical characteristics were associated with more experienced tremor)? METHODS: 121 essential tremor and 100 Parkinson's disease cases enrolled in a cross-sectional, clinical-epidemiological study underwent a detailed clinical assessment, which included a series of standardized questionnaires and neurological examination...
January 2016: Movement Disorders Clinical Practice
Samantha K Holden, Wallace E Jones, Keith A Baker, Isabel M Boersma, Benzi M Kluger
BACKGROUND: Parkinson's disease dementia (PDD) is a major cause of morbidity and mortality in Parkinson's disease (PD), which severely affects patient functioning and quality of life and increases the risk for nursing home admission. Unfortunately, current treatment options for PDD are limited and have only marginal therapeutic effects. As novel treatments are developed, there will be a need to assess their efficacy in well-designed randomized controlled trials. However, there is no consensus on the optimal outcome measures for use in PDD clinical trials...
January 2016: Movement Disorders Clinical Practice
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