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Parkinson’s Tremors

Matthew C L Phillips, Deborah K J Murtagh, Linda J Gilbertson, Fredrik J S Asztely, Christopher D P Lynch
BACKGROUND: Preliminary evidence suggests that diet manipulation may influence motor and nonmotor symptoms in PD, but conflict exists regarding the ideal fat to carbohydrate ratio. OBJECTIVES: We designed a pilot randomized, controlled trial to compare the plausibility, safety, and efficacy of a low-fat, high-carbohydrate diet versus a ketogenic diet in a hospital clinic of PD patients. METHODS: We developed a protocol to support PD patients in a diet study and randomly assigned patients to a low-fat or ketogenic diet...
August 11, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Cameron Miller-Patterson, Richard Buesa, Nicole McLaughlin, Richard Jones, Umer Akbar, Joseph H Friedman
BACKGROUND: Motor symptoms in Parkinson's disease (PD) patients are usually asymmetric at onset. The literature on change in asymmetry over time has mixed results, with some studies suggesting a retained asymmetry and others suggesting a progression towards symmetry. The aim of this study was to assess change in asymmetry over time. METHODS: Charts of 109 consecutive patients who had been followed in a movement disorders clinic for routine PD care were retrospectively reviewed...
August 3, 2018: Journal of the Neurological Sciences
Martin Jakobs, Erenik Krasniqi, Manja Kloß, Jan-Oliver Neumann, Benito Campos, Andreas W Unterberg, Karl L Kiening
OBJECTIVES: Implantation of deep brain stimulation (DBS) electrodes requires stereotactic imaging. Stereotactic magnetic resonance imaging (MRI) for DBS surgery has become more popular and intraoperative MRI scanners have become more available. We report on our cohort of movement disorder patients who underwent intraoperative stereotactic MRI-only DBS electrode implantation. METHODS: A review of our DBS database for eligible patients over a study period of 8 years was performed...
August 7, 2018: World Neurosurgery
Na Young Jung, Chang Kyu Park, Minsoo Kim, Phil Hyu Lee, Young Ho Sohn, Jin Woo Chang
OBJECTIVE Recently, MR-guided focused ultrasound (MRgFUS) has emerged as an innovative treatment for numerous neurological disorders, including essential tremor, Parkinson's disease (PD), and some psychiatric disorders. Thus, clinical applications with this modality have been tried using various targets. The purpose of this study was to determine the feasibility, initial effectiveness, and potential side effects of unilateral MRgFUS pallidotomy for the treatment of parkinsonian dyskinesia. METHODS A prospective, nonrandomized, single-arm clinical trial was conducted between December 2013 and May 2016 at a single tertiary medical center...
August 10, 2018: Journal of Neurosurgery
Maryam Haghshomar, Mahsa Dolatshahi, Farzaneh Ghazi Sherbaf, Hossein Sanjari Moghaddam, Mehdi Shirin Shandiz, Mohammad Hadi Aarabi
Parkinson's disease (PD) is a neurodegenerative disorder accompanied by a series of pathological mechanisms which contribute to a variety of motor and non-motor symptoms. Recently, there has been an increasing interest in structural diffusion tensor imaging (DTI) in PD which has shed light on our understanding of structural abnormalities underlying PD symptoms or its associations with pathological mechanisms. One of the white matter tracts shown to be disrupted in PD with a possible contribution to some PD symptoms is the inferior longitudinal fasciculus (ILF)...
2018: Frontiers in Neurology
Chintan S Oza, David T Brocker, Christina E Behrend, Warren M Grill
Deep brain stimulation (DBS) is an effective therapy for movement disorders including Parkinson's disease (PD), although the mechanisms of action remain unclear. Abnormal oscillatory neural activity is correlated with motor symptoms and pharmacological or DBS treatment that alleviates motor symptoms appears to suppress abnormal oscillations. However, whether such oscillatory activity is causal of motor deficits such as tremor remains unclear. Our goal was to generate abnormal oscillatory activity in the cortex-basal ganglia loop using patterned subthalamic nucleus DBS and quantify motor behavior in awake healthy rats...
August 8, 2018: Journal of Neurophysiology
Talyta Cortez Grippe, Nasser Allam, Pedro Renato de Paula Brandão, Danilo Assis Pereira, Francisco Eduardo Costa Cardoso, Ana Carolina Rodrigues Aguilar, Iruena Moraes Kessler
OBJECTIVE: Transcranial sonography (TCS) is an emerging ancillary examination for diagnosing Parkinson's disease (PD). OBJECTIVE: To evaluate TCS features in patients with PD and its mimics, and establish their accuracy in predicting the final clinical diagnosis after follow-up. METHODS: We retrospectively studied 85 patients with an initial clinical suspicion of PD, atypical parkinsonism or essential tremor, all of whom underwent TCS. Two specialists reviewed the follow-up clinical visit records and determined the final clinical diagnosis...
July 2018: Arquivos de Neuro-psiquiatria
G Du, P Zhuang, M Hallett, Y-Q Zhang, J-Y Li, Y-J Li
Background: The cardinal features of Parkinson's disease (PD) are bradykinesia, rigidity and rest tremor. Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms. This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD. Methods: Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus (STN) DBS ( n  = 11), unilateral pallidotomy ( n  = 9) and unilateral thalamotomy (n = 9) were studied...
2018: Translational Neurodegeneration
Sharona Ben-Haim, Zaman Mirzadeh, William S Rosenberg
OBJECTIVE Deep brain stimulation (DBS) is a well-established, evidence-based therapy with FDA approval for Parkinson's disease and essential tremor. Despite the early successful use of DBS to target the sensory thalamus for intractable facial pain, subsequent studies pursuing various chronic pain syndromes reported variable efficacy, keeping DBS for pain as an investigational and "off-label" use. The authors report promising results for a contemporary series of patients with intractable facial pain who were treated with DBS...
August 2018: Neurosurgical Focus
Chao-Hung Kuo, Gabrielle A White-Dzuro, Andrew L Ko
OBJECTIVE Deep brain stimulation (DBS) is a safe and effective therapy for movement disorders, such as Parkinson's disease (PD), essential tremor (ET), and dystonia. There is considerable interest in developing "closed-loop" DBS devices capable of modulating stimulation in response to sensor feedback. In this paper, the authors review related literature and present selected approaches to signal sources and approaches to feedback being considered for deployment in closed-loop systems. METHODS A literature search using the keywords "closed-loop DBS" and "adaptive DBS" was performed in the PubMed database...
August 2018: Neurosurgical Focus
Bornali Kundu, Andrea A Brock, Dario J Englot, Christopher R Butson, John D Rolston
Traumatic brain injury (TBI) is a looming epidemic, growing most rapidly in the elderly population. Some of the most devastating sequelae of TBI are related to depressed levels of consciousness (e.g., coma, minimally conscious state) or deficits in executive function. To date, pharmacological and rehabilitative therapies to treat these sequelae are limited. Deep brain stimulation (DBS) has been used to treat a number of pathologies, including Parkinson disease, essential tremor, and epilepsy. Animal and clinical research shows that targets addressing depressed levels of consciousness include components of the ascending reticular activating system and areas of the thalamus...
August 2018: Neurosurgical Focus
Gary Rajah, Hamidreza Saber, Rasanjeet Singh, Leonardo Rangel-Castilla
Neuromodulation and deep brain stimulation (DBS) have been increasingly used in many neurological ailments, including essential tremor, Parkinson's disease, epilepsy, and more. Yet for many patients and practitioners the desire to utilize these therapies is met with caution, given the need for craniotomy, lead insertion through brain parenchyma, and, at many times, bilateral invasive procedures. Currently endovascular therapy is a standard of care for emergency thrombectomy, aneurysm treatment, and other vascular malformation/occlusive disease of the cerebrum...
August 2018: Neurosurgical Focus
Joseph Jankovic
No abstract text is available yet for this article.
March 1, 2018: Brain: a Journal of Neurology
Hai-Yan Zhou, Pei Huang, Qian Sun, Juan-Juan Du, Shi-Shuang Cui, Yun-Yun Hu, Wei-Wei Zhan, Ying Wang, Qin Xiao, Jun Liu, Yu-Yan Tan, Sheng-Di Chen
Background: The differential diagnosis of Parkinson's disease (PD) and multiple system atrophy (MSA) remains a challenge, especially in the early stage. Here, we assessed the value of transcranial sonography (TCS) to discriminate non-tremor dominant (non-TD) PD from MSA with predominant parkinsonism (MSA-P). Methods: Eighty-six MSA-P patients and 147 age and gender-matched non-TD PD patients who had appropriate temporal acoustic bone windows were included in this study...
2018: Translational Neurodegeneration
Adam Margolius, Fernando Cubillos, Ying He, Samuel Wu, Peter Schmidt, Tanya Simuni
OBJECTIVE: To determine predictors of clinically meaningful change in Health-Related Quality of Life (HRQL) in patients with Parkinson's disease (PD). BACKGROUND: There is limited literature on longitudinal predictors of change in HRQL in PD. METHODS: Data were collected from the National Parkinson Foundation Quality Improvement Initiative (NPF-QII) registry, a multicenter, longitudinal observational study. HRQL is measured by the Parkinson's Disease Questionnaire-39 (PDQ-39)...
July 2, 2018: Parkinsonism & related Disorders
Bianca M L Stelten, Bart P C van de Warrenburg, Ron A Wevers, Aad Verrips
Cerebrotendinous xanthomatosis (CTX) is an inborn error of cholesterol and bile acid metabolism, leading to neuropsychiatric and systemic manifestations. Movement disorders have rarely been reported in CTX, while a detailed appreciation of the full phenotypic spectrum is required in order to prevent underdiagnosis of this disease. This review focuses on the frequency of more unusual, non-ataxia and non-spasticity movement disorders reported in CTX. In total, 39 articles were reviewed, describing 55 CTX patients with a movement disorder...
July 19, 2018: Parkinsonism & related Disorders
Kurt A Jellinger
BACKGROUND: With increasing age of the world population, the number of parkinsonian patients with disease onset in very old age is expected to increase. Information about the clinical and morphological phenotype of very old age onset parkinsonism is poor, and only three autopsy-confirmed studies of parkinsonian patients of 80 years and older onset are available. METHODS: A retrospective autopsy study of 345 patients clinically diagnosed as Parkinson disease (PD) included 90 cases with disease onset ≥80 years)...
July 24, 2018: Parkinsonism & related Disorders
Y Zhou, M E Jenkins, M D Naish, A L Trejos
Recent progress in wearable technology has made wearable tremor suppression devices (WTSDs) for Parkinson's patients a potentially viable alternative solution for tremor management. So far, in contrast to wrist and elbow tremor, finger tremors have not been studied in depth despite the huge impact that they have on a patient's daily life. In addition, more evidence has been found showing that the performance of current tremor estimators may be limited by their model order due to the multiple harmonics present in tremor...
July 25, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Bhuvan Molparia, Brian N Schrader, Eli Cohen, Jennifer L Wagner, Sandeep R Gupta, Sherrie Gould, Nelson Hwynn, Emily G Spencer, Ali Torkamani
Essential tremor (ET) and Parkinson's disease (PD) are among the most common adult-onset tremor disorders. Clinical and pathological studies suggest that misdiagnosis of PD for ET, and vice versa, occur in anywhere from 15% to 35% of cases. Complex diagnostic procedures, such as dopamine transporter imaging, can be powerful diagnostic aids but are lengthy and expensive procedures that are not widely available. Preliminary studies suggest that monitoring of tremor characteristics with consumer grade accelerometer devices could be a more accessible approach to the discrimination of PD from ET, but these studies have been performed in well-controlled clinical settings requiring multiple maneuvers and oversight from clinical or research staff, and thus may not be representative of at-home monitoring in the community setting...
2018: PeerJ
A Campo-Arias, E E Castillo-Tamara, E Herazo
INTRODUCTION: Parkinson's disease (PD) is characterized by motor symptoms such as bradykinesia, rigidity, alteration of postural reflexes and tremor at rest and other non-motor symptoms such as changes in sleep patterns and sexual behavior. However, little is known about paraphilic sexual behaviors. AIM: To summarize the number of cases of zoophilic behaviors in patients with PD between January 2000 and December 2017. DEVELOPMENT: A review was carried out in PubMed, Scopus and Virtual Health Library...
August 16, 2018: Revista de Neurologia
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