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Parkinson’s Tremors

Karthik Sreenivasan, Virendra Mishra, Christopher Bird, Xiaowei Zhuang, Zhengshi Yang, Dietmar Cordes, Ryan R Walsh
INTRODUCTION: The aim of the study was to identify abnormalities of whole-brain network functional organization and their relation to clinical measures in a well-characterized, multi-site cohort of very early-stage, drug-naïve Parkinson's Disease (PD) patients. METHODS: Functional-MRI data for 16 healthy controls and 20 very early-stage, drug-naïve patients with PD were obtained from the Parkinson's Progression Markers Initiative database after controlling for strict inclusion/exclusion imaging criteria...
February 7, 2019: Parkinsonism & related Disorders
Julian Varghese, Stephan Niewöhner, Iñaki Soto-Rey, Stephanie Schipmann-Miletić, Nils Warneke, Tobias Warnecke, Martin Dugas
Parkinson's disease and Essential Tremor are two of the most common movement disorders and are still associated with high rates of misdiagnosis. Collected data by technology-based objective measures (TOMs) has the potential to provide new promising and highly accurate movement data for a better understanding of phenotypical characteristics and diagnostic support. A technology-based system called Smart Device System (SDS) is going to be implemented for multi-modal high-resolution acceleration measurement of patients with PD or ET within a clinical setting...
2019: Frontiers in Neurology
Yong-Sook Park, Na Young Jung, Young Cheol Na, Jin Woo Chang
BACKGROUND: Following the emergence of magnetic resonance-guided focused ultrasound as a promising tool for movement disorder surgery, thalamotomy for essential tremor using this technique has become a useful tool based on its efficacy and lack of adverse effects. Here, we summarize the 4-year results of previous reports focusing on the durability of effectiveness of magnetic resonance-guided focused ultrasound thalamotomy for essential tremor. METHODS: From October 2013 to August 2014, 15 patients with intractable essential tremor were enrolled...
February 13, 2019: Movement Disorders: Official Journal of the Movement Disorder Society
James E McKinley, Allen Perkins
Parkinson disease (PD) is a complex neurologic disorder that involves motor and nonmotor brain functions. PD is the second most common neurodegenerative disease after Alzheimer disease. Motor symptoms include resting tremor, cogwheel rigidity, extreme slowness of movement, shuffling gait, and impaired balance. Swallowing and speaking difficulties also are common. Nonmotor symptoms include depression, hallucinations, and sleep disturbances that seriously affect quality of life. There is no cure for PD but management of motor and nonmotor symptoms can improve quality of life...
February 2019: FP Essentials
Zachary J Conway, Peter A Silburn, Wesley Thevathasan, Karen O' Maley, Geraldine A Naughton, Michael H Cole
Background: The use of alternate frequencies, amplitudes, and pulse widths to manage motor symptoms in Parkinson's disease (PD) patients with subthalamic nucleus deep brain stimulation (STN-DBS) is of clinical interest, but currently lacks systematic evidence. Objective/Hypothesis: Systematically review whether alternate STN-DBS settings influence the therapy's efficacy for managing PD motor symptoms. Methods: Systematic searches identified studies that; involved bilateral STN-DBS PD patients; manipulated ≥ 1 STN-DBS parameter (e...
January 2019: Movement Disorders Clinical Practice
Kai-Ming Jhang, Jing-Yang Huang, Oswald Ndi Nfor, Yu-Chun Tung, Wen-Yuan Ku, Cheng-Feng Jan, Yung-Po Liaw
Flunarizine (fz) causes side effects such as movement disorders (MDs). We investigated risk factors associated with fz-related MDs. Participants were recruited from the longitudinal health insurance databases and included patients who took fz for more than 1 month. Patients with one of the underlying diseases, or with concomitant drug use (antipsychotics, metoclopramide or reserpine), and those diagnosed with MDs before fz use were excluded. Fz-related MD was defined as a new diagnosis of parkinsonism or hyperkinetic syndrome including dyskinesia or secondary dystonia during fz use or within 3 months after drug discontinuation...
February 8, 2019: Scientific Reports
Anette Schrag, Zacharias Anastasiou, Gareth Ambler, Alastair Noyce, Kate Walters
BACKGROUND: Diagnosis of Parkinson's disease (PD) is typically preceded by nonspecific presentations in primary care. OBJECTIVES: The objective of this study was to develop and validate a prediction model for diagnosis of PD based on presentations in primary care. SETTING: The settings were general practices providing data for The Health Improvement Network UK primary care database. METHODS: Data from 8,166 patients aged older than age 50 years with incident diagnosis of PD and 46,755 controls were analyzed...
February 8, 2019: Movement Disorders: Official Journal of the Movement Disorder Society
Yixian Huang, Caili Huang, Wenwei Yun
BDNF-to-TrkB signaling pathways plays an important role in the long-term maintenance of the nigrostriatal system and that its deficiency may contribute to the onset and progression of Parkinson's disease (PD). To our knowledge this is the first study to investigate the expression of the brain-derived neurotrophic factor (BDNF) and phosphorylation status of TrkB in peripheral blood lymphocytes of 28 PD and 28 Essential tremor (ET) patients and 28 healthy controls using western blot analysis. Compared with controls, no significant difference of BDNF and total and phosphorylated TrkB levels were observed in ET, whereas BDNF and phosphorylated TrkB levels were significantly decreased in the PD groups (p < 0...
February 2, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jiang-Bing Liu, Jun-Ling Leng, Ying-Ge Wang, Yu Zhang, Tie-Yu Tang, Li-Hong Tao, Xin-Jiang Zhang, Chun-Feng Liu
Background: Nonmotor symptoms (NMS) are prodromal characteristics of Parkinson's disease (PD). The first-degree relatives (FDR) of PD patients had a higher risk of PD and also had more NMS. Objective: To delineate NMS in FDR of patients with different clinical types of PD. Methods: A total of 98 PD probands were recruited; 256 siblings of them were enrolled in the FDR group. Various scales were used to assess NMS, including depression, anxiety, cognitive impairment, insomnia, constipation, excessive daytime sleepiness, rapid eye movement sleep behavior disorder (RBD), and restless legs syndrome (RLS)...
2019: Parkinson's Disease
Takashi Morishita, Masa-Aki Higuchi, Hiromasa Kobayashi, Hiroshi Abe, Toshio Higashi, Tooru Inoue
OBJECTIVES: Deep brain stimulation (DBS) of the ventral intermediate (Vim) thalamic nucleus is used to treat tremors. Here, we identified the Vim nucleus on fast gray matter acquisition T1 inversion recovery (FGATIR) images and delineated the dentate-rubrothalamic tract (DRT) to determine the DBS target. We evaluated whether this method could consistently identify the Vim nucleus by anatomical imaging and fiber tractography. METHODS: We retrospectively reviewed clinical data of patients who underwent unilateral thalamic DBS for severe tremor disorders...
January 16, 2019: Journal of the Neurological Sciences
Shivam Om Mittal, Abhishek Lenka, Joseph Jankovic
Tremor is a key clinical feature of several common neurological disorders. Adequate management of tremor has been an unmet need in clinical practice. Most of the anti-tremor medications have limited efficacy and are associated with undesirable adverse effects, especially in elderly patients. Several studies have reported good outcomes with the use of botulinum neurotoxin (BoNT) for the treatment of tremor. This article aims to systematically review these studies and to highlight the role of BoNT in the management of tremor...
January 26, 2019: Parkinsonism & related Disorders
Gil Herrnstadt, Martin J McKeown, Carlo Menon
BACKGROUND: There is a need for alternative treatment options for tremor patients who do not respond well to medications or surgery, either due to side effects or poor efficacy, or that are excluded from surgery. The study aims to evaluate feasibility of a voluntary-driven, speed-controlled tremor rejection approach with individuals with pathological tremor. The suppression approach was investigated using a robotic orthosis for suppression of elbow tremor. Importantly, the study emphasizes the performance in relation to the voluntary motion...
February 1, 2019: Journal of Neuroengineering and Rehabilitation
Rory Durcan, Louise Wiblin, Rachael A Lawson, Tien K Khoo, Alison J Yarnall, Gordon W Duncan, David J Brooks, Nicola Pavese, David J Burn
BACKGROUND: The prevalence and duration of NMS in prodromal PD has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of recently diagnosed PD patients. METHODS: We evaluated the prevalence and duration of prodromal NMS in early PD patients (n= 154). NMS were screened for using the Nonmotor Symptom Questionnaire (NMS Quest). We subtracted the duration of the presence of each individual NMS reported from the duration of earliest motor symptom...
January 31, 2019: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
José Alexandre S Crippa, Jaime E C Hallak, Antônio W Zuardi, Francisco S Guimarães, Vitor Tumas, Rafael G Dos Santos
Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by motor symptoms such as bradykinesia, rest tremor, postural disturbances, and rigidity. PD is also characterized by non-motor symptoms such as sleep disturbances, cognitive deficits, and psychiatric disorders such as psychosis, depression, and anxiety. The pharmacological treatment for these symptoms is limited in efficacy and induce significant adverse reactions, highlighting the need for better treatment options. Cannabidiol (CBD) is a phytocannabinoid devoid of the euphoriant and cognitive effects of tetrahydrocannabinol, and preclinical and preliminary clinical studies suggest that this compound has therapeutic effect in non-motor symptoms of PD...
January 31, 2019: European Archives of Psychiatry and Clinical Neuroscience
Mahsa Sabour, Ali Shoeibi, Somayeh Ghahremani, Ramin Sadeghi
We reported a 71 years old woman, with history of rest and postural tremor, bradykinesia and memory problems. In her dynamic MRI, a contrast-enhanced tumor in the cerebellopontine (CP) angle was found which was compatible with a meningioma. 99m Tc-TRODAT SPECT showed decreased activity in the left putamen, indicating idiopathic Parkinson disease. There was also a focus of increased activity on the right side of the skull base, which was compatible with meningioma in MRI.
2019: Asia Oceania Journal of Nuclear Medicine & Biology
Stephen G Reich, Joseph M Savitt
The diagnosis of Parkinson disease (PD) is based on the presence of bradykinesia and either resting tremor or rigidity and there should be no features from the history or examination to suggest an alternative cause of parkinsonism. In addition to the motor manifestations of PD, there is a long list of nonmotor symptoms, several of which occur before motor signs and are considered "prodromal" PD. These are classified as neuropsychiatric, autonomic, sleep, and sensory. There are many medical options for the treatment of PD but levodopa remains the mainstay...
March 2019: Medical Clinics of North America
Anne Sofie Bøgh Malling, Bo Mohr Morberg, Lene Wermuth, Ole Gredal, Per Bech, Bente Rona Jensen
BACKGROUND: Parkinson's disease (PD) tremor comprises asymmetric rest and postural tremor with unilateral onset. Tremor intensity can be amplified by stress and reduced by attention, and the medical treatment is complex. Mirror movements and unintentional synchronization of bimanual movements, possibly caused by insufficient inhibition of inter-hemispheric crosstalk, have been reported in PD, indicating a lag of lateralization. Potential neuroprotective effects of pulsed electromagnetic fields (PEMF) have been reported in-vitro and in rodents, as have influences of PEMF on human tremor...
January 31, 2019: Journal of Neuroengineering and Rehabilitation
Yu-Qing Fang, Fei Mao, Mei-Jia Zhu, Xiu-Hua Li
RATIONALE: Parkinson disease (PD) is a complex neurodegenerative movement disorder characterized by resting tremor, muscular rigidity, bradykinesia, and so on. Genetics has been regarded as an important role in the development of PD. PARK2, an autosomal recessive gene, is the most common one referring to early-onset Parkinson disease (EOPD). Strangely, only a single heterozygous mutation in PARK2 was found in a small minority of patients with PD, which has been reported quite rarely and is difficult to explain...
February 2019: Medicine (Baltimore)
Fumiaki Ikawa, Naoko Sumi, Tomokazu Nishikawa, Hirofumi Maruyama, Takafumi Miyachi
We report a 77-year-old woman suffering from dementia with Lewy bodies (DLB) who presented with Hashimoto encephalopathy. The patient began to mistakenly believe that another person was sleeping in her bed from approximately 70 years of age. She began to show symptoms of parkinsonism after 75 years of age. One night, the patient began to exhibit loitering behavior, and made incomprehensible comments while also exhibiting other abnormal behaviors. Clinical examination revealed rigidity and tremor of the limbs, as well as hallucination, abnormal speech and behavior...
January 31, 2019: Rinshō Shinkeigaku, Clinical Neurology
Beate Pesch, Swaantje Casjens, Dirk Woitalla, Shalmali Dharmadhikari, David A Edmondson, Maria Angela Samis Zella, Martin Lehnert, Anne Lotz, Lennard Herrmann, Siegfried Muhlack, Peter Kraus, Chien-Lin Yeh, Benjamin Glaubitz, Tobias Schmidt-Wilcke, Ralf Gold, Christoph van Thriel, Thomas Brüning, Lars Tönges, Ulrike Dydak
We took advantage of magnetic resonance imaging (MRI) and spectroscopy (MRS) as non-invasive methods to quantify brain iron and neurometabolites, which were analyzed along with other predictors of motor dysfunction in Parkinson's disease (PD). Tapping hits, tremor amplitude, and the scores derived from part III of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS3 scores) were determined in 35 male PD patients and 35 controls. The iron-sensitive MRI relaxation rate R2* was measured in the globus pallidus and substantia nigra...
January 29, 2019: Cells
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