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Alegre-Ayala J, Vela-Desojo L, Fernández-Vázquez D, Navarro-López V, Macías-Macías Y, Cano-de-la-Cuerda R. Motor and process skills of people with parkinson's disease compared to healthy older adults. A cross-sectional study. Rev Neurol 2024; 78:31-39. [PMID: 38223946 DOI: 10.33588/rn.7802.2023231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Both Parkinson's disease (PD) and the process of ageing are associated with functional limitations. The aim of this study was to determine the differences in motor and process skills between individuals with PD and healthy older adults, as well as to observe how disease progression affects motor and process skills performance in PD patients. SUBJECTS AND METHODS A cross-sectional study was conducted. The Assessment of Motor and Process Skills (AMPS) measure was employed in order to analyze the differences in the motor and process skills of daily tasks in people with PD and healthy older adults age- and sex-matched. Part III of the Unified Parkinson Disease Rating Scale (UPDRS), the Hoehn and Yahr (HY) scale and the Schwab & England scale was administered to determine the severity of the disease. RESULTS Seventy participants (49 patients with PD and 21 healthy older adults) were recruited for this study. Our results showed that even at moderate stages of the disease, both motor and process skills were found deteriorated in PD patients more than older healthy older adults (p < 0.001). As PD progresses, motor and process skills present significantly deterioration. CONCLUSION PD leads to a greater deterioration in motor and process skills compared to healthy older adults. As disease stages advance according to the HY scale, performance in motor and process skills deteriorates significantly between moderate and advanced PD stages. According to the AMPS scale, PD patients show no impairment of processing skills up to HY IV, but motor impairment at HY stages II, III and IV.
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Affiliation(s)
| | - L Vela-Desojo
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, España
| | | | | | - Y Macías-Macías
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, España
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2
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Delgado C, Lopez-Jimenez A, Lopez-Valdes E, Gomez-Mayordomo V, Baltasar-Corral A, Martínez-Castrillo JC, Alonso-Canovas A, Tabar G, García-Ruiz PJ, de la Fuente S, Vela-Desojo L, Pareés I, Kurtis MM. Functional movement disorder comorbidity in Parkinson's disease: A multicenter descriptive study. Parkinsonism Relat Disord 2023; 114:105776. [PMID: 37544162 DOI: 10.1016/j.parkreldis.2023.105776] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/16/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Isabel Pareés
- Hospital Ruber Internacional, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain
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3
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Alegre-Ayala J, Vela-Desojo L, Fernández-Vázquez D, Navarro-López V, Macías-Macías Y, Cano-de-la-Cuerda R. Occupational performance skills in Parkinson's disease: relationship with health-related quality of life and caregiver burden. Rev Neurol 2023; 77:3-11. [PMID: 37365719 PMCID: PMC10663802 DOI: 10.33588/rn.7701.2023097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION The progression of Parkinson's disease (PD) results in a loss of ability to performance activities of daily living and health-related quality of life. The objectives of this study were to establish the relations between occupational performance skills and health-related quality of life, and the degree of caregiver burden in PD patients. PATIENTS AND METHODS Forty-nine patients at different stages of PD according to the Hoehn and Yahr scale participated in the study. Patients were assessed using the Parkinson's Disease Questionnaire (PDQ-39), the EuroQoL (EQ-5D), the Assessment of Motor and Process Skills (AMPS), and the Zarit Caregiver Burden Interview (ZCBI). RESULTS Strong correlations were found between the motor skills section of the AMPS scale and the PDQ-39 (r = -0.76; p = 0.001), and the EQ-5D questionnaires (r = 0.72; p = 0.001), while moderate correlations were found with the process skills. AMPS process skills were moderately correlated with mobility and activities of daily living. The ZCBI was only weakly correlated with the AMPS motor skills (r = -0.34; p = 0.02). CONCLUSION Declining scores on the AMPS scale are closely related to the loss of health-related quality of life in PD patients, and, to a lesser extent, with the degree of caregiver burden.
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Affiliation(s)
| | - L Vela-Desojo
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, España
| | | | | | - Y Macías-Macías
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, España
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4
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Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I. A circuit-based approach to modulate hypersexuality in Parkinson's disease. Psychiatry Clin Neurosci 2022; 77:223-232. [PMID: 36579893 DOI: 10.1111/pcn.13523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
AIM Impulse-control disorder is a common neuropsychiatric complication in Parkinson's disease (PD) under dopamine replacement therapy. Prior studies tested the balance between enhanced desire towards reward and cognitive control deficits, hypothesized to be biased towards the former in impulse control disorders. We provide evidence for this hypothesis by measuring behavioral and neural patterns behind the influence of sexual desire over response inhibition and tools towards functional restoration using repetitive transcranial stimulation in patients with hypersexuality as predominant impulsive disorder. METHODS The effect of sexual cues on inhibition was measured with a novel erotic stop-signal task under on and off dopaminergic medication. Task-related functional and anatomical connectivity models were estimated in 16 hypersexual and 17 nonhypersexual patients with PD as well as in 17 healthy controls. Additionally, excitatory neuromodulation using intermittent theta-burst stimulation (sham-controlled) was applied over the pre-supplementary motor area in 20 additional hypersexual patients with PD aiming to improve response inhibition. RESULTS Compared with their nonhypersexual peers, patients with hypersexuality recruited caudate, pre-supplementary motor area, ventral tegmental area, and anterior cingulate cortex while on medication. Reduced connectivity was found between pre-supplementary motor area and caudate nucleus in hypersexual compared with nonhypersexual patients (while medicated), a result paralleled by compensatory enhanced anatomical connectivity. Furthermore, stimulation over the pre-supplementary motor area improved response inhibition in hypersexual patients with PD when exposed to sexual cues. CONCLUSION This study, therefore, has identified a specific fronto-striatal and mesolimbic circuitry underlying uncontrolled sexual responses in medicated patients with PD where cortical neuromodulation halts its expression.
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Affiliation(s)
- David Mata-Marín
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - José Ángel Pineda-Pardo
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Mario Michiels
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Cristina Pagge
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Claudia Ammann
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain
| | - Raúl Martínez-Fernández
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | | | | | | | - Ignacio Obeso
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,Department of Psychobiology & Methods for the Behavioral Sciences Department, Complutense University of Madrid, Madrid, Spain
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Kovács N, Szász J, Vela-Desojo L, Svenningsson P, Femia S, Parra JC, Sanchez-Soliño O, Bergmann L, Gurevich T, Fasano A. Motor and nonmotor symptoms in patients treated with 24-hour daily levodopa-carbidopa intestinal gel infusion: Analysis of the COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS). Parkinsonism Relat Disord 2022; 105:139-144. [PMID: 36008198 DOI: 10.1016/j.parkreldis.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Patients with advanced Parkinson's disease (APD) commonly experience motor and nonmotor symptoms (NMS) associated with functional limitations and decreased quality of life. We compared motor and nonmotor outcomes in patients with APD receiving 24- versus 16-h levodopa-carbidopa intestinal gel (LCIG). METHODS Data from COSMOS, a large, real-world, retrospective and cross-sectional, observational study on LCIG and comedication in APD were obtained from medical records and a single patient visit for patients receiving 24- and 16-h LCIG infusion. Changes from baseline were evaluated for motor symptoms, NMS, and clinical characteristics. Safety was also assessed. RESULTS Data for 401 patients were included in this subanalysis. At the patient visit there were 35 patients on 24-h LCIG and 366 on 16-h LCIG. "Off" time and dyskinesia (duration and severity) were reduced in both groups. In both LCIG treatment groups, prevalence of most symptoms was reduced. There were significant differences in the change from baseline in severity and frequency of freezing of gait with 24-h LCIG versus 16-h LCIG (p = 0.011 and p = 0.038), severity of urinary symptoms (p = 0.006), and frequency of cognitive impairment (p = 0.014) with 24-h LCIG versus 16-h LCIG. Adverse events were similar for both treatment groups and considered tolerable. CONCLUSIONS LCIG 24-h infusion may be a useful treatment option, when clinically justified, for select patients with APD. CLINICAL TRIAL NUMBER NCT03362879.
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Affiliation(s)
| | - József Szász
- GE Palade University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, Emergency Clinical County Hospital Mureș, Tîrgu Mureș, Romania
| | - Lydia Vela-Desojo
- Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Per Svenningsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | - Tanya Gurevich
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel
| | - Alfonso Fasano
- Edmond J Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada; Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada
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6
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Dileone M, Ammann C, Catanzaro V, Pagge C, Piredda R, Monje MH, Navalpotro-Gomez I, Bergareche A, Rodríguez-Oroz MC, Vela-Desojo L, Alonso-Frech F, Catalán MJ, Molina JA, López-Ariztegu N, Oliviero A, Obeso JA, Foffani G. Home-based transcranial static magnetic field stimulation of the motor cortex for treating levodopa-induced dyskinesias in Parkinson's disease: A randomized controlled trial. Brain Stimul 2022; 15:857-860. [DOI: 10.1016/j.brs.2022.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 11/02/2022] Open
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Vela-Desojo L, Urso D, Kurtis-Urra M, García-Ruiz PJ, Pérez-Fernández E, Lopez-Valdes E, Posada-Rodriguez I, Ybot-Gorrin I, Lopez-Manzanares L, Mata M, Borrue C, Ruiz-Huete C, Del Valle M, Martinez-Castrillo JC. Sexual Dysfunction in Early-Onset Parkinson's Disease: A Cross-Sectional, Multicenter Study. J Parkinsons Dis 2021; 10:1621-1629. [PMID: 32925093 DOI: 10.3233/jpd-202066] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Sexual dysfunction (SD) is one of the least studied non-motor symptoms in Parkinson's disease (PD). OBJECTIVES To assess sexual function in a cohort of patients with early-onset PD (EOPD) and compare it to a group of healthy controls. METHODS In this cross-sectional multicenter study, SD was assessed with gender-specific multi-dimensional self-reported questionnaires: The Brief Male Sexual Function Inventory (BSFI-M) and the Female Sexual Function Index (FSFI). Scores between patients and controls were compared and associations between SD and demographical and clinical variables were studied. RESULTS One hundred and five patients (mean age 47.35±7.8, disease duration 6 (3-11) years, UPDRS part III 17 (10-23) and 90 controls were recruited. The BSFI-M total score was lower in EOPD men than in controls, and specific items were also significantly lower, such as drive, erections, ejaculation, and satisfaction. EOPD women had lower scores than controls in totalFSFI, and certain domains such as lubrication and pain. SD was present in 70.2% of patients and 52.5% of controls. Sexual satisfaction in 35.2% of patients and 81.2% of controls. By gender, male and female patients had more SD than controls but only male patients had more dissatisfaction than controls. Gender, higher depression scores and urinary dysfunction were associated with SD in multivariate analysis; and gender, UPDRS and urinary dysfunction with sexual satisfactionConclusion:In this Spanish cohort, SD and sexual dissatisfaction was more prevalent in EOPD patients than in the general population. Gender and urinary disfunction were associated with SD and sexual dissatisfaction.
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Affiliation(s)
| | - Daniele Urso
- Centro Integral de Neurociencias, HM Puerta del Sur, Móstoles, Madrid, Spain
| | | | | | | | | | | | - Isabel Ybot-Gorrin
- Hospital Universitario La Paz, Madrid, Spain.,Hospital Vithas-Nuestra Señora de América, Madrid, Spain
| | | | - Marina Mata
- Hospital Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain.,Hospital Ruber Juan Bravo, Madrid, Spain
| | - Carmen Borrue
- Hospital Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
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8
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Monje MHG, Sánchez-Ferro Á, Pineda-Pardo JÁ, Vela-Desojo L, Alonso-Frech F, Obeso JÁ. Reply to: Motor Features in a Peruvian Cohort of Parkinson's Disease Patients. Mov Disord 2021; 36:1994-1995. [PMID: 34409687 DOI: 10.1002/mds.28690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Mariana H G Monje
- HM-CINAC, HM Puerta del Sur University Hospital, Móstoles, Spain.,CEU-San Pablo University, Madrid, Spain.,Department of Anatomy, Histology and Neuroscience, Universidad Autónoma Madrid, Madrid, Spain
| | - Álvaro Sánchez-Ferro
- HM-CINAC, HM Puerta del Sur University Hospital, Móstoles, Spain.,CEU-San Pablo University, Madrid, Spain
| | - Jose Á Pineda-Pardo
- HM-CINAC, HM Puerta del Sur University Hospital, Móstoles, Spain.,CEU-San Pablo University, Madrid, Spain
| | - Lydia Vela-Desojo
- HM-CINAC, HM Puerta del Sur University Hospital, Móstoles, Spain.,CEU-San Pablo University, Madrid, Spain.,Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - Fernando Alonso-Frech
- HM-CINAC, HM Puerta del Sur University Hospital, Móstoles, Spain.,CEU-San Pablo University, Madrid, Spain
| | - José Á Obeso
- HM-CINAC, HM Puerta del Sur University Hospital, Móstoles, Spain.,CEU-San Pablo University, Madrid, Spain.,CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Instituto Carlos III, Madrid, Spain
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Fasano A, Gurevich T, Jech R, Kovács N, Svenningsson P, Szász J, Parra JC, Bergmann L, Johnson A, Sanchez-Soliño O, Tang Z, Vela-Desojo L. Concomitant Medication Usage with Levodopa-Carbidopa Intestinal Gel: Results from the COSMOS Study. Mov Disord 2021; 36:1853-1862. [PMID: 33908647 PMCID: PMC8453961 DOI: 10.1002/mds.28596] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/25/2021] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background Levodopa‐carbidopa intestinal gel (LCIG) is administered directly to the small intestine of patients with advanced Parkinson's disease (APD) to help maintain stable plasma levodopa levels. Objective The objective of this study was to investigate the effect of LCIG in reducing polypharmacy for the treatment of APD. Methods The COmedication Study assessing Mono‐ and cOmbination therapy with levodopa‐carbidopa inteStinal gel (COSMOS) is a large, real‐world, multinational observational study investigating comedication use with LCIG. All enrolled patients had used LCIG for ≥12 months and data were collected cross‐sectionally (study visit) and retrospectively. The primary endpoint was the percentage of patients using LCIG as monotherapy (without add‐on PD medications) at initiation and at 3, 6, 9, and 12 months thereafter. Results Overall, 409 patients were enrolled from 14 countries and were treated with LCIG for a mean of 35.8 ± 23.2 months. A total of 15.2% of patients initiated LCIG as monotherapy and 31.7% were receiving monotherapy at 12 months after initiation. The mean duration of LCIG monotherapy was 39.3 ± 25.6 months. Use of add‐on medications decreased over time with all LCIG regimens. From LCIG initiation to the patient visit, mean off time decreased by 3.8, 4.6, and 3.9 hours/day for LCIG monotherapy, LCIG daytime monotherapy, and LCIG polytherapy groups, respectively, while duration of dyskinesia decreased by 1.7, 2.0, and 1.9 hours/day, respectively. Adverse events likely related to study treatment occurred in 112 patients (27.4%) during LCIG treatment. Conclusions LCIG is an effective long‐term monotherapy option with a positive risk–benefit profile and contributes to reduced polypharmacy for patients with APD. © 2021 The AbbVie Inc. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Alfonso Fasano
- Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
| | - Tanya Gurevich
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, and Tel Aviv University, Tel Aviv, Israel
| | - Robert Jech
- Department of Neurology and Center of Clinical Neurosciences, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | | | - Per Svenningsson
- Department of Clinical Neuroscience, Section for Neurology, Karolinska Institutet, Stockholm, Sweden
| | - József Szász
- George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, Emergency Clinical County Hospital Tîrgu Mureș, Târgu Mureș, Romania
| | | | | | | | | | | | - Lydia Vela-Desojo
- Department of Neurology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Ammann C, Dileone M, Pagge C, Catanzaro V, Mata-Marín D, Hernández-Fernández F, Monje MHG, Sánchez-Ferro Á, Fernández-Rodríguez B, Gasca-Salas C, Máñez-Miró JU, Martínez-Fernández R, Vela-Desojo L, Alonso-Frech F, Oliviero A, Obeso JA, Foffani G. Cortical disinhibition in Parkinson's disease. Brain 2021; 143:3408-3421. [PMID: 33141146 DOI: 10.1093/brain/awaa274] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/23/2020] [Accepted: 07/08/2020] [Indexed: 11/13/2022] Open
Abstract
In Parkinson's disease, striatal dopamine depletion produces profound alterations in the neural activity of the cortico-basal ganglia motor loop, leading to dysfunctional motor output and parkinsonism. A key regulator of motor output is the balance between excitation and inhibition in the primary motor cortex, which can be assessed in humans with transcranial magnetic stimulation techniques. Despite decades of research, the functional state of cortical inhibition in Parkinson's disease remains uncertain. Towards resolving this issue, we applied paired-pulse transcranial magnetic stimulation protocols in 166 patients with Parkinson's disease (57 levodopa-naïve, 50 non-dyskinetic, 59 dyskinetic) and 40 healthy controls (age-matched with the levodopa-naïve group). All patients were studied OFF medication. All analyses were performed with fully automatic procedures to avoid confirmation bias, and we systematically considered and excluded several potential confounding factors such as age, gender, resting motor threshold, EMG background activity and amplitude of the motor evoked potential elicited by the single-pulse test stimuli. Our results show that short-interval intracortical inhibition is decreased in Parkinson's disease compared to controls. This reduction of intracortical inhibition was obtained with relatively low-intensity conditioning stimuli (80% of the resting motor threshold) and was not associated with any significant increase in short-interval intracortical facilitation or intracortical facilitation with the same low-intensity conditioning stimuli, supporting the involvement of cortical inhibitory circuits. Short-interval intracortical inhibition was similarly reduced in levodopa-naïve, non-dyskinetic and dyskinetic patients. Importantly, intracortical inhibition was reduced compared to control subjects also on the less affected side (n = 145), even in de novo drug-naïve patients in whom the less affected side was minimally symptomatic (lateralized Unified Parkinson's Disease Rating Scale part III = 0 or 1, n = 23). These results suggest that cortical disinhibition is a very early, possibly prodromal feature of Parkinson's disease.
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Affiliation(s)
- Claudia Ammann
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain.,CIBERNED, Instituto de Salud Carlos III, Madrid, Spain
| | - Michele Dileone
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Cristina Pagge
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Valentina Catanzaro
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - David Mata-Marín
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Frida Hernández-Fernández
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain.,Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Nursing, Villaviciosa de Odón, Madrid, Spain
| | - Mariana H G Monje
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Álvaro Sánchez-Ferro
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | | | - Carmen Gasca-Salas
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Jorge U Máñez-Miró
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Raul Martínez-Fernández
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain
| | - Lydia Vela-Desojo
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain.,Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Fernando Alonso-Frech
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain.,Hospital Clínico San Carlos, Madrid, Spain
| | | | - José A Obeso
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain.,CIBERNED, Instituto de Salud Carlos III, Madrid, Spain
| | - Guglielmo Foffani
- CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, Móstoles, Madrid, Spain.,CIBERNED, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
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Martínez-Fernández R, Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Shah BB, Hernández-Fernández F, Pineda-Pardo JA, Monje MHG, Fernández-Rodríguez B, Sperling SA, Mata-Marín D, Guida P, Alonso-Frech F, Obeso I, Gasca-Salas C, Vela-Desojo L, Elias WJ, Obeso JA. Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson's Disease. N Engl J Med 2020; 383:2501-2513. [PMID: 33369354 DOI: 10.1056/nejmoa2016311] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The subthalamic nucleus is the preferred neurosurgical target for deep-brain stimulation to treat cardinal motor features of Parkinson's disease. Focused ultrasound is an imaging-guided method for creating therapeutic lesions in deep-brain structures, including the subthalamic nucleus. METHODS We randomly assigned, in a 2:1 ratio, patients with markedly asymmetric Parkinson's disease who had motor signs not fully controlled by medication or who were ineligible for deep-brain stimulation surgery to undergo focused ultrasound subthalamotomy on the side opposite their main motor signs or a sham procedure. The primary efficacy outcome was the between-group difference in the change from baseline to 4 months in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score (i.e., part III) for the more affected body side (range, 0 to 44, with higher scores indicating worse parkinsonism) in the off-medication state. The primary safety outcome (procedure-related complications) was assessed at 4 months. RESULTS Among 40 enrolled patients, 27 were assigned to focused ultrasound subthalamotomy (active treatment) and 13 to the sham procedure (control). The mean MDS-UPDRS III score for the more affected side decreased from 19.9 at baseline to 9.9 at 4 months in the active-treatment group (least-squares mean difference, 9.8 points; 95% confidence interval [CI], 8.6 to 11.1) and from 18.7 to 17.1 in the control group (least-squares mean difference, 1.7 points; 95% CI, 0.0 to 3.5); the between-group difference was 8.1 points (95% CI, 6.0 to 10.3; P<0.001). Adverse events in the active-treatment group were dyskinesia in the off-medication state in 6 patients and in the on-medication state in 6, which persisted in 3 and 1, respectively, at 4 months; weakness on the treated side in 5 patients, which persisted in 2 at 4 months; speech disturbance in 15 patients, which persisted in 3 at 4 months; facial weakness in 3 patients, which persisted in 1 at 4 months; and gait disturbance in 13 patients, which persisted in 2 at 4 months. In 6 patients in the active-treatment group, some of these deficits were present at 12 months. CONCLUSIONS Focused ultrasound subthalamotomy in one hemisphere improved motor features of Parkinson's disease in selected patients with asymmetric signs. Adverse events included speech and gait disturbances, weakness on the treated side, and dyskinesia. (Funded by Insightec and others; ClinicalTrials.gov number, NCT03454425.).
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Affiliation(s)
- Raúl Martínez-Fernández
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Jorge U Máñez-Miró
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Rafael Rodríguez-Rojas
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Marta Del Álamo
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Binit B Shah
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Frida Hernández-Fernández
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - José A Pineda-Pardo
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Mariana H G Monje
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Beatriz Fernández-Rodríguez
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Scott A Sperling
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - David Mata-Marín
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Pasqualina Guida
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Fernando Alonso-Frech
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Ignacio Obeso
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Carmen Gasca-Salas
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - Lydia Vela-Desojo
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - W Jeffrey Elias
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
| | - José A Obeso
- From HM Centro Integral en Neurociencias AC (CINAC), University Hospital HM Puerta del Sur, CEU San Pablo University, Mostoles (R.M.-F., J.U.M.-M., R.R.-R., M.A., F.H.-F., J.A.P.-P., M.H.G.M., B.F.-R., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.), and the Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid (R.M.-F., R.R.-R., M.A., F.H.-F., J.A.P.-P., D.M.-M., P.G., F.A.-F., I.O., C.G.-S., L.V.-D., J.A.O.) - both in Spain; and the University of Virginia Health Sciences Center, Charlottesville (B.B.S., S.A.S., W.J.E.)
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Valverde-Guijarro E, Alguacil-Diego IM, Vela-Desojo L, Cano-de-la-Cuerda R. Effects of contemporary dance and physiotherapy intervention on balance and postural control in Parkinson's disease. Disabil Rehabil 2020; 44:2632-2639. [PMID: 33135935 DOI: 10.1080/09638288.2020.1839973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To describe the effects of a contemporary dance program, combined with conventional physiotherapy, on postural control, satisfaction and adherence in mild-moderate Parkinson's disease (PD) patients. METHODS A withdrawal/reversion test with three intervention periods. Each period lasts for two months: physiotherapy, physiotherapy + dance and withdrawing dance and continuing with the physiotherapy sessions. Berg Balance Scale (BBS), Timed Up & Go test (TUG), Sensory Organization Test (SOT), Motor Control Test (MCT) and Rhythmic Weigh Shift (RWS) were assessed at T1 (baseline), T2 (post-physiotherapy treatment), T3 (post-physiotherapy and dance) and T4 (post-physiotherapy). A satisfaction questionnaire and adherence were registered. RESULTS 27 patients (67.32 ± 6.14 yrs) completed the study. Statistical analysis revealed differences between T2-T3 (p = 0.027), T2-T4 (p = 0.029), T1-T3 (p = 0.010) and T1-T4 (p = 0.008) for BBS; and between T1-T2 (p = 0.037), T1-T3 (p = 0.005), T1-T4 (p = 0.004), T2-T3 (p = 0.022) and T2-T4 (p = 0.041) for TUG. Significant differences for CES (p < 0.001), VEST (p = 0.024) and strategy (p = 0.011) were observed, but not for MCT. Lateromedial velocity (p = 0.003) and anteroposterior velocity (p < 0.001) were significant for RWT. Patients showed a high level of satisfaction and adherence. CONCLUSIONS A short 8-weeks contemporary dance program plus combined physiotherapy shows benefits in functional mobility and balance, with a high degree of satisfaction and adherence in PD.IMPLICATIONS FOR REHABILITATIONContemporary dance, combined with physiotherapy, is a useful therapeutic tool to treat balance disorders and postural control in people with PD.A short 8-weeks contemporary dance program plus combined physiotherapy shows high satisfaction in people with PD.Contemporary dance, combined with physiotherapy, shows high adherence in people with mild-moderate PD to treat postural control.
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Affiliation(s)
| | - Isabel María Alguacil-Diego
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Lydia Vela-Desojo
- Neurology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Madrid, Spain
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Fasano A, Parra J, Gurevich T, Jech R, Bergmann L, Sánchez-Soliño O, Svenningsson P, Szász J, Vela-Desojo L. Physician preferences for levodopa-carbidopa intestinal gel as monotherapy versus combination therapy for advanced Parkinson's disease: Analysis from the COSMOS study. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cano-de-la-Cuerda R, Vela-Desojo L, Moreno-Verdú M, Ferreira-Sánchez MDR, Macías-Macías Y, Miangolarra-Page JC. Trunk Range of Motion Is Related to Axial Rigidity, Functional Mobility and Quality of Life in Parkinson's Disease: An Exploratory Study. Sensors (Basel) 2020; 20:E2482. [PMID: 32349394 PMCID: PMC7248848 DOI: 10.3390/s20092482] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/15/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND People with Parkinson's disease (PD) present deficits of the active range of motion (ROM), prominently in their trunk. However, if these deficits are associated with axial rigidity, the functional mobility or health related quality of life (HRQoL), remains unknown. The aim of this paper is to study the relationship between axial ROM and axial rigidity, the functional mobility and HRQoL in patients with mild to moderate PD. METHODS An exploratory study was conducted. Non-probabilistic sampling of consecutive cases was used. Active trunk ROM was assessed by a universal goniometer. A Biodex System isokinetic dynamometer was used to measure the rigidity of the trunk. Functional mobility was determined by the Get Up and Go (GUG) test, and HRQoL was assessed with the PDQ-39 and EuroQol-5D questionnaires. RESULTS Thirty-six mild to moderate patients with PD were evaluated. Significant correlations were observed between trunk extensors rigidity and trunk flexion and extension ROM. Significant correlations were observed between trunk flexion, extension and rotation ROM and GUG. Moreover, significant correlations were observed between trunk ROM for flexion, extension and rotations (both sides) and PDQ-39 total score. However, these correlations were considered poor. CONCLUSIONS Trunk ROM for flexion and extension movements, measured by a universal goniometer, were correlated with axial extensors rigidity, evaluated by a technological device at 30°/s and 45°/s, and functional mobility. Moreover, trunk ROM for trunk flexion, extension and rotations were correlated with HRQoL in patients with mild to moderate PD.
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Affiliation(s)
- Roberto Cano-de-la-Cuerda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (J.C.M.-P.)
| | - Lydia Vela-Desojo
- Neurology Service. Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, 28922 Madrid, Spain; (L.V.-D.); (Y.M.-M.)
| | - Marcos Moreno-Verdú
- Asociación Parkinson Madrid, 28014 Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Yolanda Macías-Macías
- Neurology Service. Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, 28922 Madrid, Spain; (L.V.-D.); (Y.M.-M.)
| | - Juan Carlos Miangolarra-Page
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (J.C.M.-P.)
- Rehabilitation Unit, Hospital Universitario de Fuenlabrada, Fuenlabrada, 28942 Madrid, Spain
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Bandres-Ciga S, Ahmed S, Sabir MS, Blauwendraat C, Adarmes-Gómez AD, Bernal-Bernal I, Bonilla-Toribio M, Buiza-Rueda D, Carrillo F, Carrión-Claro M, Gómez-Garre P, Jesús S, Labrador-Espinosa MA, Macias D, Méndez-del-Barrio C, Periñán-Tocino T, Tejera-Parrado C, Vargas-González L, Diez-Fairen M, Alvarez I, Tartari JP, Buongiorno M, Aguilar M, Gorostidi A, Bergareche JA, Mondragon E, Vinagre-Aragon A, Croitoru I, Ruiz-Martínez J, Dols-Icardo O, Kulisevsky J, Marín-Lahoz J, Pagonabarraga J, Pascual-Sedano B, Ezquerra M, Cámara A, Compta Y, Fernández M, Fernández-Santiago R, Muñoz E, Tolosa E, Valldeoriola F, Gonzalez-Aramburu I, Sanchez Rodriguez A, Sierra M, Menéndez-González M, Blazquez M, Garcia C, Suarez-San Martin E, García-Ruiz P, Martínez-Castrillo JC, Vela-Desojo L, Ruz C, Barrero FJ, Escamilla-Sevilla F, Mínguez-Castellanos A, Cerdan D, Tabernero C, Gomez Heredia MJ, Perez Errazquin F, Romero-Acebal M, Feliz C, Lopez-Sendon JL, Mata M, Martínez Torres I, Kim JJ, Dalgard CL, Brooks J, Saez-Atienzar S, Gibbs JR, Jorda R, Botia JA, Bonet-Ponce L, Morrison KE, Clarke C, Tan M, Morris H, Edsall C, Hernandez D, Simon-Sanchez J, Nalls MA, Scholz SW, Jimenez-Escrig A, Duarte J, Vives F, Duran R, Hoenicka J, Alvarez V, Infante J, Marti MJ, Clarimón J, López de Munain A, Pastor P, Mir P, Singleton A. The Genetic Architecture of Parkinson Disease in Spain: Characterizing Population-Specific Risk, Differential Haplotype Structures, and Providing Etiologic Insight. Mov Disord 2019; 34:1851-1863. [PMID: 31660654 PMCID: PMC8393828 DOI: 10.1002/mds.27864] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/08/2019] [Accepted: 08/25/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The Iberian Peninsula stands out as having variable levels of population admixture and isolation, making Spain an interesting setting for studying the genetic architecture of neurodegenerative diseases. OBJECTIVES To perform the largest PD genome-wide association study restricted to a single country. METHODS We performed a GWAS for both risk of PD and age at onset in 7,849 Spanish individuals. Further analyses included population-specific risk haplotype assessments, polygenic risk scoring through machine learning, Mendelian randomization of expression, and methylation data to gain insight into disease-associated loci, heritability estimates, genetic correlations, and burden analyses. RESULTS We identified a novel population-specific genome-wide association study signal at PARK2 associated with age at onset, which was likely dependent on the c.155delA mutation. We replicated four genome-wide independent signals associated with PD risk, including SNCA, LRRK2, KANSL1/MAPT, and HLA-DQB1. A significant trend for smaller risk haplotypes at known loci was found compared to similar studies of non-Spanish origin. Seventeen PD-related genes showed functional consequence by two-sample Mendelian randomization in expression and methylation data sets. Long runs of homozygosity at 28 known genes/loci were found to be enriched in cases versus controls. CONCLUSIONS Our data demonstrate the utility of the Spanish risk haplotype substructure for future fine-mapping efforts, showing how leveraging unique and diverse population histories can benefit genetic studies of complex diseases. The present study points to PARK2 as a major hallmark of PD etiology in Spain. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sara Bandres-Ciga
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Sarah Ahmed
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Marya S. Sabir
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Astrid D. Adarmes-Gómez
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Inmaculada Bernal-Bernal
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Marta Bonilla-Toribio
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Dolores Buiza-Rueda
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Fátima Carrillo
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Mario Carrión-Claro
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Pilar Gómez-Garre
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Silvia Jesús
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Miguel A. Labrador-Espinosa
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Daniel Macias
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Carlota Méndez-del-Barrio
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Teresa Periñán-Tocino
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Cristina Tejera-Parrado
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Laura Vargas-González
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Monica Diez-Fairen
- Fundació Docència i Recerca Mútua de Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Ignacio Alvarez
- Fundació Docència i Recerca Mútua de Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Juan Pablo Tartari
- Fundació Docència i Recerca Mútua de Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Mariateresa Buongiorno
- Fundació Docència i Recerca Mútua de Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Miquel Aguilar
- Fundació Docència i Recerca Mútua de Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Ana Gorostidi
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Plataforma de Genomica, Instituto de Investigacion Biodonostia, San Sebastián, Spain
| | - Jesús Alberto Bergareche
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Unidad de Trastornos de Movimiento, Departamento de Neurologia, Hospital Universitario de Donostia, San Sebastián, Spain
| | - Elisabet Mondragon
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Unidad de Trastornos de Movimiento, Departamento de Neurologia, Hospital Universitario de Donostia, San Sebastián, Spain
| | - Ana Vinagre-Aragon
- Unidad de Trastornos de Movimiento, Departamento de Neurologia, Hospital Universitario de Donostia, San Sebastián, Spain
| | - Ioana Croitoru
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Javier Ruiz-Martínez
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Unidad de Trastornos de Movimiento, Departamento de Neurologia, Hospital Universitario de Donostia, San Sebastián, Spain
| | - Oriol Dols-Icardo
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Genetics of Neurodegenerative Disorders Unit, IIB Sant Pau, and Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Jaime Kulisevsky
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Juan Marín-Lahoz
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Javier Pagonabarraga
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Berta Pascual-Sedano
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Mario Ezquerra
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Ana Cámara
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Yaroslau Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Manel Fernández
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Rubén Fernández-Santiago
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Esteban Muñoz
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Eduard Tolosa
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Francesc Valldeoriola
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Isabel Gonzalez-Aramburu
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla (IDIVAL) and Universidad de Cantabria, Santander, Spain
| | - Antonio Sanchez Rodriguez
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla (IDIVAL) and Universidad de Cantabria, Santander, Spain
| | - María Sierra
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla (IDIVAL) and Universidad de Cantabria, Santander, Spain
| | - Manuel Menéndez-González
- Servicio de Neurología, Hospital Universitario Central de Asturias, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Marta Blazquez
- Servicio de Neurología, Hospital Universitario Central de Asturias, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Ciara Garcia
- Servicio de Neurología, Hospital Universitario Central de Asturias, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Esther Suarez-San Martin
- Servicio de Neurología, Hospital Universitario Central de Asturias, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Pedro García-Ruiz
- Departamento de Neurologia, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - Juan Carlos Martínez-Castrillo
- Departamento de Neurologia, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Lydia Vela-Desojo
- Servicio de Neurologia, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Clara Ruz
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigacion Biomedica and Departamento de Fisiologia, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Francisco Javier Barrero
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Servicio de Neurología, Hospital Universitario San Cecilio, Granada, Universidad de Granada, Spain
| | - Francisco Escamilla-Sevilla
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Adolfo Mínguez-Castellanos
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Debora Cerdan
- Servicio de Neurología, Hospital General de Segovia, Segovia, Spain
| | - Cesar Tabernero
- Servicio de Neurología, Hospital General de Segovia, Segovia, Spain
| | | | | | - Manolo Romero-Acebal
- Servicio de Neurología, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Cici Feliz
- Departamento de Neurologia, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - Jose Luis Lopez-Sendon
- Departamento de Neurologia, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marina Mata
- Departamento de Neurologia, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - Irene Martínez Torres
- Departamento de Neurologia, Instituto de Investigación Sanitaria La Fe, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jonggeol Jeffrey Kim
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Clifton L. Dalgard
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The American Genome Center, Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | | | - Janet Brooks
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Sara Saez-Atienzar
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - J. Raphael Gibbs
- Computational Biology Group, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Rafael Jorda
- Departamento de Ingeniería de la Información y las Comunicaciones, Universidad de Murcia, Murcia, Spain
| | - Juan A. Botia
- Departamento de Ingeniería de la Información y las Comunicaciones, Universidad de Murcia, Murcia, Spain
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, United Kingdom
| | - Luis Bonet-Ponce
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Karen E. Morrison
- Department of Neurology, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Carl Clarke
- University of Birmingham, Birmingham, United Kingdom
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Manuela Tan
- Department of Clinical Neuroscience, University College London, London, United Kingdom
| | - Huw Morris
- Department of Clinical Neuroscience, University College London, London, United Kingdom
| | - Connor Edsall
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Dena Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Javier Simon-Sanchez
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, and DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Mike A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
- Data Tecnica International, Glen Echo, Maryland, USA
| | - Sonja W. Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
- Department of Neurology, Johns Hopkins Medical Center, Baltimore, Maryland, USA
| | - Adriano Jimenez-Escrig
- Departamento de Neurologia, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Jacinto Duarte
- Servicio de Neurología, Hospital General de Segovia, Segovia, Spain
| | - Francisco Vives
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigacion Biomedica and Departamento de Fisiologia, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Raquel Duran
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigacion Biomedica and Departamento de Fisiologia, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Janet Hoenicka
- Laboratorio de Neurogenética y Medicina Molecular, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Victoria Alvarez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
- Laboratorio de Genética, Hospital Universitario Central de Asturias, Asturias, Spain
| | - Jon Infante
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla (IDIVAL) and Universidad de Cantabria, Santander, Spain
| | - Maria José Marti
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Lab. of Parkinson disease and Other Neurodegenerative Movement Disorders, IDIBAPS-Institut d’Investigacions Biomèdiques, Barcelona, Catalonia, Spain
- Unitat de Parkinson i Trastorns del Moviment. Servicio de Neurologia, Hospital Clínic de Barcelona and Institut de Neurociencies de la Universitat de Barcelona (Maria de Maetzu Center), Catalonia, Spain
| | - Jordi Clarimón
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Genetics of Neurodegenerative Disorders Unit, IIB Sant Pau, and Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Adolfo López de Munain
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Departamento de Neurociencias. UPV-EHU, Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, Spain
| | - Pau Pastor
- Fundació Docència i Recerca Mútua de Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Pablo Mir
- Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
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Pineda-Pardo JA, Urso D, Martínez-Fernández R, Rodríguez-Rojas R, del-Alamo M, Millar Vernetti P, Máñez-Miró JU, Hernández-Fernández F, de Luis-Pastor E, Vela-Desojo L, Obeso JA. Transcranial Magnetic Resonance-Guided Focused Ultrasound Thalamotomy in Essential Tremor: A Comprehensive Lesion Characterization. Neurosurgery 2019; 87:256-265. [DOI: 10.1093/neuros/nyz395] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/21/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) thalamotomy is a novel and effective treatment for controlling tremor in essential tremor patients.
OBJECTIVE
To provide a comprehensive characterization of the radiological, topographical, and volumetric aspects of the tcMRgFUS thalamic lesion, and to quantify how they relate to the clinical outcomes.
METHODS
In this study, clinical and radiological data from forty patients with medically-refractory essential tremor treated with unilateral tcMRgFUS thalamotomy were retrospectively analyzed. Treatment efficacy was assessed with Clinical Rating Scale for Tremor (CRST). Lesions were manually segmented on T1, T2, and susceptibility-weighted images, and 3-dimensional topographical analysis was then carried out. Statistical comparisons were performed using nonparametric statistics.
RESULTS
The greatest clinical improvement was correlated with a more inferior and posterior lesion, a bigger lesion volume, and percentage of the ventral intermediate nucleus covered by the lesion; whereas, the largest lesions accounted for the occurrence of gait imbalance. Furthermore, the volume of the lesion was significantly predicted by the number of sonications surpassing 52°C.
CONCLUSION
Here we provide a comprehensive characterization of the thalamic tcMRgFUS lesion including radiological and topographical analysis. Our results indicate that the location and volume of the lesion were significantly associated with the clinical outcome and that mid-temperatures may be responsible for the lesion size. This could serve ultimately to improve targeting and judgment and to optimize clinical outcome of tcMRgFUS thalamotomy.
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Affiliation(s)
- José Angel Pineda-Pardo
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases, Instituto Carlos III, Madrid, Spain
| | - Daniele Urso
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
- Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Raul Martínez-Fernández
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases, Instituto Carlos III, Madrid, Spain
| | - Rafael Rodríguez-Rojas
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases, Instituto Carlos III, Madrid, Spain
| | - Marta del-Alamo
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
| | | | - Jorge U Máñez-Miró
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
| | - Frida Hernández-Fernández
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
- Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Nursing
| | | | - Lydia Vela-Desojo
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
| | - José A Obeso
- CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur, CEU-San Pablo University, Móstoles, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases, Instituto Carlos III, Madrid, Spain
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Linares-del Rey M, Vela-Desojo L, Cano-de la Cuerda R. Mobile phone applications in Parkinson's disease: a systematic review. Neurología (English Edition) 2019. [DOI: 10.1016/j.nrleng.2018.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Linares-del Rey M, Vela-Desojo L, Cano-de la Cuerda R. Aplicaciones móviles en la enfermedad de Parkinson: una revisión sistemática. Neurologia 2019; 34:38-54. [DOI: 10.1016/j.nrl.2017.03.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 02/20/2017] [Accepted: 03/02/2017] [Indexed: 02/07/2023] Open
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Cano-de-la-Cuerda R, Vela-Desojo L, Miangolarra-Page JC, Macías-Macías Y. Axial rigidity is related to the risk of falls in patients with Parkinson’s disease. NeuroRehabilitation 2017; 40:569-577. [DOI: 10.3233/nre-171444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Lydia Vela-Desojo
- Neurology Service, Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, Madrid, Spain
| | - Juan Carlos Miangolarra-Page
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Yolanda Macías-Macías
- Neurology Service, Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, Madrid, Spain
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Cano-de-la-Cuerda R, Vela-Desojo L, Miangolarra-Page JC, Macías-Macías Y. Isokinetic dynamometry as a technologic assessment tool for trunk rigidity in Parkinson's disease patients. NeuroRehabilitation 2014; 35:493-501. [DOI: 10.3233/nre-141142] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Lydia Vela-Desojo
- Neurology Service, Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, Madrid, Spain
| | - Juan Carlos Miangolarra-Page
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Yolanda Macías-Macías
- Neurology Service, Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, Madrid, Spain
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Cano-de la Cuerda R, Vela-Desojo L, Miangolarra-Page JC, Macías-Macías Y, Muñoz-Hellin E. [Health-related quality of life in Parkinson's disease]. Medicina (B Aires) 2010; 70:503-507. [PMID: 21163736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Parkinson's disease is a disabling and progressive neurological condition characterized by multiple motor and non motor symptoms that contribute to deterioration in quality of life. The diversity of symptoms associated with the disease and its management affect the patients on their physical, social and mental quality of life. The aim of this study was to identify key dimensions of health related quality of life (HRQOL) in a population affected with Parkinson's disease with a degree of mild-moderate impairment. Thirty six patients with Parkinson were recruited. The Hoehn and Yarh scale, the Unified Parkinson's Disease Rate Scale, the scale of activities of daily life and Schwab & England Get Up & Go Test were applied. HRQOL was assessed with the EuroQol-5D and the specific questionnaire Parkinson's Disease Questionnaire-39 items. The dimensions of the PDQ-39, except the PDQ-39 Pain domain and the EuroQol-5D correlated significantly with the severity of the disease. HRQOL was correlated with the functional status of patients. Only the PDQ-39 pain domain correlated with the risk of falls. Our results suggest that the HRQOL of patients with PD, in a state of mild-moderate impairment, is strongly influenced by disease severity and functional status.
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Affiliation(s)
- Roberto Cano-de la Cuerda
- Departamento de Fisioterapia, Terapia Ocupacional, Medicina Física y Rehabilitación, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, España.
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Vela-Desojo L, Vaamonde-Gamo J, Obeso-Insausti JA. [Paroxysmal movement disorders]. Rev Neurol 2000; 31:71-9. [PMID: 10948589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Paroxysmal movement disorders are of sudden onset, paroxystic or intermittent, with normality or at least absence of abnormal movements between episodes. They are uncommon conditions with high familial incidence. The commonest form is paroxystic dystony. Paroxystic ataxia and paroxystic tremor are much rarer. DEVELOPMENT Paroxystic dystony is seen clinically as paroxystic episodes of variable duration, consisting of dystonic movements and postures which present spontaneously or are triggered by certain stimuli or situations. There are different types: kinesgenic paroxystic choreoathetosis, dystonic paroxystic choreoathetosis, intermediate paroxystic choreoathetosis and nocturnal paroxystic choreoathetosis. The paroxystic ataxias are characterized by recurrent episodes of ataxia in the absence of any known metabolic defect. In type 1 episodic ataxia there are also episodes of ataxia and myochemical changes. The gene responsible for this condition has been found on the short arm of chromosome 12. Type 2 episodic ataxia is characterized by its excellent response to acetazolamide. The gene responsible is found on the short arm of chromosome 19. CONCLUSION Very few cases of paroxystic tremor have been described.
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