J Jankovic

..Our aim is to provide a guide for clinicians and medical staff involved in the treatment of patients with deep brain stimulation for rapid recognition and efficient management of these complications...

..These studies provide evidence that BTX-A exerts meaningful benefits on the quality of life of patients treated with this biologic agent...

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..However, there is no support for levodopa-induced neurotoxicity from in vivo studies. This review discusses possible mechanisms of levodopa-related complications and therapeutic strategies for their prevention and management...

..One-third of the patients who were negative for BTX-B Abs at baseline became positive for BTX-B Abs at last visit. Thus, the high antigenicity of BTX-B limits its long-term efficacy...

..To examine the prevalence of cervical dystonia (CD) in the US population...

..To assess the response to the rotigotine transdermal system (Neupro; Schwarz Pharma Ltd, Monheim, Germany), a nonergolinic dopamine agonist, in patients with early Parkinson disease...

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..Although there is no evidence that BTX slows the progression of the disease, as a result of early intervention with BTX, many of the long-term complications of CD, such as contractures and radiculopathy, have been largely eliminated...

..We examine here the evidence for and against an association between ET and PD, and critically review data supporting the notion that a subset of ET patients is predisposed to developing PD...

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..004). The current preparation decreased the risk of antibody formation by a factor of six. The authors conclude that the low risk of antibody formation after current BTX type A treatment is related to lower protein load...

..To characterize the clinical and therapeutic aspects of essential tremor (ET) among children...

..The medical-legal community must learn to recognize the vulnerability of this patient population to potential mistreatment by the courts of justice...

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..Recognition of the full spectrum of clinical phenomenology of levodopa-related motor complications is essential for their treatment and prevention...

..Long term experience with this agent suggests that it is an effective and safe treatment not only for approved indications but also for an increasing number of off-label indications...

..The controversy has stimulated this review, the primary aim of which is to critically and objectively examine the evidence or lack of evidence for a relationship among welding, manganese, parkinsonism, and PD...

..This review provides and update on the treatment of CD with BoNT type A (BOTOX, Dysport, Xeomin and BoNT type B (Myobloc, NeuroBloc...

..Psychogenic movement disorders are increasingly encountered in specialized clinics, and represent approximately 15% of all patients evaluated in the Baylor College of Medicine Movement Disorders Clinic...

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..To determine the overall rate of functional decline and to assess the progression of different signs of Parkinson disease (PD)...

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..It is postulated that one type of postural tremor in Parkinson's disease represents a rest tremor that re-emerges after a variable delay while maintaining posture, hence "re-emergent tremor"...

..Experts in movement disorders are expected to have greater accuracy of initial diagnosis of PD...

..We conclude that pallidotomy is an effective and safe procedure in the treatment of medically intractable LID...

..Although the tingling sensation produced by TENS makes it poorly suited for a controlled clinical trial, the device has a favorable side-effect profile and is an acceptable palliative treatment for a subset of PMD patients...

..In addition, adults with TS are more likely to exhibit substance abuse and mood disorders compared with children with TS...

..1% Xeomin and 4.5% Botox). Conclusion: Clinical evidence to date suggests that Xeomin is an effective treatment for blepharospasm that does not differ from Botox in terms of its potency, duration of effect or adverse reaction profile...

..To investigate the effects of topiramate on Tourette syndrome (TS)...

..In this study, we evaluate the effect of STN DBS on quality of life using the QLS(M), a modular questionnaire in which satisfaction scores for each item are weighted in light of patient-rated importance...

..Patient selection and the proper choice of dose and administration site are the most important determinants of a favorable response to BTX treatment...

..This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders...

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..The pathophysiology of these disorders is reviewed...

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..Finally, success with surgical approaches, particularly deep brain stimulation in patients with Parkinson's disease who have levodopa-induced dyskinesias, has been extended to the treatment of many hyperkinetic movement disorders...

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..This study suggests that Nurr1 may play an important role in maintaining mature mesencephalic dopaminergic neuron function and that a defect in Nurr1 may increase susceptibility to SN injury...

..We investigated the cognitive and psychiatric outcome 6 months after bilateral subthalamic nucleus deep brain stimulation (DBS) for the treatment of Parkinson's disease (PD) using a disease control group...

..No previous study has systematically examined the impact of depressive symptoms in early, untreated PD...

..Patients treated with BTX-B had less saliva production (p < 0.01) and greater severity of constipation (p = 0.037) than those treated with BTX-A, but did not differ in other tests of autonomic functions...

..Progressive supranuclear palsy (PSP) is a neurodegenerative disorder that is frequently mistaken for Parkinson's disease (PD) in its early stages...

..To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of movement disorders...

..5 cells. These results indicate that pramipexole's neuroprotective effects are likely associated with its antioxidant property independent of D2/D3 receptor activation...

..6%), and akathisia (7.6%). Comparison of log-likelihood ratios revealed that age was a reliable predictor of Parkinsonism (P < 0.0001). TBZ is a safe and effective drug for the long-term treatment of hyperkinetic movement disorders...

..Subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to have beneficial effects on the motor features of Parkinson's disease (PD), but its impact on non-motor symptoms, most notably mood, has not been fully explored...

..To determine whether variants in the Slit and Trk-like 1 gene (SLITRK1) are present in American Caucasian population of patients with Tourette syndrome (TS)...

..Additional therapies are required for patients with an inadequate response or intolerable side effects. In small trials, topiramate appeared to be beneficial in essential tremor...

..We investigated the potential contribution of mtDNA variants or mutations to the risk of PD...

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..PD is associated with a variety of sleep problems. The dopamine agonists (DA) pramipexole and ropinirole were recently implicated in causing "sleep attacks" and motor vehicle accidents...

..We conclude that VIM DBS may mildly improve ipsilateral ET, and that concerns about meaningful ipsilateral tremor augmentation after device deactivation are not warranted...

..All these studies suggest that Nurr1 is not only essential in the development of mensencephalic dopaminergic neurons and maintenance of their functions, but it may also play a role in the pathogenesis of PD...

..We systematically and critically reviewed the literature on the effects of DBS on HRQoL in PD, ET, dystonia, and cerebellar outflow tremor related to multiple sclerosis...

..Axial or leg dystonia, without significant involvement of an arm, is rare. There is no effective treatment for this relentless disorder, except for temporary relief of dystonia and pain, with local botulinum toxin injections...

..We investigated retrospectively the short and long-term motor and cognitive functioning of staged bilateral pallidotomy using motor testing and a comprehensive neuropsychological battery before and after each procedure...

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..To determine whether the Nurr1 gene, which is critical for the development and maintenance of nigral dopaminergic neurons, is a risk factor associated with PD...

..To rationalize the technique and reduce the costs associated with chronic deep brain stimulation of the thalamus for treatment of refractory tremor...

..There are, however, relatively little data concerning bilateral thalamic DBS and no thorough comparisons between the 2 methods...

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..In this study, we compare our results using thalamotomy and pallidotomy to treat patients with different forms of dystonia, and we discuss our results in the context of other published series...

..Advantages over existing dopamine agonists include once-daily administration, absence of food interactions, maintenance of stable plasma levels and utility in patients with swallowing difficulties...

..Except for 1 patient, the 4 Ab-positive and the 2 clinical nonresponders are being treated with BTX-B. This longest reported follow-up of BTX injections confirms the long-term efficacy and safety of this treatment...

..Further studies in a larger population of patients with FoG are needed to determine whether atomoxetine is a useful drug in the treatment of this, often disabling, feature of PD...

..To assess tetrabenazine (TBZ) efficacy by evaluating the change in Huntington disease-associated chorea resulting from TBZ treatment withdrawal...

..The best way to initiate dopaminergic therapy for early Parkinson disease remains unclear...

..Mutations in the parkin gene (PRKN) cause autosomal recessive early-onset Parkinson disease (EOPD)...

..The molecular and clinical implications of these findings are discussed...

..In contrast, TAF1 and CXCR3 gene expression in peripheral blood lymphocytes is not a suitable surrogate disease marker for DYT3...

..Tetrabenazine, a monoamine depleter and dopamine receptor blocker, is used to treat several hyperkinetic movement disorders. The authors studied the use of tetrabenazine for tardive dyskinesia...

..Such data might provide insights which augment patient care, and may be instructive regarding medical education, since patient-related telephone calls are often addressed by physicians-in-training...

..The aetiology of EDS is probably multifactorial but is probably exacerbated by dopaminergic medications. Modafinil is a wake-promoting agent approved for use in narcolepsy, but it is often used to treat a variety of somnolent conditions...

..To assess hearing in patients with essential tremor (ET) vs patients with Parkinson disease (PD) and normal controls...

..TBZ was well tolerated and resulted in a significant improvement in modified AIMS scores in HD patients. These results support the use of TBZ for chorea in patients with HD...

..9% (p=0.008) and upper extremity 92.5% (p=0.008) TRS subscore. Functional improvement was noted with pouring liquids. Our findings provide support that STN DBS is an effective treatment of tremor associated with PD...

..These regions afford candidates for epitope-specific manipulation of anti-toxin immune responses...

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..Adverse events were similar in frequency to previously published studies of PGB, the most common being drowsiness and dizziness...

..We conclude that premonitory sensations are an important aspect of motor tics and some patients perceive motor tics as a voluntary movement in response to an involuntary sensation...

..The results may provide new insights into the cause and diagnosis of PD and have implications for genetic counseling...

..Restless legs syndrome (RLS) and Parkinson disease (PD) are common neurological conditions that respond to dopaminergic therapy. To our knowledge, the relationship between the two has not been thoroughly explored...

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..Adverse events included dizziness (n=2), sedation (n=1), and nervousness (n=1). Levetiracetam was well tolerated but failed to improve tremor consistently in this small trial...

..The aim of this study was to evaluate the long-term safety and efficacy of DBS of the ventralis intermedius nucleus (VIM) of the thalamus for PD and ET...

..The adverse effects of DAs are similar to those experienced with LD, except that the ergot agents are associated with a small risk of tissue fibrosis not noted with the non-ergot DAs...

..This may be partially due to a selection bias, but it may also indicate that prior pallidotomy is a negative predictor of outcome of STN DBS and should be considered in patient selection...

..We also review evidence that the risk of this complication is substantially lower with the newer nonergot dopamine agonists...

..If implemented early in the course of the disease, such treatments, if found effective, may not only alter the natural progression of the disease but may also delay or minimize motor and nonmotor complications associated with levodopa...

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..Additionally, mutations in NR4A2 affect transcription of the gene encoding tyrosine hydroxylase. These data suggest that mutations in NR4A2 can cause dopaminergic dysfunction, associated with Parkinson disease...

..Further analyses of these genetic abnormalities may lead to the identification of causative mutations and a better understanding of the molecular mechanisms in this common movement disorder...