M S Okun

..These findings also indicate that the relationship between visual-spatial ability and frontal-executive function in PD is likely complex, and that the visual-spatial deficits in PD may be sensitive to the sex of the individual with PD...

..To elucidate the role of Dr. Americo Negrette in diagnosing and reclassifying the dancing mania in Maracaibo, Venezuela as Huntington disease (HD)...

..To examine in a pilot study inappropriate crying and laughing (also termed pseudobulbar affect (PBA)) and underlying mood disturbances in a large clinic based population of Parkinson's disease and movement disorder patients...

..Further efficacy studies on chronic stimulation to disrupt the abnormal oscillatory activity in this disorder are warranted...

..To collect the information necessary to design the methods and outcome variables for a larger trial of scheduled deep brain stimulation (DBS) for Tourette syndrome...

..However, other BoNT serotypes are under study for possible clinical use and new clinical indications;..

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..Preliminary data from this study, however, suggest that slight movement dorsal or ventral to the site of optimal motor performance may be associated with more adverse changes in mood with STN stimulation than with GPi stimulation...

..We should, however, be careful not to abandon an effective therapy before fully exploring through randomized trials the relative effect of different surgical approaches for the treatment of patients with movement disorders...

..Clinicians should be aware of this potential complication, the importance of differentiating it from stimulation induced depression, and its response to a serotonin reuptake inhibitor, such as sertraline...

..Joseph F. F. Babinski worked in the shadow of his mentor, Jean M. Charcot, until 1893, but then developed independent studies to examine patients with both types of weakness...

..Part II was a multicenter study to assess the correlation of FLASQ-PD scores. The results of this study suggest that the FLASQ-PD may be a useful triage tool for screening PD patients for DBS surgery...

..An attempt is made herein to evaluate the reasons for DBS failure in a series of such patients and to make recommendations to improve overall DBS outcomes...

..This education can help to ensure that outcome meets or exceeds expectation, and as a result they become a more satisfied and easy-to-manage DBS patient...

..To pilot a data-driven quality care program in National Parkinson Foundation (NPF) Centers of Excellence...

..To describe smiling and euphoria induced by deep brain stimulation (DBS)...

..In normal subjects, low testosterone levels are associated with cognitive and neuropsychiatric symptoms, yet the relationship between testosterone levels and cognitive function in PD and AD remains unclear...

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..To review the spectrum of problems that can occur in the DBS patient and to suggest potential troubleshooting tips for identification and management of DBS related issues...

..Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease...

..Alternatively, newer procedures may choose and specifically target non-motor territories for chronic electrical stimulation...

..To investigate whether a single daily dose of testosterone replacement gel has beneficial effects on testosterone deficiency symptoms, cognitive function, nonmotor symptoms of Parkinson disease (PD), and motor symptoms of PD...

..Deep brain stimulation (DBS) has been associated with mood sequelae in a subset of patients operated on in either the subthalamic nucleus or the globus pallidus internus for the treatment of Parkinson disease...

..Additionally, this article will review all aspects of the DBS procedure that can result in mood, cognitive, and behavioral effects and what role(s) the neuropsychologist should play in screening and follow-up...

..Our approach is aimed to maximize benefit(s) and minimize risk(s) in order to best tailor therapy for an individual patient...

..To evaluate the chair test for diagnosis of psychogenic gait disorders...

..The stimulation-induced benefits and side effects can be reversibly and blindly applied to a variety of locations in this region...

..Many innocent victims were persecuted and even tried as witches as the medical community struggled to arrive at a better understanding of Huntington's disease...

..Previously, we reported that testosterone deficiency is more common in patients with PD compared with age-matched control subjects, and we also reported in 2 small open-label studies that some nonmotor symptoms responded favorably to TT...

..The aim of this study was to evaluate the effects of unilateral and bilateral ventralis intermedius (Vim) deep brain stimulation (DBS) on mood and motor function...

..Secondarily, to evaluate whether the longevity of the MER and lead placement effects were influenced by target location (subthalamic nucleus (STN) or globus pallidus interna (GPi))...

..An artist reported changes in her artistic creativity and art appreciation when treated with left DBS. We sought to study her artistic productions and her appreciation of art while both "on" and "off" left DBS...

..Middle-aged adults (<65) had a steeper trajectory of apathy than older adults (≥ 65). Apathy trajectory was not related to motor severity, laterality of DBS, levodopa medication reduction, or motor changes after surgery...

..We used screening tests administered by a certified driving rehabilitation specialist and by Parkinson's disease (PD) specialty neurologists to develop a model to predict on-road outcomes for patients with PD...

..This suggests that the degree of right-sided symptoms is more correlated to specific cognitive domains than is group classification of laterality...

..quot; This response may result from activation of limbic and autonomic networks...

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..Further studies will be needed to determine the effect of treatment on these associations and whether disturbances in energy are related to sleep disturbances or to primary fatigue issues...

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..The goal of the current study was to perform an unblinded retrospective chart review of DBS patients with unsatisfactory outcomes who presented for reoperation...

..To examine the hypothesis that apathy is a core feature of Parkinson disease (PD) and that apathy can be dissociated from depression...

..In this paper the authors disclose the standardized and prospectively recorded AE data from their institution, correlated with clinical outcome and quality of life (QOL) measures...

..Also discussed are the emerging targets, what is known about the cognitive sequelae of DBS, and what has been learned about the complications and therapeutic failures...

..These results suggest that PD patients show normal sympathetic arousal to affective stimuli (indexed by pupil diameter), but differences in motor correlates of emotion (eye movements)...

..The current study's objective was to test the treatment outcome of a 4-week device-driven EMST program on swallow safety and define the physiologic mechanisms through measures of swallow timing and hyoid displacement...

..Results suggest the n-back is not a pure measure of working memory, but may be able to detect subtle differences in cognitive functioning between PD patients and controls...

..No significant differences were obtained between medicated states ('on'/'off') for any of the 35 individual speech dimensions and speech-sign clusters. Global motor function significantly improved following dopaminergic medications...

..This study examined potential factors that might have corresponded to increased post-operative stays following unilateral DBS surgery...

..CONCLUSION: Placement of an STN DBS should be considered as the procedure of choice for surgical treatment of patients with a combination of PD and ET...

..The patient was an artist before her disease started, permitting us to analyze changes in her artistic-creative production over the course of the illness and during her treatment with DBS...

..These findings suggest subtle effects of stimulation on verbal fluency performance, consistent with the functional nonmotor subregions/somatotopy of the STN...

..There were no group differences in FT, a measure of bradykinesia-rigidity, but CR rotation was impaired in PD. Thus, LKA, not related to bradykinesia-rigidity, is associated with PD...

..These findings highlight the view that diminished emotional expressivity in PD should not be mistaken for decreased subjective emotional experience...

..Expiratory muscle strength training (EMST) was tested to improve cough and swallow function...

..These findings must be interpreted in light of group-level differences between the PD control and DBS patients on demographic and disease-related factors...

..Although VAEs have been described in many types of neurosurgical procedures, their incidence during DBS surgery is unknown...

..Although the present study does not compare the LARS to a diagnostic gold standard or promote its utility for diagnosing apathy, it provides further support for the LARS as a promising instrument to examine apathy in PD...

..g., 3, 4) continues to increase specificity at the expense of dramatically reducing sensitivity. These findings suggest the use of caution when screening for apathy with item 4 due to its poor sensitivity in relation to the AS...

..We hope that use of the FGATIR to aid initial targeting will translate in future studies to faster and more accurate procedures with consequent improvements in clinical outcomes...

..The purpose of this study is to compare the prevalence of idiopathic rhinorrhea in PD patients versus controls, to determine the correlation between rhinorrhea and anosmia, and the factors associated with rhinorrhea...

..We therefore suggest that future large scale randomized trials are warranted to evaluate the efficacy of aerobic exercise for ameliorating declines in cognitive performance in persons with PD...

..The brain target for stimulation was the anterior limb internal capsule (ALIC)...

..038 and .04 respectively). Our study suggests that increasing levels of dopaminergic therapy inhibits reflexive tachycardia. Furthermore, our study suggests that anosmia and constipation progress with the primary disease process...

..This review will summarize each disorder (depression, OCD and TS), review pathophysiology (both known and speculated), and update the current observations on DBS in each neuropsychiatric condition...

..The future will undoubtedly be filled with optimization of targets and stimulation parameters and the development of best practices. With tailored therapeutic approaches, epilepsy patients have the potential to improve with DBS...

..Greater understanding of the relationship between motor and cognitive processes in Parkinson's disease will be critical for understanding the disease process and its potential therapeutic possibilities...

..Despite the small sample, this is the first double-blind trial to show quetiapine's efficacy over placebo in controlling VH in the PD population. However, normalization of sleep architecture was not supported as the mechanism...

..The aim of this study was to determine the impact of intraoperative MER and lead placement on tremor severity in a cohort of patients with essential tremor...

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..In addition to device management, regular ED standards of care should apply to this special cohort of patients...

..Our study shows that while depressive symptoms correlated with global cognitive performance, naming, verbal memory, and language are the most susceptible cognitive domains affected with depressive symptoms...

..48, P = 0.003). These exploratory data highlight the psychosocial sequelae that swallowing impairment can have in those with IPD and suggest a possible association between swallowing, social function, and depression...

..Patients receiving GPi DBS reported greater improvements that cannot be explained by differential mood or motor effects; however, verbal fluency changes may have partially contributed to lesser QoL improvements amongst STN patients...

..To evaluate the relationship between knee extensor strength, postural stability, functional ambulation, and disease severity in Parkinson's disease (PD)...

..Finally, use of Reliable Change highlights the impact of individual variability and indicates that fluency declines likely reflect significant changes in a subset of patients who demonstrate a poorer surgical outcome overall...

..Cases involving transient manic behavior after pallidotomy have not been previously reported. Centers performing pallidotomy or DBS should be aware that lesions or stimulation too anterior in the GPi might lead to manic behavior...

..This improvement has the potential to positively impact high forced respiratory activities, such as forced breathing maneuvers, swallow, cough and speech functions that require greater magnitude and duration of expiration...

..Clinicians should be aware that depression is a frequent problem in dystonia and ET, in addition to PD, and inquire about depression symptoms in these patients so that they can be appropriately treated...

..Abnormal affective startle modulation may be used to help distinguish between malingering and PMD. Future studies using larger samples are needed to better understand the role of emotions in conversion disorder...

..The smiles could not be elicited even with long washout periods. These findings imply potential long-term habituation and changes in the neural chemistry (possibly neuroplasticity) induced by chronic DBS...

..In 3 patients the "rebound psychosis" was worse than the original psychotic episode and required subsequent higher antipsychotic medication doses...

..We observed numerous patients with PD whose nonmotor symptoms were refractory to treatment...

..General neurologists and even general practitioners may be called upon to screen potential candidates for DBS. The patient selection process plays an important role in this procedure...

..Patients with greater UE and LE motor impairments had lower QoL scores. However, LE impairments had a greater influence than UE impairments across all QoL measures...

..Lesion therapy represents a viable alternative and has several important advantages, including a decreased need for access to specialists and clinical follow-up, improved affordability, and a lower infection risk...

..We therefore argue that taking the patients' perspectives of their condition may allow for a more in-depth assessment of patient goals and subsequent tailoring of care...

..We report on a case of CV2 paraneoplastic syndrome with obsessive-compulsive behavior preceding the motor manifestations of chorea with associated leukoencephalopathy on MRI. The literature on paraneoplastic chorea is reviewed...

..This study examined the prevalence and contribution of comorbidities on cognitive performance in a large cohort of Parkinson patients...

..We plan to improve our techniques to remedy omitted clinical/research data, and expand the Network to include a larger donor pool. We will enhance sample preparation to facilitate advanced molecular studies and progenitor cell retrieval...

..Recent data, however, demonstrates that astrocytes may be active players in the DBS mechanism of action. In this review article, we will discuss the potential role of reactive and neurogenic astrocytes (neural progenitors) in DBS...

..To compare the phenotype of primary-appearing dystonia due to variant ataxia-telangiectasia (A-T) with that of other dystonia ascertained for genetics research...

..The reported incidence of significant complications varies considerably, and the long-term complication rate remains unknown...

..We aimed to review the English and Chinese literature on Pa Ping and to confirm by personal interview the story of how its pathogenesis was uncovered...

..To explore how amantadine transitioned from an anti-flu drug to antiparkinsonian agent...

..Deep brain stimulation (DBS) is a promising treatment for medication refractory obsessive compulsive disorder (OCD); however, there may be neuropsychiatric symptoms from unintended battery failure...

..Additionally, the factors that may influence these changes have not been carefully studied...

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..An emerging treatment option is the use of acetylcholinesterase inhibitors. This article reviews what is known about the epidemiology, risk factors, pathophysiology, and treatment of PD-related psychosis...

..Even though there have been great advances in the medical options for symptomatic management of PD, there are still many unmet needs for this patient population...

..This proposal includes active and experienced mentoring, access to diverse resources, and a scientific environment suited specifically for the development of the PI as an independent physician scientist. ..