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Matar E, Bhatia K. Dystonia and Parkinson's disease: Do they have a shared biology? INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 169:347-411. [PMID: 37482398 DOI: 10.1016/bs.irn.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Parkinsonism and dystonia co-occur across many movement disorders and are most encountered in the setting of Parkinson's disease. Here we aim to explore the shared neurobiological underpinnings of dystonia and parkinsonism through the clinical lens of the conditions in which these movement disorders can be seen together. Foregrounding the discussion, we briefly review the circuits of the motor system and the neuroanatomical and neurophysiological aspects of motor control and highlight their relevance to the proposed pathophysiology of parkinsonism and dystonia. Insight into shared biology is then sought from dystonia occurring in PD and other forms of parkinsonism including those disorders in which both can be co-expressed simultaneously. We organize these within a biological schema along with important questions to be addressed in this space.
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Affiliation(s)
- Elie Matar
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London, United Kingdom; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Kailash Bhatia
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London, United Kingdom
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Fan QY, Zhang XD, Hu ZD, Huang SS, Zhu SG, Chen CP, Zhang X, Wang JY. Case report: Blepharospasm in peak-dose dyskinesia may benefit from amantadine in Parkinson's disease. Front Neurol 2022; 13:961758. [PMID: 36247788 PMCID: PMC9561359 DOI: 10.3389/fneur.2022.961758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/29/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Blepharospasm is uncommon in Parkinson's disease, especially in the peak-dose dyskinesia period. Case presentation We herein present the case of a patient with PD who developed blepharospasm in the peak-dose dyskinesia period. The symptom was improved by taking amantadine. Conclusion The current report expands the phenomenology of peak-dose dykinesia in PD to include dystonic blepharospasm. This complication of levodopa therapy may respond to amantadine despite the dystonic appearance of movements.
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Affiliation(s)
- Qian-Ya Fan
- Department of Neurology, The First People's Hospital of Jiande, Hangzhou, China
| | - Xiao-Dong Zhang
- Department of Cerebral Surgery, The First People's Hospital of Jiande, Hangzhou, China
| | - Ze-Di Hu
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shi-Shi Huang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shi-Guo Zhu
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | | | - Xiong Zhang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Xiong Zhang
| | - Jian-Yong Wang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
- Jian-Yong Wang
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Balint B, Mulroy E, Gövert F, Latorre A, Di Lazarro G, Erro R, Batla A, Holton JL, Miki Y, Warner TT, Bhatia KP. Development of parkinsonism after long-standing cervical dystonia - A cohort. J Neurol Sci 2021; 427:117477. [PMID: 34015516 DOI: 10.1016/j.jns.2021.117477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Dystonia occurring in the context of parkinsonism is well-known, e.g. as foot dystonia in young-onset Parkinson's disease (PD), anterocollis in multisystem atrophy (MSA) or blepharospasm (levator inhibition) in progressive supranuclear palsy. We have, however, encountered a series of patients whose phenotype differed from the above described entities. METHODS We describe a cohort of patients in whom typical idiopathic isolated (primary) late-onset focal or segmental (predominantly cervical) dystonia preceded the development of parkinsonism by several years, sometimes decades. RESULTS In a cohort of 450 patients followed in our botulinum toxin injections clinic, we identified 11 (2.4%; 7 women) who developed parkinsonism at a median of 14 years after the onset of dystonia. Median age at onset of parkinsonism was 70 years (range 59-87), usually manifesting with a new tremor or a change of tremor pattern, complaints of 'slowing down' or new walking difficulties. Parkinsonism resembled PD in 5 (one pathologically confirmed); the remainder had atypical parkinsonism of MSA (n = 3) or indeterminate phenotype (n = 3). CONCLUSION The relatively frequent occurrence of parkinsonism after long-standing dystonia would suggest a link between the two, in line with evidence from other clinical reports, imaging studies, animal models and genetics. It appears that in some cases of dystonia this could be an antecedent manifestation of a syndrome with parkinsonism developing later, or be a risk factor for parkinsonism. In practice, it is important for clinicians to be alert to new symptoms/signs in patients with long-standing dystonia. From a research point of view, longitudinal case-control studies would be required to further investigate the link between long-standing dystonia and subsequent parkinsonism.
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Affiliation(s)
- Bettina Balint
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London WC1N 3BG, United Kingdom; Department of Neurology, University Hospital Heidelberg, Germany.
| | - Eoin Mulroy
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London WC1N 3BG, United Kingdom
| | - Felix Gövert
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Anna Latorre
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London WC1N 3BG, United Kingdom; Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Giulia Di Lazarro
- Department of Systems Medicine, University of Rome Tor Vergata, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana,", University of Salerno, Baronissi (Salerno), Italy
| | - Amit Batla
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London WC1N 3BG, United Kingdom
| | - Janice L Holton
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Yasuo Miki
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Thomas T Warner
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Kailash P Bhatia
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London WC1N 3BG, United Kingdom.
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Lal V, Mehta S, Takkar A, Ray S. Ophthalmological findings in movement disorders. ANNALS OF MOVEMENT DISORDERS 2021. [DOI: 10.4103/aomd.aomd_35_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Treatment of Blepharospasm and Oromandibular Dystonia with Botulinum Toxins. Toxins (Basel) 2020; 12:toxins12040269. [PMID: 32331272 PMCID: PMC7232182 DOI: 10.3390/toxins12040269] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 12/16/2022] Open
Abstract
Blepharospasm and oromandibular dystonia are focal dystonias characterized by involuntary and often patterned, repetitive muscle contractions. There is a long history of medical and surgical therapies, with the current first-line therapy, botulinum neurotoxin (BoNT), becoming standard of care in 1989. This comprehensive review utilized MEDLINE and PubMed and provides an overview of the history of these focal dystonias, BoNT, and the use of toxin to treat them. We present the levels of clinical evidence for each toxin for both, focal dystonias and offer guidance for muscle and site selection as well as dosing.
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Papadopoulos C, Malfatti E, Anagnostou E, Savarese M, Udd B, Papadimas GK. Valosin-containing protein-related myopathy and Meige syndrome: Just a coincidence or not? Muscle Nerve 2019; 60:E43-E45. [PMID: 31509253 DOI: 10.1002/mus.26704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/04/2019] [Accepted: 09/07/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Constantinos Papadopoulos
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Edoardo Malfatti
- Neurology Department, Raymond-Poincaré teaching hospital, centre de référence des maladies neuromusculaires Nord/Est/Ile-de-France, AP-HP, Garches, France
| | - Evangelos Anagnostou
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Marco Savarese
- The Folkhälsan Institute of Genetics, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Finland
| | - Bjarne Udd
- The Folkhälsan Institute of Genetics, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Finland.,Tampere Neuromuscular Center, University and University Hospital of Tampere, Finland
| | - George Konstantinos Papadimas
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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De Verdal M, Renard D, Collombier L, Castelnovo G. 123 I-FP-CIT SPECT imaging in blepharospasm. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mild parkinsonian features in dystonia: Literature review, mechanisms and clinical perspectives. Parkinsonism Relat Disord 2017; 35:1-7. [DOI: 10.1016/j.parkreldis.2016.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/30/2016] [Accepted: 10/28/2016] [Indexed: 11/30/2022]
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Affiliation(s)
- Tae Yoon La
- Department of Ophthalmology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
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Pandey S, Sharma S. Meige's syndrome: History, epidemiology, clinical features, pathogenesis and treatment. J Neurol Sci 2017; 372:162-170. [DOI: 10.1016/j.jns.2016.11.053] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/31/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
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Chung SJ, Lew H. Cognitive Function Evaluation by Mini-Mental State Examination-Korea in Essential Blepharospasm. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.6.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sok Joong Chung
- Department of Ophthalmology, Bundang CHA Medical Center, CHA University, Seongnam, Korea
| | - Helen Lew
- Department of Ophthalmology, Bundang CHA Medical Center, CHA University, Seongnam, Korea
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Barun B, Brinar VV, Zadro I, Lušić I, Radović D, Habek M. Parkinsonism and multiple sclerosis—Is there association? Clin Neurol Neurosurg 2008; 110:958-61. [DOI: 10.1016/j.clineuro.2008.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 03/18/2008] [Accepted: 03/20/2008] [Indexed: 10/22/2022]
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Defazio G, Martino D, Abbruzzese G, Girlanda P, Tinazzi M, Fabbrini G, Colosimo C, Aniello MS, Avanzino L, Buccafusca M, Majorana G, Trompetto C, Livrea P, Berardelli A. Influence of coffee drinking and cigarette smoking on the risk of primary late onset blepharospasm: evidence from a multicentre case control study. J Neurol Neurosurg Psychiatry 2007; 78:877-9. [PMID: 17578856 PMCID: PMC2117757 DOI: 10.1136/jnnp.2007.119891] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 04/20/2007] [Accepted: 04/20/2007] [Indexed: 11/03/2022]
Abstract
Prior coffee and smoking habits were investigated in a multicentre case control study involving 166 patients presenting with primary late onset blepharospasm (BSP), 228 hospital control patients with primary hemifacial spasm and 187 population control subjects from five Italian centres. Information on age at disease onset, smoking and coffee drinking status at the reference age and average number of cups of coffee drunk/cigarettes smoked per day reached high and similar test-retest reproducibility in case and control patients. Unadjusted logistic regression analysis yielded a significant inverse association of prior coffee drinking and cigarette smoking with case status for the control groups. After adjustment for age, sex, referral centre, disease duration, years of schooling and ever coffee drinking/cigarette smoking, as appropriate, the smoking estimate lacked significance whereas the association of coffee intake and BSP did not (cases vs hospital control patients: OR 0.37 (95% CI 0.20 to 0.67); cases vs population control subjects: OR 0.44 (95% CI 0.23 to 0.85)). The strength of the inverse association between BSP and coffee intake tended to increase with the average number of cups drunk per day. There was a significant correlation between age of BSP onset and number of cups per day (adjusted regression coefficient 1.73; p = 0.001) whereas no correlation was found with number of packs of cigarettes per day. Coffee drinking may be inversely associated with the development of primary BSP and this association may partly depend on the amount consumed.
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Affiliation(s)
- G Defazio
- Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy.
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Shahed J, Jankovic J. Motor symptoms in Parkinson's disease. HANDBOOK OF CLINICAL NEUROLOGY 2007; 83:329-42. [DOI: 10.1016/s0072-9752(07)83013-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Bhidayasiri R, Cardoso F, Truong DD. Botulinum toxin in blepharospasm and oromandibular dystonia: comparing different botulinum toxin preparations. Eur J Neurol 2006; 13 Suppl 1:21-9. [PMID: 16417594 DOI: 10.1111/j.1468-1331.2006.01441.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Amongst all regions of the body, the craniocervical region is the one most frequently affected by dystonia. Whilst blepharospasm--involuntary bilateral eye closure--is produced by spasmodic contractions of the orbicularis oculi muscles, oromandibular dystonia may cause jaw closure with trismus and bruxism, or involuntary jaw opening or deviation, interfering with speaking and chewing. Both forms of dystonia can be effectively treated with botulinum toxin injection. This article summarizes injection techniques in both forms of dystonia and compares doses, potency and efficacy of different commercially available toxins, including Botox, Dysport, Xeomin and Myobloc/NeuroBloc.
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Affiliation(s)
- R Bhidayasiri
- Division of Neurology, Chulalongkorn University Hospital, Bangkok, Thailand
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Affiliation(s)
- Guy J Ben Simon
- Jules Stein Eye Institute, Room 2-267, 100 Stein Plaza, Los Angeles, CA 90095, USA
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