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Levick S, Staples AD, Warschausky S, Huth-Bocks A, Taylor HG, Gidley Larson JC, Peterson C, Lukomski A, Lajiness-O'Neill R. [Formula: see text] Caregiver-reported infant motor and imitation skills predict M-CHAT-R/F. Child Neuropsychol 2024; 30:1035-1053. [PMID: 38275156 PMCID: PMC11272902 DOI: 10.1080/09297049.2024.2304378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/08/2023] [Indexed: 01/27/2024]
Abstract
Altered motor and social-communicative abilities in infancy have been linked to later ASD diagnosis. Most diagnostic instruments for ASD cannot be utilized until 12 months, and the average child is diagnosed substantially later. Imitation combines motor and social-communicative skills and is commonly atypical in infants at risk for ASD. However, few measures have been developed to assess infant imitation clinically. One barrier to the diagnostic age gap of ASD is accessibility of screening and diagnostic services. Utilization of caregiver report to reliably screen for ASD mitigates such barriers and could aid in earlier detection. The present study developed and validated a caregiver-report measure of infant imitation at 4, 6, and 9 months and explored the relationship between caregiver-reported imitation and motor abilities with later ASD risk. Participants (N = 571) were caregivers of term and preterm infants recruited as part of a large multi-site study of PediaTrac™, a web-based tool for monitoring and tracking infant development. Caregivers completed online surveys and established questionnaires on a schedule corresponding to well-child visits from birth to 18 months, including the M-CHAT-R/F at 18 months. Distinct imitation factors were derived from PediaTrac at 4, 6, and 9 months via factor analysis. The results supported validity of the imitation factors via associations with measures of infant communication (CSBS; ASQ). Imitation and motor skills at 9 months predicted 18-month ASD risk over and above gestational age. Implications for assessment of infant imitation, detecting ASD risk in the first year, and contributing to access to care are discussed.
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Affiliation(s)
- Samantha Levick
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Angela D Staples
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Seth Warschausky
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Alissa Huth-Bocks
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
| | - H Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital, and Pediatrics, The Ohio State University, Columbus, OH, USA
| | | | - Catherine Peterson
- Pediatric Psychology and Neuropsychology, Atrium Health Levine Children's Rea Village Pediatrics, Charlotte, NC, USA
| | | | - Renée Lajiness-O'Neill
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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2
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Mahgoub Y, Pathare A, Hamlin D, Kindt H, Francis A. Mannerisms and stereotypies in catatonia: beyond simple motor movements. Front Psychiatry 2024; 15:1435719. [PMID: 39328347 PMCID: PMC11424461 DOI: 10.3389/fpsyt.2024.1435719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 08/23/2024] [Indexed: 09/28/2024] Open
Abstract
Background Catatonia is a complex syndrome with prominent psychomotor, cognitive, and affective manifestations. Among the commonly described manifestations of catatonia are mannerisms and stereotypies. Kahlbaum, who coined the term catatonia, described several presentations of mannerisms and stereotypies as complex behaviors in his monograph. However, most of the subsequent psychiatric literature has described both phenomena in the context of simple motor movements or actions. Study design or method We identified complex behavioral presentations of mannerisms and stereotypies described by Kahlbaum in his monograph. We summarize the development and use of mannerisms and stereotypies as psychiatric terminology since Kahlbaum, emphasizing the spectrum of behavior captured early in this usage. We list the inconsistent and interchangeable use of these terms in subsequent literature and describe recent examples of complex behavioral manifestations of mannerisms and stereotypies in the context of catatonia. Study results We propose a new framework for mannerisms and stereotypies that utilizes descriptive psychopathology factors in various normative references, the context of the behavior examined, and critical pathological processes identified in mannerisms and stereotypies to identify and describe complex manifestations of these phenomena. Conclusion Catatonia continues to remain under-recognized and under-treated. Our current diagnostic tools can make mannerisms and stereotypies complex and challenging to recognize. We suggest defining stereotypies as non-contextual repetitive activities while mannerisms as non-contextual peculiarities of activities. Utilizing our proposed framework and definitions can improve the description, recognition, and treatment of catatonia.
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Affiliation(s)
- Yassir Mahgoub
- Department of Psychiatry and Behavioral Health, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Aum Pathare
- Department of Psychiatry and Behavioral Health, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Dallas Hamlin
- Department of Psychiatry and Behavioral Health, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Hailey Kindt
- College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Andrew Francis
- Department of Psychiatry and Behavioral Health, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
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3
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Abkur T, Tartaglia C, Lang AE. Clonic Perseveration in Neurodegenerative Parkinsonism. Mov Disord Clin Pract 2024; 11:1145-1148. [PMID: 39021328 PMCID: PMC11452793 DOI: 10.1002/mdc3.14168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024] Open
Affiliation(s)
- Tarig Abkur
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders ClinicToronto Western Hospital, University Health NetworkTorontoOntarioCanada
- Division of NeurologyUniversity of TorontoTorontoOntarioCanada
- Rossy Progressive Supranuclear Palsy CentreUniversity Health Network and the University of TorontoTorontoOntarioCanada
| | - Carmela Tartaglia
- Rossy Progressive Supranuclear Palsy CentreUniversity Health Network and the University of TorontoTorontoOntarioCanada
- Memory ClinicToronto Western Hospital, University Health NetworkTorontoOntarioCanada
- Canadian Concussion CentreKrembil Brain InstituteTorontoOntarioCanada
- Tanz Centre for Research in Neurodegenerative DiseasesUniversity of TorontoTorontoOntarioCanada
| | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders ClinicToronto Western Hospital, University Health NetworkTorontoOntarioCanada
- Division of NeurologyUniversity of TorontoTorontoOntarioCanada
- Rossy Progressive Supranuclear Palsy CentreUniversity Health Network and the University of TorontoTorontoOntarioCanada
- Tanz Centre for Research in Neurodegenerative DiseasesUniversity of TorontoTorontoOntarioCanada
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4
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Restrepo-Martínez M, Ramirez-Bermudez J, Chacon-Gonzalez J, Ruiz-Garcia R, Malik R, Finger E. Defining repetitive behaviours in frontotemporal dementia. Brain 2024; 147:1149-1165. [PMID: 38134315 DOI: 10.1093/brain/awad431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Repetitive behaviours are common manifestations of frontotemporal dementia (FTD). Patients with FTD exhibit various types of repetitive behaviours with unique behavioural and cognitive substrates, including compulsivity, lack of impulse control, stereotypy and hoarding. Other sources of repetitive behaviours, such as restrictive interests and insistence on sameness, may also be seen in FTD. Although repetitive behaviours are highly prevalent and potentially discriminatory in this population, their expression varies widely between patients, and the field lacks consensus about the classification of these behaviours. Terms used to describe repetitive behaviours in FTD are highly heterogeneous and may lack precise definitions. This lack of harmonization of the definitions for distinct forms of repetitive behaviour limits the ability to differentiate between pathological behaviours and impedes understanding of their underlying mechanisms. This review examines established definitions of well-characterized repetitive behaviours in other neuropsychiatric disorders and proposes operational definitions applicable to patients with FTD. Building on extant models of repetitive behaviours in non-human and lesion work and models of social behavioural changes in FTD, we describe the potential neurocognitive bases for the emergence of different types of repetitive behaviours in FTD and their potential perpetuation by a predisposition towards habit formation. Finally, examples of distinct therapeutic approaches for different forms of repetitive behaviours are highlighted, along with future directions to accurately classify, measure and treat these symptoms when they impair quality of life.
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Affiliation(s)
- Miguel Restrepo-Martínez
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Deparment of Cognitive Neurology, Parkwood Institute, London, ON N6C 5J1, Canada
| | - Jesus Ramirez-Bermudez
- Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, 14269, Mexico
| | - Jacobo Chacon-Gonzalez
- Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, 14269, Mexico
| | - Ramiro Ruiz-Garcia
- Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, 14269, Mexico
| | - Rubina Malik
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Deparment of Cognitive Neurology, Parkwood Institute, London, ON N6C 5J1, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Deparment of Cognitive Neurology, Parkwood Institute, London, ON N6C 5J1, Canada
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5
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Cavanna AE, Purpura G, Riva A, Nacinovich R. Co-morbid tics and stereotypies: a systematic literature review. Neurol Sci 2024; 45:477-483. [PMID: 37775616 PMCID: PMC10791822 DOI: 10.1007/s10072-023-07095-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/24/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Tics and stereotypies are childhood-onset repetitive behaviours that can pose significant diagnostic challenges in clinical practice. Both tics and stereotypies are characterised by a complex co-morbidity profile, however little is known about the co-occurrence of these hyperkinetic disorders in the same patient population. OBJECTIVE This review aimed to assess the relationship between tics and stereotypies when these conditions present in co-morbidity. METHODS We conducted a systematic literature review of original studies on co-morbid tics and stereotypies, according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Our literature search identified six studies of suitable sample size (n ≥ 40) presenting data on the association between tics and stereotypies in otherwise typically developing patients. A considerable proportion (23%) of patients diagnosed with stereotypic movement disorder present with co-morbid tics (range 18-43%). Likewise, the prevalence of primary stereotypies is increased in patients with tic disorders such as Tourette syndrome (8%, range 6-12%). DISCUSSION Tics and stereotypies can often develop in co-morbidity. The association of tics and stereotypies in the same patient has practical implications, in consideration of the different treatment approaches. Future research should focus on the assessment and management of both conditions, particularly in special populations (e.g. patients with pervasive developmental disorders).
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Affiliation(s)
- Andrea E Cavanna
- Department of Neuropsychiatry, National Centre for Mental Health, BSMHFT and University of Birmingham, 25 Vincent Drive, Birmingham, B15 2FG, UK.
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, UK.
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK.
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Anna Riva
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Renata Nacinovich
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, Monza, Italy
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Ichihashi S, Iha A, Yasumura S, Kariya S. Tardive Dyskinesia With Chorea-Ballism Improved by Valbenazine: A Case Report. Cureus 2024; 16:e54666. [PMID: 38524080 PMCID: PMC10960204 DOI: 10.7759/cureus.54666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Tardive dyskinesia (TD) is an involuntary muscle movement typically caused by prolonged exposure to antipsychotic medications. Depending on the symptom severity and the affected body parts, it can cause a terrible decline in patients' daily activities and life quality. TD often persists despite discontinuation of the offending drugs. There was no approved or effective agent to treat the patients until valbenazine, a vesicular monoamine transporter-2 inhibitor, became available. We report the case of a 64-year-old woman who started to take antipsychotics at the age of her late 20s for her schizophrenic symptoms and later developed left arm chorea-ballism in mid-50s. The patient's involuntary movements got progressively worse even after being freed from the medications and caused severe body weight loss due to difficulties in taking meals. Daily treatment with valbenazine gradually mitigated her symptoms, resulting in significant improvement in her feeding activities, body weight, and daily life quality. This is the first report, to our knowledge, describing the therapeutic potential of valbenazine to improve chorea-ballism associated with TD. Our observation highlights that valbenazine may relieve a broader spectrum of antipsychotic-induced involuntary movements.
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Affiliation(s)
| | - Akihiro Iha
- Division of Rehabilitation, Katsuren Hospital, Itoman, JPN
| | | | - Shingo Kariya
- Division of Internal Medicine, Katsuren Hospital, Itoman, JPN
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7
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Wong T, Falcomata TS, Barnett M. The Collateral Effects of Antecedent Exercise on Stereotypy and Other Nonstereotypic Behaviors Exhibited by Individuals with Autism Spectrum Disorder: A Systematic Review. Behav Anal Pract 2023; 16:407-420. [PMID: 37187841 PMCID: PMC10169941 DOI: 10.1007/s40617-022-00746-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 10/14/2022] Open
Abstract
The presence of stereotypy is one of the core features exhibited by individuals diagnosed with autism spectrum disorder (ASD). Stereotypy can interfere with academic engagement and become a major barrier to appropriate education and social development of individuals with ASD. Studies have shown that antecedent physical exercise can produce reductions in stereotypy and positive collateral effects. The purpose of the current systematic review was to examine the collateral effects of antecedent physical exercise on stereotypy and engagement in nonstereotypic behaviors. The findings suggest that individuals with ASD can benefit from incorporating antecedent physical exercise with regard to stereotypy and other positive collateral behaviors. Implications of the results and areas for further research are discussed.
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Affiliation(s)
- Travis Wong
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
| | - Terry S. Falcomata
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
| | - Monique Barnett
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
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8
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Nilles C, Amorelli G, Pringsheim TM, Martino D. "Unvoluntary" Movement Disorders: Distinguishing between Tics, Akathisia, Restless Legs, and Stereotypies. Semin Neurol 2023; 43:123-146. [PMID: 36854394 DOI: 10.1055/s-0043-1764164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Tics, stereotypies, akathisia, and restless legs fall at different places on the spectrum of discrete, unwanted and potentially disabling motor routines. Unlike tremor, chorea, myoclonus, or dystonia, this subgroup of abnormal movements is characterized by the subject's variable ability to inhibit or release undesired motor patterns on demand. Though it may be sometimes clinically challenging, it is crucial to distinguish these "unvoluntary" motor behaviors because secondary causes and management approaches differ substantially. To this end, physicians must consider the degree of repetitiveness of the movements, the existence of volitional control, and the association with sensory symptoms, or cognitive-ideational antecedent. This review aims to summarize the current existing knowledge on phenomenology, diagnosis, and treatment of tics, stereotypies, akathisia, and restless leg syndrome.
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Affiliation(s)
- Christelle Nilles
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gabriel Amorelli
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tamara M Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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9
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Melo C, Ribeiro TP, Prior C, Gesta C, Martins V, Oliveira G, Temudo T. Motor stereotypies in autism spectrum disorder: Clinical randomized study and classification proposal. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:456-471. [PMID: 35762643 DOI: 10.1177/13623613221105479] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Motor stereotypies are one of the most frequent features in children with a diagnosis of autism spectrum disorder. They may disrupt children's functioning and development and be a potential source of stress for families. Several factors, including sex, age, cognitive ability, and severity of autism spectrum disorder, may influence the presence and intensity of stereotypies. The present study aimed to identify the prevalence of motor stereotypies in a group of children with autism spectrum disorder. In addition, it sought to investigate whether sex, age, cognitive ability, verbal language, neurological comorbidities, and severity of autism spectrum disorder were associated with an increased probability and higher number, duration, and variability of stereotypies. A total of 134 participants aged 2.3-17.6 years underwent a clinical protocol with standardized video-recorded sessions. Stereotypies were identified and classified by two independent evaluators. The prevalence of stereotypies was 56.7%, and a total of 1198 motor stereotypies were captured. Children who were younger, nonverbal, and had higher severity of autism spectrum disorder had an increased probability of presenting stereotypies. Being nonverbal or having higher severity of autism spectrum disorder was also associated with presenting a higher number of stereotypies. Children with developmental delay, intellectual disability, or epilepsy displayed longer stereotypies, and children with developmental delay or intellectual disability additionally presented more diverse stereotypies. As part of the study, the authors present a clinical classification model, a glossary, and video samples of motor stereotypies. The findings of this study suggest that children who are younger, nonverbal, have lower cognitive ability, and have higher severity of autism spectrum disorder may have a higher burden of stereotypies. Earlier intervention and monitoring of these children have the potential to improve their long-term outcomes.
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Affiliation(s)
- Cláudia Melo
- Centro Hospitalar do São João, Portugal.,University of Porto, Portugal
| | - Tiago Pinto Ribeiro
- Centro Hospitalar Universitário do Porto, Portugal.,PIN-Progresso infantil, Portugal
| | | | - Camila Gesta
- Centro Hospitalar Universitário do Porto, Portugal
| | | | - Guiomar Oliveira
- Centro Hospitalar e Universitário de Coimbra, Portugal.,University of Coimbra, Portugal
| | - Teresa Temudo
- Centro Hospitalar Universitário do Porto, Portugal.,Instituto de Ciências Biomédicas de Abel Salazar, Portugal
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Bhatoa RS, Malik O, Robinson S, Hedderly T. Clinical management of complex motor stereotypies. Arch Dis Child 2022; 107:861-865. [PMID: 34725047 DOI: 10.1136/archdischild-2021-322624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/20/2021] [Indexed: 11/03/2022]
Abstract
This paper will review complex motor stereotypies and provide a summary of the current proposed treatment pathway.
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Affiliation(s)
- Raj Seraya Bhatoa
- Children's Neurosciences, Tics and Neurodevelopmental Movements Service (TANDeM), Evelina London Children's Hospital, London, UK
| | - Osman Malik
- Children's Neurosciences, Tics and Neurodevelopmental Movements Service (TANDeM), Evelina London Children's Hospital, London, UK
| | - Sally Robinson
- Children's Neurosciences, Tics and Neurodevelopmental Movements Service (TANDeM), Evelina London Children's Hospital, London, UK
| | - Tammy Hedderly
- Children's Neurosciences, Tics and Neurodevelopmental Movements Service (TANDeM), Evelina London Children's Hospital, London, UK
- Child Health Children's Academic Group, King's College London, London, UK
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11
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Ramteke A, Lamture Y. Tics and Tourette Syndrome: A Literature Review of Etiological, Clinical, and Pathophysiological Aspects. Cureus 2022; 14:e28575. [PMID: 36185878 PMCID: PMC9520955 DOI: 10.7759/cureus.28575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/30/2022] [Indexed: 11/07/2022] Open
Abstract
Tourette syndrome (TS) is a condition characterized by tics produced because of neuropsychiatric malfunctioning occurring in childhood, which becomes less severe in adulthood, followed by a difference in the severity of tics between two persons. TS is a diverse variable in which symptoms vary in different patients. It is associated with comorbidities like obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and depression, and hampers the quality of life. Comorbid disorders must be investigated and treated as part of the clinical approach for all TS patients. Clinicians should be aware of the infrequent but serious neurological problems that can occur in these patients and recommend aggressively treating tics. Currently, there is more emphasis on symptom-based treatments by medicines, but as etiological knowledge improves, we will divert to disease-modifying medications in the future. Behavioral, pharmacological, and surgical methods can treat TS. Neuroleptics, other drugs, and behavioral therapies are the first-line options. Deep brain stimulation is evolving but has its pros and cons. The main focus of this review is on tics characteristics, how to manage and assess them, and limitations in the clinical spectrum.
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12
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Virameteekul S, Bhidayasiri R. We Move or Are We Moved? Unpicking the Origins of Voluntary Movements to Better Understand Semivoluntary Movements. Front Neurol 2022; 13:834217. [PMID: 35265031 PMCID: PMC8899122 DOI: 10.3389/fneur.2022.834217] [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: 12/13/2021] [Accepted: 01/21/2022] [Indexed: 11/29/2022] Open
Abstract
The capacity for voluntary control is seen as essential to human movements; the sense that one intended to move (willing) and those actions were self-generated (self-agency) gives the sense of voluntariness and of being in control. While the mechanisms underlying voluntary movement have long been unclear, recent neuroscientific tools have identified networks of different brain areas, namely, the prefrontal cortex, supplementary motor area, and parietal cortex, that underlie voluntary action. Dysfunction in these brain areas can result in different forms of semivoluntary movement as the borderland of voluntary and involuntary movement where a person may experience a disordered sense of will or agency, and thus the movement is experienced as unexpected and involuntary, for an otherwise voluntary-appearing movement. Tics, functional movement disorders, stereotypies, perseveration, compulsions, utilization behaviors, and motor mannerism have been described elsewhere in the context of psychoses, and are often mistaken for each other. Yet, they reflect an impairment of prefrontal cortices and related circuits rather than simple motor systems, which results in the absence of subjective recognition of the movements, in contrast to other neurological movement disorders where principal abnormalities are located within the basal ganglia and its connections. Therefore, their recognition is clinically important since they are usually associated with neurodevelopmental and neurodegenerative disorders. In this review, we first defined a conceptual framework, from both a neuroanatomical and a neurophysiological point of view, for the generation of voluntary movement. We then examined the evidence linking dysfunctions in different motor pathways to each type of movement disorder. We looked at common semivoluntary movement disorders providing an overview, where possible, of their phenomenology and brain network abnormalities for each condition. We also emphasized important clinical feature similarities and differences to increase recognition of each condition in practice.
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Affiliation(s)
- Sasivimol Virameteekul
- Department of Medicine, Faculty of Medicine, Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Roongroj Bhidayasiri
- Department of Medicine, Faculty of Medicine, Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
- *Correspondence: Roongroj Bhidayasiri
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13
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McGonigal A. Frontal lobe seizures: overview and update. J Neurol 2022; 269:3363-3371. [PMID: 35006387 DOI: 10.1007/s00415-021-10949-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/27/2022]
Abstract
Frontal lobe seizures (FLS) are debilitating for patients, highly diverse and often challenging for clinicians to evaluate. Frontal lobe epilepsy is the second most common localization for focal epilepsy, and if pharmacoresistant, can be amenable to resective surgery. Detailed study of frontal seizure semiology in conjunction with careful anatomical and electrophysiological correlation based on intracerebral recording with stereoelectroencephalography (SEEG) has allowed demonstration that ictal motor semiology reflects a hierarchical rostro-caudal axis of frontal lobe functional organization, thus helping with presurgical localization. Main semiological features allowing distinction between different frontal sublobar regions include motor signs and emotional signs. Frontal lobe seizure semiology also represents a valuable source of in vivo human behavioral data from a neuroscientific perspective. Advances in defining underlying etiologies of FLE are likely to be crucial for appropriate selection and exploration of potential surgical candidates, which could improve upon current surgical outcomes. Future research on investigating the genetic basis of epilepsies and relation to structural substrate (e.g. focal cortical dysplasia) and seizure organization and expression, could permit a "genotype-phenotype" approach that could be complementary to anatomical electroclinical correlations in better defining the spectrum of FLS. This could help with optimizing patient selection and prognostication with regards to therapeutic choices.
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Affiliation(s)
- Aileen McGonigal
- Clinical Neurophysiology, Timone Hospital, APHM, Marseille, France. .,Inserm, INS, Institut de Neurosciences Des Systèmes, Aix Marseille Univ, Marseille, France.
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14
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Dopamine transporter silencing in the rat: systems-level alterations in striato-cerebellar and prefrontal-midbrain circuits. Mol Psychiatry 2022; 27:2329-2339. [PMID: 35246636 PMCID: PMC9126810 DOI: 10.1038/s41380-022-01471-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/15/2022] [Accepted: 02/02/2022] [Indexed: 12/12/2022]
Abstract
Silencing of dopamine transporter (DAT), a main controlling factor of dopaminergic signaling, results in biochemical and behavioral features characteristic for neuropsychiatric diseases with presumed hyperdopaminergia including schizophrenia, attention deficit hyperactivity disorder (ADHD), bipolar disorder, and obsessive-compulsive disorder (OCD). Investigation of DAT silencing thus provides a transdiagnostic approach towards a systems-level understanding of common underlying pathways. Using a high-field multimodal imaging approach and a highly sensitive cryogenic coil, we integrated structural, functional and metabolic investigations in tandem with behavioral assessments on a newly developed preclinical rat model, comparing DAT homozygous knockout (DAT-KO, N = 14), heterozygous knockout (N = 8) and wild-type male rats (N = 14). We identified spatially distributed structural and functional brain alterations encompassing motor, limbic and associative loops that demonstrated strong behavioral relevance and were highly consistent across imaging modalities. DAT-KO rats manifested pronounced volume loss in the dorsal striatum, negatively correlating with cerebellar volume increase. These alterations were associated with hyperlocomotion, repetitive behavior and loss of efficient functional small-world organization. Further, prefrontal and midbrain regions manifested opposite changes in functional connectivity and local network topology. These prefrontal disturbances were corroborated by elevated myo-inositol levels and increased volume. To conclude, our imaging genetics approach provides multimodal evidence for prefrontal-midbrain decoupling and striato-cerebellar neuroplastic compensation as two key features of constitutive DAT blockade, proposing them as transdiagnostic mechanisms of hyperdopaminergia. Thus, our study connects developmental DAT blockade to systems-level brain changes, underlying impaired action inhibition control and resulting in motor hyperactivity and compulsive-like features relevant for ADHD, schizophrenia and OCD.
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15
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Not the Stereotypical Wilson Disease: A Case Report. Tremor Other Hyperkinet Mov (N Y) 2021; 11:44. [PMID: 34754603 PMCID: PMC8555623 DOI: 10.5334/tohm.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Wilson disease (WD), a potentially treatable genetic disorder with perturbations in copper metabolism, presents with hepatic and neuropsychiatric manifestations. Both hyper and hypokinetic movements predominate the latter spectrum. Motor stereotypies, however, are exceedingly rare. Case Report: We present a case of a 12-year-old girl, with progressive behavioural alterations and cognitive impairment, with motor stereotypies involving the upper limbs, as the dominant movement semiology. She was diagnosed as WD with evidence of striatal involvement on brain imaging. Her motor symptoms partially responded to chelation therapy. Discussion: There are about five documented cases of motor stereotypies in WD worldwide, with only one being previously reported from India.
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16
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Jacobs B, Rally H, Doyle C, O'Brien L, Tennison M, Marino L. Putative neural consequences of captivity for elephants and cetaceans. Rev Neurosci 2021; 33:439-465. [PMID: 34534428 DOI: 10.1515/revneuro-2021-0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/02/2021] [Indexed: 12/20/2022]
Abstract
The present review assesses the potential neural impact of impoverished, captive environments on large-brained mammals, with a focus on elephants and cetaceans. These species share several characteristics, including being large, wide-ranging, long-lived, cognitively sophisticated, highly social, and large-brained mammals. Although the impact of the captive environment on physical and behavioral health has been well-documented, relatively little attention has been paid to the brain itself. Here, we explore the potential neural consequences of living in captive environments, with a focus on three levels: (1) The effects of environmental impoverishment/enrichment on the brain, emphasizing the negative neural consequences of the captive/impoverished environment; (2) the neural consequences of stress on the brain, with an emphasis on corticolimbic structures; and (3) the neural underpinnings of stereotypies, often observed in captive animals, underscoring dysregulation of the basal ganglia and associated circuitry. To this end, we provide a substantive hypothesis about the negative impact of captivity on the brains of large mammals (e.g., cetaceans and elephants) and how these neural consequences are related to documented evidence for compromised physical and psychological well-being.
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Affiliation(s)
- Bob Jacobs
- Laboratory of Quantitative Neuromorphology, Neuroscience Program, Colorado College, Colorado Springs, CO, 80903, USA
| | - Heather Rally
- Foundation to Support Animal Protection, Norfolk, VA, 23510, USA
| | - Catherine Doyle
- Performing Animal Welfare Society, P.O. Box 849, Galt, CA, 95632, USA
| | - Lester O'Brien
- Palladium Elephant Consulting Inc., 2408 Pinewood Dr. SE, Calgary, AB, T2B1S4, Canada
| | - Mackenzie Tennison
- Department of Psychology, University of Washington, Seattle, WA, 98195, USA
| | - Lori Marino
- Whale Sanctuary Project, Kanab, UT, 84741, USA
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17
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Sala-Coromina J, Raspall-Chaure M, Marcé-Grau A, de la Ossa AM, Macaya A. Early-onset eyelid stereotypies are a frequent and distinctive feature in Dravet syndrome. Seizure 2021; 92:155-157. [PMID: 34521063 DOI: 10.1016/j.seizure.2021.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/14/2021] [Accepted: 08/31/2021] [Indexed: 11/19/2022] Open
Abstract
Dravet syndrome (DS) is a severe infantile-onset epilepsy syndrome featuring drug resistant epilepsy, global developmental delay and intellectual disability. In addition to ataxia and progressive crouch gait, Parkinsonism has recently been reported as characteristic in young adults with DS. We describe 5 patients out of a series of 23 patients with DS who present between 12 and 24 months of age with repetitive episodes of eyelid closure, sometimes as fast as eye blinking or flickering. Consistent lack of any EEG correlate in serial video-EEG ruled out an epileptic origin. We propose that this movement disorder, namely 'eyelid stereotypies', might be an early motor trait of SCN1A-associated DS.
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Affiliation(s)
- Júlia Sala-Coromina
- Department of Paediatric Neurology, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain; Paediatric Neurology Research Group, Hospital Vall d'Hebron and Research Institute (VHIR), Edifici Mediterrània Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - Miquel Raspall-Chaure
- Department of Paediatric Neurology, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain; Paediatric Neurology Research Group, Hospital Vall d'Hebron and Research Institute (VHIR), Edifici Mediterrània Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Anna Marcé-Grau
- Paediatric Neurology Research Group, Hospital Vall d'Hebron and Research Institute (VHIR), Edifici Mediterrània Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - Alejandro Martinez de la Ossa
- Department of Paediatric Neurophysiology, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Alfons Macaya
- Department of Paediatric Neurology, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain; Paediatric Neurology Research Group, Hospital Vall d'Hebron and Research Institute (VHIR), Edifici Mediterrània Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
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18
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McCarty MJ, Brumback AC. Rethinking Stereotypies in Autism. Semin Pediatr Neurol 2021; 38:100897. [PMID: 34183141 PMCID: PMC8654322 DOI: 10.1016/j.spen.2021.100897] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 11/30/2022]
Abstract
Stereotyped movements ("stereotypies") are semi-voluntary repetitive movements that are a prominent clinical feature of autism spectrum disorder. They are described in first-person accounts by people with autism as relaxing and that they help focus the mind and cope in overwhelming sensory environments. Therefore, we generally recommend against techniques that aim to suppress stereotypies in individuals with autism. Further, we hypothesize that understanding the neurobiology of stereotypies could guide development of treatments to produce the benefits of stereotypies without the need to generate repetitive motor movements. Here, we link first-person reports and clinical findings with basic neuroanatomy and physiology to produce a testable model of stereotypies. We hypothesize that stereotypies improve sensory processing and attention by regulating brain rhythms, either directly from the rhythmic motor command, or via rhythmic sensory feedback generated by the movements.
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19
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Gayraud D, Bonnefoi B, Roux A, Viallet F. Movimenti anomali secondari (distonie, coree/ballismo, miocloni, tremori, discinesie). Neurologia 2021. [DOI: 10.1016/s1634-7072(21)44997-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Lanzarini E, Pruccoli J, Grimandi I, Spadoni C, Angotti M, Pignataro V, Sacrato L, Franzoni E, Parmeggiani A. Phonic and Motor Stereotypies in Autism Spectrum Disorder: Video Analysis and Neurological Characterization. Brain Sci 2021; 11:brainsci11040431. [PMID: 33800677 PMCID: PMC8066337 DOI: 10.3390/brainsci11040431] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Stereotypies are among the core symptoms of Autism spectrum disorder (ASD) and can cause significant clinical impairment. At present, phonic stereotypies in ASD have been scarcely explored. This study investigates the frequency, variability, and typologies of phonic and motor stereotypies in children with ASD and their association with clinical neurological variables. We examined 35 patients by recording standardized video sessions and administering the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Phonic stereotypies were present in 83.0% of the patients. The most prevalent subtypes were noncommunicative vocalizations (60.0%), single syllables (37.1%), and echolalic stereotypies (22.9%). Noncommunicative vocalizations were more frequent in nonverbal patients (OR = 4.629, p = 0.008), while echolalic stereotypies were more represented in verbal patients (OR = 0.279, p = 0.028). Patients with intellectual disability (ID) showed a higher number (F(1,26) = 9.406, p = 0.005) and variability (F(1,25) = 7.174, p = 0.013) of motor stereotypies, with a higher number (F(1,26) = 13.268, p = 0.005) and variability (F(1,26) = 9.490, p = 0.005) of stereotypies involving the head/trunk/shoulders category. Patients with guttural stereotypies showed a higher variability of total motor stereotypies (OR = 1.487, p = 0.032) and self-directed motor stereotypies (OR = 4.389, p = 0.042). These results, combined with a standardized video-analysis, document the frequency and variability of phonic stereotypies among children with ASD. Correlations between specific phonic stereotypies and verbal abilities should be investigated further.
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Affiliation(s)
- Evamaria Lanzarini
- Child Neurology and Psychiatry Unit, Infermi Hospital, AUSL Romagna, 47923 Rimini, Italy;
| | - Jacopo Pruccoli
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Irene Grimandi
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Chiara Spadoni
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Marida Angotti
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Veronica Pignataro
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Leonardo Sacrato
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Emilio Franzoni
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Antonia Parmeggiani
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-214-4013
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21
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Brandsma R, van Egmond ME, Tijssen MAJ. Diagnostic approach to paediatric movement disorders: a clinical practice guide. Dev Med Child Neurol 2021; 63:252-258. [PMID: 33150968 PMCID: PMC7894329 DOI: 10.1111/dmcn.14721] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 12/15/2022]
Abstract
Paediatric movement disorders (PMDs) comprise a large group of disorders (tics, myoclonus, tremor, dystonia, chorea, Parkinsonism, ataxia), often with mixed phenotypes. Determination of the underlying aetiology can be difficult given the broad differential diagnosis and the complexity of the genotype-phenotype relationships. This can make the diagnostic process time-consuming and difficult. In this overview, we present a diagnostic approach for PMDs, with emphasis on genetic causes. This approach can serve as a framework to lead the clinician through the diagnostic process in eight consecutive steps, including recognition of the different movement disorders, identification of a clinical syndrome, consideration of acquired causes, genetic testing including next-generation sequencing, post-sequencing phenotyping, and interpretation of test results. The aim of this approach is to increase the recognition and diagnostic yield in PMDs. WHAT THIS PAPER ADDS: An up-to-date description and diagnostic framework for testing of paediatric movement disorders is presented. The framework helps to determine which patients will benefit from next-generation sequencing.
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Affiliation(s)
- Rick Brandsma
- Department of Pediatric NeurologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Martje E van Egmond
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Marina A J Tijssen
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
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22
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McGovern E, Pringsheim T, Medina A, Cosentino C, Shalash A, Sardar Z, Fung VSC, Kurian MA, Roze E. Transitional Care for Young People with Neurological Disorders: A Scoping Review with A Focus on Patients with Movement Disorders. Mov Disord 2020; 36:1316-1324. [PMID: 33200525 DOI: 10.1002/mds.28381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood-onset movement disorders represent a heterogenous group of conditions. Given the complexity of these disorders, the transition of care from pediatric to adult medicine is an important consideration. We performed a scoping review of the literature on transitional care in chronic neurological disease, exploring key transitional issues and proposed transitional care models. Our aim was to describe the current knowledge and gaps about the transition process of young adults with chronic neurological disorders, paying special attention to childhood onset movement disorders. A total of 64 articles were included in the qualitative synthesis; 56 articles reported on transitional care issues, and 8 articles reported on transitional care models. Only 2 articles included patients with movement disorders. The following 4 main transitional issues were identified following synthesis of the available literature: (1) inadequate preparation for the transition process, (2) inappropriate and inconsistent transition practices, (3) inadequate adult services, and (4) heightened emotional response surrounding transition. Of the reported transitional care models, multidisciplinary ambulatory care was the most common approach. In studies evaluating patient-related outcomes, positive health, educational, and vocational outcomes were found. The available literature provides insights on issues that can arise during transition that should be addressed to improve patient and caregiver comfort and satisfaction with care. Further research is needed to evaluate how transitional care programs affect outcomes and their cost effectiveness. More studies are required to determine the needs and outcomes specific to patients with childhood onset movement disorders. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Eavan McGovern
- Dublin Neurological Institute, Mater University Hospital, Dublin, Ireland
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Alex Medina
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Zomer Sardar
- Department of Neurology, Mayo Hospital, Lahore, Pakistan
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital & Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Emmanuel Roze
- Department of Neurology, Salpêtrière Hospital, Sorbonne University and Assistance Publique - Hôpitaux de Paris, Paris, France
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23
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Pandey S, Shukla T, Mishra A. The Spectrum of Repetitive Behaviors Associated With Subacute Sclerosing Panencephalitis. Mov Disord 2020; 36:497-503. [PMID: 32986918 DOI: 10.1002/mds.28323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/30/2020] [Accepted: 09/03/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Repetitive behaviors refer to a broad class of responses ranging from stereotypic body movements to impulsive/compulsive behaviors. They may be associated with neurological disorders. METHODS This is a case series of six subacute sclerosing panencephalitis (SSPE) patients who presented with a wide spectrum of repetitive motor behaviors and vocalizations. RESULTS Repetitive motor behaviors involved the upper limbs in all patients and lower limbs in 3 patients. The repetitive movements in the upper limbs were clapping, finger-clicking, hand rubbing, flailing, and dystonic posturing. In the lower limbs, the repetitive movements were rubbing with the heel, pelvic thrusting with flexion extension of the leg, and foot tapping. The spectrum of vocalizations included palilalia, whistling, grunting with spitting, and pathological crying. Repetitive behaviors were the presenting features in 2 patients. CONCLUSIONS This case series expands the spectrum of repetitive behaviors seen in neurological disorders associated with brain infections. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sanjay Pandey
- Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, India
| | - Tanvi Shukla
- Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, India
| | - Anumeha Mishra
- Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, India
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24
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Ubhi M, Achinivu K, Seri S, Cavanna AE. Motor stereotypies in adult patients with Tourette syndrome. FUTURE NEUROLOGY 2020. [DOI: 10.2217/fnl-2019-0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Aim: Correctly diagnosing repetitive behaviors in patients with Tourette syndrome (TS) can be challenging. The differential diagnosis between tics and stereotypies is of particular importance, because of treatment implications. Methods: We assessed the prevalence and clinical characteristics of stereotypies in a large sample of adult patients with TS attending a specialist clinic. Results: Mild stereotypies were reported by 21/148 patients (14.2%). Patients with stereotypies were significantly more likely to have a comorbid diagnosis of Asperger syndrome, attention-deficit and hyperactivity disorder, and obsessive-compulsive disorder, compared with patients without stereotypies. Multiple linear regression analysis revealed that the presence of Asperger syndrome significantly predicted stereotypy severity. Conclusion: Stereotypies are not rare in adults with TS and other neurodevelopmental conditions, especially Asperger syndrome.
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Affiliation(s)
- Maneeka Ubhi
- Michael Trimble Neuropsychiatry Research Group, University of Birmingham & BSMHFT, Birmingham, UK
| | - Kanu Achinivu
- Michael Trimble Neuropsychiatry Research Group, University of Birmingham & BSMHFT, Birmingham, UK
| | - Stefano Seri
- School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Andrea E Cavanna
- Michael Trimble Neuropsychiatry Research Group, University of Birmingham & BSMHFT, Birmingham, UK
- School of Life & Health Sciences, Aston University, Birmingham, UK
- Sobell Department of Motor Neuroscience & Movement Disorders, Institute of Neurology & University College London, UK
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25
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Rhythmic rocking stereotypies in frontal lobe seizures: A quantified video study. Neurophysiol Clin 2020; 50:75-80. [DOI: 10.1016/j.neucli.2020.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/15/2020] [Accepted: 02/15/2020] [Indexed: 11/23/2022] Open
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26
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Abstract
Researchers from the Rett Syndrome Natural History Study (RNHS) present longitudinal data across the United States of America aimed to characterize hand stereotypies (HS) in this large cohort of patients with Rett syndrome.
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Affiliation(s)
- Matheus G Ferreira
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
| | - Hélio A G Teive
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
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27
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Mainka T, Balint B, Gövert F, Kurvits L, van Riesen C, Kühn AA, Tijssen MAJ, Lees AJ, Müller-Vahl K, Bhatia KP, Ganos C. The spectrum of involuntary vocalizations in humans: A video atlas. Mov Disord 2019; 34:1774-1791. [PMID: 31651053 DOI: 10.1002/mds.27855] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/22/2019] [Accepted: 08/21/2019] [Indexed: 12/11/2022] Open
Abstract
In clinical practice, involuntary vocalizing behaviors are typically associated with Tourette syndrome and other tic disorders. However, they may also be encountered throughout the entire tenor of neuropsychiatry, movement disorders, and neurodevelopmental syndromes. Importantly, involuntary vocalizing behaviors may often constitute a predominant clinical sign, and, therefore, their early recognition and appropriate classification are necessary to guide diagnosis and treatment. Clinical literature and video-documented cases on the topic are surprisingly scarce. Here, we pooled data from 5 expert centers of movement disorders, with instructive video material to cover the entire range of involuntary vocalizations in humans. Medical literature was also reviewed to document the range of possible etiologies associated with the different types of vocalizing behaviors and to explore treatment options. We propose a phenomenological classification of involuntary vocalizations within different categorical domains, including (1) tics and tic-like vocalizations, (2) vocalizations as part of stereotypies, (3) vocalizations as part of dystonia or chorea, (4) continuous vocalizing behaviors such as groaning or grunting, (5) pathological laughter and crying, (6) vocalizations resembling physiological reflexes, and (7) other vocalizations, for example, those associated with exaggerated startle responses, as part of epilepsy and sleep-related phenomena. We provide comprehensive lists of their associated etiologies, including neurodevelopmental, neurodegenerative, neuroimmunological, and structural causes and clinical clues. We then expand on the pathophysiology of the different vocalizing behaviors and comment on available treatment options. Finally, we present an algorithmic approach that covers the wide range of involuntary vocalizations in humans, with the ultimate goal of improving diagnostic accuracy and guiding appropriate treatment. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tina Mainka
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Gövert
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Lille Kurvits
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Christoph van Riesen
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.,Department of Neurology, University Medicine Göttingen, Göttingen, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Marina A J Tijssen
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, UK
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Christos Ganos
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
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28
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Skármeta NP, Hormazabal Navarrete F. Questions on the clinical applicability on the international consensus on the assessment of bruxism. J Oral Rehabil 2019; 47:255-257. [PMID: 31562643 DOI: 10.1111/joor.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/20/2019] [Accepted: 09/11/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Nicolás Patricio Skármeta
- Faculty of Health Sciences, School of Dental Medicine, Orofacial Pain and Dental Occlusion, Universidad San Sebastián, Santiago, Chile.,Orofacial Pain and TMD, Hospital del Salvador, SMMO, Santiago, Chile.,Orofacial Pain and TMD, OPHdental, Santiago, Chile
| | - Fernando Hormazabal Navarrete
- School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile.,Orofacial Pain, Pain Unit, Hospital Clínico Mutual de Seguridad de la Cámara Chilena de la Construcción, Santiago, Chile
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Melo C, Ruano L, Jorge J, Pinto Ribeiro T, Oliveira G, Azevedo L, Temudo T. Prevalence and determinants of motor stereotypies in autism spectrum disorder: A systematic review and meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:569-590. [PMID: 31552746 DOI: 10.1177/1362361319869118] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Stereotypies are frequently reported in people with autism spectrum disorder (ASD) but remain one of the less explained phenomena. We aimed to describe, through a systematic review and a meta-analysis, the prevalence of motor stereotypies in ASD and study the factors that influence this prevalence. Our literature search included MEDLINE, Scopus, and PsycINFO databases. Quality and risk of bias were assessed. Thirty-seven studies were included and the median prevalence of motor stereotypies in ASD was 51.8%, ranging from 21.9% to 97.5%. The most frequent determinants associated with a higher number of stereotypies in ASD were a younger age, lower intelligence quotient, and a greater severity of ASD. Moreover, gender did not seem to influence the prevalence of stereotypies. Meta-analytic analysis showed that lower IQ and autism diagnosis (independent of IQ) are associated with a higher prevalence of motor stereotypies (odds ratio = 2.5 and 4.7, respectively). Limitations of the reviewed literature include the use of convenience samples, with small sizes and heterogeneous inclusion criteria, and the predominance of high-functioning autism individuals.
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Affiliation(s)
- Cláudia Melo
- Pediatric Department, Centro Hospitalar Universitário São João, Porto, Portugal.,Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Luís Ruano
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Joana Jorge
- Child Psychiatry Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - Guiomar Oliveira
- Autism Unit from Child Developmental Center and Centro de Investigação e Formação Clinica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Luís Azevedo
- Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Teresa Temudo
- Pediatric Neurology Department, Centro Materno-Infantil, Centro Hospitalar do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
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Mostile G, Barone R, Nicoletti A, Rizzo R, Martinelli D, Sturiale L, Fiumara A, Jankovic J, Zappia M. Hyperkinetic movement disorders in congenital disorders of glycosylation. Eur J Neurol 2019; 26:1226-1234. [PMID: 31132195 DOI: 10.1111/ene.14007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/14/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Congenital disorders of glycosylation (CDG) represent an increasing number of rare inherited metabolic diseases associated with abnormal glycan metabolism and disease onset in infancy or early childhood. Most CDG are multisystemic diseases mainly affecting the central nervous system. The aim of the current study was to investigate hyperkinetic movement disorders in patients affected by CDG and to characterize phenomenology based on CDG subtypes. METHODS Subjects were identified from a cohort of patients with CDG who were referred to the University Hospital of Catania, Italy. Patients were evaluated by neurologists with expertise in movement disorders and videotaped using a standardized protocol. RESULTS A variety of hyperkinetic movement disorders was detected in eight unrelated CDG patients. Involuntary movements were generally observed early in childhood, maintaining a clinical stability over time. Distribution ranged from a generalized, especially in younger subjects, to a segmental/multifocal involvement. In patients with phosphomannomutase 2 CDG, the principal movement disorders included dystonia and choreo-athetosis. In patients affected by other CDG types, the movement disorders ranged from pure generalized chorea to mixed movement disorders including dystonia and complex stereotypies. CONCLUSIONS Hyperkinetic movement disorder is a key clinical feature in patients with CDG. CDG should be considered in the differential diagnosis of childhood-onset dyskinesia, especially when associated with ataxia, developmental delay, intellectual disability, autism or seizure disorder.
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Affiliation(s)
- G Mostile
- Neurology Clinic, Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - R Barone
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Regional Referral Center for Inborn Errors Metabolism, Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Institute for Polymers Composites and Biomaterials, CNR, Catania, Italy
| | - A Nicoletti
- Neurology Clinic, Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - R Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - D Martinelli
- Division of Metabolism, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Sturiale
- Institute for Polymers Composites and Biomaterials, CNR, Catania, Italy
| | - A Fiumara
- Regional Referral Center for Inborn Errors Metabolism, Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - J Jankovic
- Parkinson's Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - M Zappia
- Neurology Clinic, Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
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Pandey S, Shukla T. Stereotypy in Neuroleptic Malignant Syndrome. Mov Disord Clin Pract 2019; 6:411-412. [PMID: 33999971 DOI: 10.1002/mdc3.12770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/28/2019] [Accepted: 04/01/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sanjay Pandey
- Department of Neurology Govind Ballabh Pant Postgraduate Institute of Medical Education and Research New Delhi India
| | - Tanvi Shukla
- Department of Neurology Govind Ballabh Pant Postgraduate Institute of Medical Education and Research New Delhi India
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Movement disorders phenomenology in focal motor seizures. Parkinsonism Relat Disord 2019; 61:161-165. [DOI: 10.1016/j.parkreldis.2018.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/30/2018] [Accepted: 10/15/2018] [Indexed: 11/20/2022]
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Developmental Motor Profile in Preschool Children with Primary Stereotypic Movement Disorder. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1427294. [PMID: 30895189 PMCID: PMC6393901 DOI: 10.1155/2019/1427294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/15/2019] [Accepted: 01/31/2019] [Indexed: 11/17/2022]
Abstract
Aim Different neuropsychological dysfunctions have been described in children with primary Stereotypic Movement Disorder (SMD), mainly attention or motor coordination problems. Up to now with no study has evaluated psychomotor functions in preschoolers primary SMD. The aim of this observational study was to gather information on the motor profiles of SMD patients in this age range in comparison with typically developing children. Patients and Methods Twenty-six children (four girls) aged 36 to 76 months (mean= 53 ±10) with primary SMD were assessed by a structured evaluation including the Movement Assessment Battery for Children-Second Edition (MABC-2), the Beery-Buktenica Developmental test of Visual-Motor Integration (VMI), the Repetitive Behaviour Scale-Revised (RBS-R), the Motor Severity Stereotypy Scale (MSSS), and the Child Behaviour Checklist (CBCL). The diagnoses of Intellectual Disability or Autism Spectrum Disorder were exclusion criteria from the study. A comparison group of twenty-seven (four girls) typically developing children without stereotypies aged 36 to 59 months (mean= 48 ±7) was also examined. Results The MABC-2 total score was lower than 15th percentile in fifteen children with SMD (58%); the worst performances were observed in Balance and Manual Dexterity subtests. The motor coordination score of VMI was lower than 15th percentile in ten children (38%). The majority of the children with low scores at MABC-2 also had low scores at the motor coordination subscale of VMI. MABC-2 standard scores of the clinical group were significantly lower than those of controls on MABC-2 Total, Balance, and Ball Skills subtests. Conclusion The finding of widespread dysfunction of gross and fine motor abilities in preschoolers with primary SMD seems to delineate a peculiar phenotype and could provide new approaches to the management of this neurodevelopment disorder.
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Bhatti A, Jain N, Desai K, Ravat SH, Agarwal PA. "Finger-Flapping" Hand Stereotypy as a Presenting Feature of Wilson's Disease. Mov Disord Clin Pract 2019; 6:74-76. [PMID: 30746420 DOI: 10.1002/mdc3.12686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Amit Bhatti
- Department of Neurology Seth GS Medical College and King Edward Memorial (KEM) Hospital Mumbai India
| | - Neeraj Jain
- Department of Neurology Seth GS Medical College and King Edward Memorial (KEM) Hospital Mumbai India
| | - Karan Desai
- Department of Neurology Seth GS Medical College and King Edward Memorial (KEM) Hospital Mumbai India
| | - Sangeeta H Ravat
- Department of Neurology Seth GS Medical College and King Edward Memorial (KEM) Hospital Mumbai India.,Department of Neurology Gleneagles Global Hospitals Mumbai India
| | - Pankaj A Agarwal
- Department of Neurology Seth GS Medical College and King Edward Memorial (KEM) Hospital Mumbai India.,Department of Neurology Gleneagles Global Hospitals Mumbai India
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Tics and stereotypies: A comparative clinical review. Parkinsonism Relat Disord 2019; 59:117-124. [DOI: 10.1016/j.parkreldis.2019.02.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/28/2018] [Accepted: 02/03/2019] [Indexed: 01/07/2023]
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Abstract
SUMMARYTardive dyskinesia is a common iatrogenic neurological and neurobehavioural syndrome associated with the use of antidopaminergic medication, especially antipsychotics. Prior to the introduction of the newer antipsychotics in the 1990s, it was one of the major areas of psychiatric research but interest waned as the new drugs were reputed to have a reduced liability to extrapyramidal adverse effects in general, a claim now discredited by numerous pragmatic research studies. Early small-scale short-term prevalence studies were presented as evidence to support the assumption that patients on the newer drugs did indeed have a lower prevalence of tardive dyskinesia but recent large-scale review of studies with patients exposed for longer suggest that things have not changed. This article presents a clinical overview of a complex and varied syndrome in terms of its phenomenology, epidemiology and risk factors; a companion article will consider treatment. This overview aims to highlight tardive dyskinesia once again, especially to practitioners who have trained in an environment where this was considered mainly in historical terms.LEARNING OBJECTIVES•Understand the complex phenomenology comprising the syndrome of tardive dyskinesia•Appreciate recent data on prevalence and incidence with the newer antipsychotics•Be aware of risk factors when recommending antipsychotic (and other antidopaminergic) drugsDECLARATION OF INTERESTNone.
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Prioni S, Redaelli V, Soliveri P, Fetoni V, Barocco F, Caffarra P, Scaglioni A, Tramacere I, Girotti F. Stereotypic behaviours in frontotemporal dementia and progressive supranuclear palsy. Cortex 2018; 109:272-278. [PMID: 30399478 DOI: 10.1016/j.cortex.2018.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 06/04/2018] [Accepted: 09/27/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The behavioural variant of frontotemporal dementia (bvFTD), and the Richardson variant of progressive supranuclear palsy (PSP-RS) share several clinical signs and symptoms. Since stereotypic behaviours are fairly common in bvFTD, and are also described in other degenerative dementias including Alzheimer's disease, and parkinsonisms with dementia, we aimed to examine the extent to which stereotypies also characterise PSP-RS. METHODS We compared 53 bvFTD patients with 40 demented PSP-RS patients, seen consecutively as outpatients at four Italian Hospitals. Patients were assessed by the Neuropsychiatric Inventory (NPI); Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) for cognitive functions; Stereotypy Rating Inventory (SRI) for stereotypies; Unified Parkinson's Disease Rating Scale (UPDRS) for motor function; and Activities of Daily Living (ADL) to assess autonomy in daily life. RESULTS The groups did not differ for age, illness duration, cognitive functions or total NPI score; PSP-RS had significantly more depressive symptoms and greater motor and autonomy compromise than bvFTD. The groups did not differ significantly on total SRI score, but bvFTD had significantly more cooking and eating stereotypies. Twenty-three (57.5%) PSP-RS and 43 (81%) bvFTD patients had at least one stereotypy; 16/23 (69.5%) PSP-RS and 9/43 (20.9%) bvFTD patients appeared aware of their stereotypies. CONCLUSION Stereotypies were common in our demented PSP-RS patients. Further studies on earlier stage non-demented PSP patients are required to ascertain whether stereotypies are characteristic of PSP in general or are confined to PSP-RS, and whether they may be used to suggest a PSP diagnosis early in disease course.
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Affiliation(s)
- Sara Prioni
- Neurology Department, C. Besta Neurological Institute and Foundation (IRCCS), Milano, Italy
| | - Veronica Redaelli
- Neurology Department, C. Besta Neurological Institute and Foundation (IRCCS), Milano, Italy
| | - Paola Soliveri
- Neurology Department, C. Besta Neurological Institute and Foundation (IRCCS), Milano, Italy
| | | | | | | | | | - Irene Tramacere
- Research and Clinical Development Department, C. Besta Neurological Institute and Foundation (IRCCS), Milano, Italy
| | - Floriano Girotti
- Neurology Department, C. Besta Neurological Institute and Foundation (IRCCS), Milano, Italy.
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Overdijk MJ, de Bie RM, Berendse HW, van Rootselaar AF. An Unusual Dystonic Manifestation in Wilson's Disease. Mov Disord Clin Pract 2018; 5:546-547. [DOI: 10.1002/mdc3.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/29/2018] [Accepted: 05/07/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- M. Joleine Overdijk
- Department of Neurology/Clinical Neurophysiology; IJsselland Hospital; Capelle aan den IJssel Netherlands
- Department of Neurology/Clinical Neurophysiology; Academic Medical Center; Amsterdam Netherlands
| | - Rob M.A. de Bie
- Department of Neurology/Clinical Neurophysiology; Academic Medical Center; Amsterdam Netherlands
| | - Henk W. Berendse
- Department of Neurology; VU University Medical Center; Amsterdam Netherlands
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Lotia M, York MK, Strutt AM, Jankovic J. Leg stereotypy syndrome: phenomenology and prevalence. J Neurol Neurosurg Psychiatry 2018; 89:692-695. [PMID: 29332008 DOI: 10.1136/jnnp-2017-317057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/30/2017] [Accepted: 12/20/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To describe the phenomenology and prevalence of leg stereotypy syndrome (LSS), characterised chiefly by repetitive, rhythmical, stereotypic leg movement, especially when sitting. METHODS We sought to characterise LSS in two groups of subjects: (1) general population (GP) group, defined as individuals accompanying patients during their visits to Baylor College of Medicine Parkinson's Disease Center and Movement Disorders Clinic who are not genetically related to the patients; and (2) movement disorders (MD) group, composed of consecutive patients with diagnoses of restless legs syndrome, Parkinson's disease, Tourette syndrome and tardive dyskinesia. RESULTS There were 92 participants enrolled in this study; 7% of 57 individuals in the GP group and 17% of those in the MD group met the diagnostic criteria for LSS. The mean age of individuals with LSS was 44.5 (±11.9) years and mean age at onset of LSS was 17.5 (±5.7) years. In half of the individuals, the 'shaking' involved predominantly one leg. All had a positive family history of similar disorder and none had diurnal variation. The seven-item Leg Stereotypy Syndrome Questionnaire was developed as a screening tool to aid in differentiating LSS from other movement disorders. CONCLUSIONS LSS is a common condition, occurring in up to 7% of otherwise healthy individuals, and it is even more common in patients with hyperkinetic movement disorders. Although it phenomenologically may overlap with other stereotypic disorders, we argue that it is a distinct, familial, neurological syndrome.
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Affiliation(s)
- Mitesh Lotia
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
| | - Michele K York
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
| | - Adriana M Strutt
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
| | - Joseph Jankovic
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
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Abstract
The Gilles de la Tourette syndrome (or Tourette’s syndrome) has a prevalence of 1% of children with a wide range of severity and associated comorbidities. The last 20 years have seen advances in the understanding of the syndrome’s complex genetics and underlying neurobiology. Investigation with imaging and neurophysiology techniques indicate it is a neurodevelopmental condition with dysfunction of basal ganglia–cortical interactions, which are now also being studied in animal models. There is also increasing evidence for treatments although it often remains difficult to manage. First-line options include neuroleptics, other drugs and specialised behavioural treatments. Deep brain stimulation is an evolving field, not yet fully established. This review focuses on the phenomenology of tics, how to assess and manage the syndrome, and uses examples of atypical cases to explore the characteristics and limits of its clinical spectrum.
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Abstract
This review summarizes motor stereotypies in terms of description, prevalence, pathophysiology, diagnosis and management. They are fixed and persistent movements. Stereotypies begin before 3 years of age and continue into adulthood. Primary motor stereotypies occur in children of normal intelligence, whereas secondary stereotypies ensue in the setting of an additional diagnosis such as autism spectrum disorder or other neurologic disorders. They are highly associated with comorbidities such as anxiety, obsessive-compulsive symptoms, inattention, and tics. The pathophysiology of stereotypies involves fronto-striatal overactive dopaminergic pathways, and underactive cholinergic and GABAergic inhibitory pathways. No genetic markers have been identified despite a clear genetic predisposition. Behavioral therapy is the principle treatment. Future studies will focus on identifying genetic markers, and on better understanding the functional and structural neurobiology of these movements.
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42
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Functional (psychogenic) stereotypies. J Neurol 2017; 264:1482-1487. [DOI: 10.1007/s00415-017-8551-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/17/2017] [Accepted: 06/18/2017] [Indexed: 12/18/2022]
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Budimirovic DB, Berry-Kravis E, Erickson CA, Hall SS, Hessl D, Reiss AL, King MK, Abbeduto L, Kaufmann WE. Updated report on tools to measure outcomes of clinical trials in fragile X syndrome. J Neurodev Disord 2017; 9:14. [PMID: 28616097 PMCID: PMC5467057 DOI: 10.1186/s11689-017-9193-x] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 02/22/2017] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Fragile X syndrome (FXS) has been the neurodevelopmental disorder with the most active translation of preclinical breakthroughs into clinical trials. This process has led to a critical assessment of outcome measures, which resulted in a comprehensive review published in 2013. Nevertheless, the disappointing outcome of several recent phase III drug trials in FXS, and parallel efforts at evaluating behavioral endpoints for trials in autism spectrum disorder (ASD), has emphasized the need for re-assessing outcome measures and revising recommendations for FXS. METHODS After performing an extensive database search (PubMed, Food and Drug Administration (FDA)/National Institutes of Health (NIH)'s www.ClinicalTrials.gov, etc.) to determine progress since 2013, members of the Working Groups who published the 2013 Report evaluated the available outcome measures for FXS and related neurodevelopmental disorders using the COSMIN grading system of levels of evidence. The latter has also been applied to a British survey of endpoints for ASD. In addition, we also generated an informal classification of outcome measures for use in FXS intervention studies as instruments appropriate to detect shorter- or longer-term changes. RESULTS To date, a total of 22 double-blind controlled clinical trials in FXS have been identified through www.ClinicalTrials.gov and an extensive literature search. The vast majority of these FDA/NIH-registered clinical trials has been completed between 2008 and 2015 and has targeted the core excitatory/inhibitory imbalance present in FXS and other neurodevelopmental disorders. Limited data exist on reliability and validity for most tools used to measure cognitive, behavioral, and other problems in FXS in these trials and other studies. Overall, evidence for most tools supports a moderate tool quality grading. Data on sensitivity to treatment, currently under evaluation, could improve ratings for some cognitive and behavioral tools. Some progress has also been made at identifying promising biomarkers, mainly on blood-based and neurophysiological measures. CONCLUSION Despite the tangible progress in implementing clinical trials in FXS, the increasing data on measurement properties of endpoints, and the ongoing process of new tool development, the vast majority of outcome measures are at the moderate quality level with limited information on reliability, validity, and sensitivity to treatment. This situation is not unique to FXS, since reviews of endpoints for ASD have arrived at similar conclusions. These findings, in conjunction with the predominance of parent-based measures particularly in the behavioral domain, indicate that endpoint development in FXS needs to continue with an emphasis on more objective measures (observational, direct testing, biomarkers) that reflect meaningful improvements in quality of life. A major continuous challenge is the development of measurement tools concurrently with testing drug safety and efficacy in clinical trials.
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Affiliation(s)
- Dejan B. Budimirovic
- Departments of Psychiatry and Behavioral Sciences, Kennedy Krieger Institute and Child Psychiatry, Johns Hopkins University School of Medicine, 716 N. Broadway, Baltimore, MD 21205 USA
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences, Biochemistry, Rush University Medical Center, 1725 West Harrison, Suite 718, Chicago, IL 60612 USA
| | - Craig A. Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA
| | - Scott S. Hall
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - David Hessl
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Allan L. Reiss
- Division of Interdisciplinary Brain Sciences, Departments of Psychiatry and Behavioral Sciences, Radiology and Pediatrics, Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - Margaret K. King
- Autism & Developmental Medicine Institute, Geisinger Health System, Present address: Novartis Pharmaceuticals Corporation, US Medical, One Health Plaza, East Hanover, NJ 07936 USA
| | - Leonard Abbeduto
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Walter E. Kaufmann
- Center for Translational Research, Greenwood Genetic Center, 113 Gregor Mendel Circle, Greenwood, SC 29646 USA
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115 USA
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Affiliation(s)
- Tammy Hedderly
- Evelina London Children's Healthcare - Paediatric Neurosciences, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College Hospital, London, UK
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45
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Maltête D. Adult-onset stereotypical motor behaviors. Rev Neurol (Paris) 2016; 172:477-482. [PMID: 27498241 DOI: 10.1016/j.neurol.2016.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/18/2016] [Accepted: 07/07/2016] [Indexed: 11/16/2022]
Abstract
Stereotypies have been defined as non-goal-directed movement patterns repeated continuously for a period of time in the same form and on multiple occasions, and which are typically distractible. Stereotypical motor behaviors are a common clinical feature of a variety of neurological conditions that affect cortical and subcortical functions, including autism, tardive dyskinesia, excessive dopaminergic treatment of Parkinson's disease and frontotemporal dementia. The main differential diagnosis of stereotypies includes tic disorders, motor mannerisms, compulsion and habit. The pathophysiology of stereotypies may involve the corticostriatal pathways, especially the orbitofrontal and anterior cingulated cortices. Because antipsychotics have long been used to manage stereotypical behaviours in mental retardation, stereotypies that present in isolation tend not to warrant pharmacological intervention, as the benefit-to-risk ratio is not great enough.
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Affiliation(s)
- D Maltête
- Department of Neurology, Rouen University Hospital, University of Rouen, 1, rue de Germont, 76031 cedex Rouen, France; Inserm U 1073, 22, boulevard Gambetta, 76183 Rouen cedex, France.
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Forceful Backbending Stereotypies Revealing MEF2C Haploinsufficiency. Pediatr Neurol 2016; 60:90-1. [PMID: 27212417 DOI: 10.1016/j.pediatrneurol.2016.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/15/2016] [Accepted: 03/15/2016] [Indexed: 11/20/2022]
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Choi SM. Movement Disorders Following Cerebrovascular Lesions in Cerebellar Circuits. J Mov Disord 2016; 9:80-8. [PMID: 27240809 PMCID: PMC4886204 DOI: 10.14802/jmd.16004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/04/2016] [Accepted: 03/30/2016] [Indexed: 12/29/2022] Open
Abstract
Cerebellar circuitry is important to controlling and modifying motor activity. It conducts the coordination and correction of errors in muscle contractions during active movements. Therefore, cerebrovascular lesions of the cerebellum or its pathways can cause diverse movement disorders, such as action tremor, Holmes’ tremor, palatal tremor, asterixis, and dystonia. The pathophysiology of abnormal movements after stroke remains poorly understood. However, due to the current advances in functional neuroimaging, it has recently been described as changes in functional brain networks. This review describes the clinical features and pathophysiological mechanisms in different types of movement disorders following cerebrovascular lesions in the cerebellar circuits.
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Affiliation(s)
- Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
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Antelmi E, Plazzi G, Erro R, Tinuper P, Balint B, Liguori R, Bhatia KP. Intermittent head drops: the differential spectrum. J Neurol Neurosurg Psychiatry 2016; 87:414-9. [PMID: 26085650 DOI: 10.1136/jnnp-2015-310864] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 05/27/2015] [Indexed: 01/18/2023]
Abstract
Intermittent Head Drops are episodic head flexion movements that can occur in a number of conditions. Typically, the term has mainly been related to epileptic episodes, but the spectrum of clinical conditions associated with this feature is wide-ranging even if never discussed in detail. By searching the electronic database, we may find that apart from the epileptic conditions, Intermittent Head Drops have been in fact reported in the setting of movement disorders, sleep disorders and even internal medicine disorders, such as Sandifer syndrome. We render an in-depth description of this characteristic phenomenon in different diseases, describing the clinical clues and neurophysiological patterns that may help the clinician to distinguish between the different settings of occurrence.
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Affiliation(s)
- Elena Antelmi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, UK
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, UK
| | - Paolo Tinuper
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Bettina Balint
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, UK
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, UK
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Abstract
Frontotemporal dementia (FTD) refers to a group of clinically and genetically heterogeneous neurodegenerative disorders that are a common cause of adult-onset behavioural and cognitive impairment. FTD often presents in combination with various hyperkinetic or hypokinetic movement disorders, and evidence suggests that various genetic mutations underlie these different presentations. Here, we review the known syndromatic-genetic correlations in FTD. Although no direct genotype-phenotype correlations have been identified, mutations in multiple genes have been associated with various presentations. Mutations in the genes that encode microtubule-associated protein tau (MAPT) and progranulin (PGRN) can manifest as symmetrical parkinsonism, including the phenotypes of Richardson syndrome and corticobasal syndrome (CBS). Expansions in the C9orf72 gene are most frequently associated with familial FTD, typically combined with motor neuron disease, but other manifestations, such as symmetrical parkinsonism, CBS and multiple system atrophy-like presentations, have been described in patients with these mutations. Less common gene mutations, such as those in TARDBP, CHMP2B, VCP, FUS and TREM2, can also present as atypical parkinsonism. The most common hyperkinetic movement disorders in FTD are motor and vocal stereotypies, which have been observed in up to 78% of patients with autopsy-proven FTD. Other hyperkinetic movements, such as chorea, orofacial dyskinesias, myoclonus and dystonia, are also observed in some patients with FTD.
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