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Gao Z, Lv S, Ran X, Wang Y, Xia M, Wang J, Qiu M, Wei Y, Shao Z, Zhao Z, Zhang Y, Zhou X, Yu Y. Influencing factors of corticomuscular coherence in stroke patients. Front Hum Neurosci 2024; 18:1354332. [PMID: 38562230 PMCID: PMC10982423 DOI: 10.3389/fnhum.2024.1354332] [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] [Received: 12/12/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Stroke, also known as cerebrovascular accident, is an acute cerebrovascular disease with a high incidence, disability rate, and mortality. It can disrupt the interaction between the cerebral cortex and external muscles. Corticomuscular coherence (CMC) is a common and useful method for studying how the cerebral cortex controls muscle activity. CMC can expose functional connections between the cortex and muscle, reflecting the information flow in the motor system. Afferent feedback related to CMC can reveal these functional connections. This paper aims to investigate the factors influencing CMC in stroke patients and provide a comprehensive summary and analysis of the current research in this area. This paper begins by discussing the impact of stroke and the significance of CMC in stroke patients. It then proceeds to elaborate on the mechanism of CMC and its defining formula. Next, the impacts of various factors on CMC in stroke patients were discussed individually. Lastly, this paper addresses current challenges and future prospects for CMC.
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Affiliation(s)
- Zhixian Gao
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Shiyang Lv
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Xiangying Ran
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Yuxi Wang
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Mengsheng Xia
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Junming Wang
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Mengyue Qiu
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Yinping Wei
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Zhenpeng Shao
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Zongya Zhao
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Yehong Zhang
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
| | - Xuezhi Zhou
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
| | - Yi Yu
- School of Medical Engineering, Xinxiang Medical University, Xinxiang, China
- Engineering Technology Research Center of Neurosense and Control of Henan Province, Xinxiang, China
- Henan International Joint Laboratory of Neural Information Analysis and Drug Intelligent Design, Xinxiang, China
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Mitoma H, Kakei S, Tanaka H, Manto M. Morphological and Functional Principles Governing the Plasticity Reserve in the Cerebellum: The Cortico-Deep Cerebellar Nuclei Loop Model. BIOLOGY 2023; 12:1435. [PMID: 37998034 PMCID: PMC10669841 DOI: 10.3390/biology12111435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
Cerebellar reserve compensates for and restores functions lost through cerebellar damage. This is a fundamental property of cerebellar circuitry. Clinical studies suggest (1) the involvement of synaptic plasticity in the cerebellar cortex for functional compensation and restoration, and (2) that the integrity of the cerebellar reserve requires the survival and functioning of cerebellar nuclei. On the other hand, recent physiological studies have shown that the internal forward model, embedded within the cerebellum, controls motor accuracy in a predictive fashion, and that maintaining predictive control to achieve accurate motion ultimately promotes learning and compensatory processes. Furthermore, within the proposed framework of the Kalman filter, the current status is transformed into a predictive state in the cerebellar cortex (prediction step), whereas the predictive state and sensory feedback from the periphery are integrated into a filtered state at the cerebellar nuclei (filtering step). Based on the abovementioned clinical and physiological studies, we propose that the cerebellar reserve consists of two elementary mechanisms which are critical for cerebellar functions: the first is involved in updating predictions in the residual or affected cerebellar cortex, while the second acts by adjusting its updated forecasts with the current status in the cerebellar nuclei. Cerebellar cortical lesions would impair predictive behavior, whereas cerebellar nuclear lesions would impact on adjustments of neuronal commands. We postulate that the multiple forms of distributed plasticity at the cerebellar cortex and cerebellar nuclei are the neuronal events which allow the cerebellar reserve to operate in vivo. This cortico-deep cerebellar nuclei loop model attributes two complementary functions as the underpinnings behind cerebellar reserve.
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Affiliation(s)
- Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Shinji Kakei
- Department of Anatomy and Physiology, Jissen Women’s University, Tokyo 191-8510, Japan;
| | - Hirokazu Tanaka
- Faculty of Information Technology, Tokyo City University, Tokyo 158-8557, Japan;
| | - Mario Manto
- Cerebellar Ataxias Unit, Department of Neurology, Médiathèque Jean Jacquy, CHU-Charleroi, 6042 Charleroi, Belgium;
- Service des Neurosciences, University of Mons, 7000 Mons, Belgium
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3
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Ogut E, Armagan K, Tufekci D. The Guillain-Mollaret triangle: a key player in motor coordination and control with implications for neurological disorders. Neurosurg Rev 2023; 46:181. [DOI: https:/doi.org/10.1007/s10143-023-02086-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
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Ogut E, Armagan K, Tufekci D. The Guillain-Mollaret triangle: a key player in motor coordination and control with implications for neurological disorders. Neurosurg Rev 2023; 46:181. [PMID: 37468768 DOI: 10.1007/s10143-023-02086-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
The dentato-rubro-olivary pathway, also known as the Guillain-Mollaret triangle (GMT) or myoclonic triangle, consists of the dentate nucleus, the red nucleus, and the inferior olivary nucleus (ION). GMT is important for motor coordination and control, and abnormalities in this network can lead to various neurological disorders. The present study followed a systematic approach in conducting a review on GMT studies. The inclusion criteria were limited to human subjects with primary objectives of characterizing and evaluating GMT syndromes, and the methodology used was not a determining factor for eligibility. The search strategy used MeSH terms and keywords relevant to the study's objective in various databases until August 2022. A total of 76 studies were included in the review after assessing 527 articles for eligibility based on the final inclusion criteria. Most of the studies evaluated the GMT in human subjects, with the majority utilizing magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), or combination of them. The review found that Hypertrophic olivary degeneration (HOD), a common consequence of GMT damage, has diverse underlying causes, including stroke, brainstem cavernous malformations, and structural impairments. Palatal tremor, ocular myoclonus, ataxia, nystagmus, and vertigo were frequently reported symptoms associated with HOD. This systematic review provides comprehensive insights into the association between GMT and various neurological syndromes, shedding light on the diagnostic, etiological, and prognostic aspects of GMT dysfunction. Understanding the role of the GMT and its implications in movement disorders could pave the way for improved treatment options and better management of neurological conditions related to this critical brainstem pathway.
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Affiliation(s)
- Eren Ogut
- Department of Anatomy, Bahçeşehir University Faculty of Medicine, 34734, Istanbul, Turkey.
| | - Kutay Armagan
- Medical Faculty Student, Bahçeşehir University Faculty of Medicine, 34734, Istanbul, Turkey
| | - Doruktan Tufekci
- Medical Faculty Student, Bahçeşehir University Faculty of Medicine, 34734, Istanbul, Turkey
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Lavanya K, Shankar PV, Visvanathan K, Sundar S, Philohazeena P. Deep Brain Stimulation for Holmes Tremors and Literature Review. Ann Indian Acad Neurol 2023; 26:296-299. [PMID: 37538416 PMCID: PMC10394444 DOI: 10.4103/aian.aian_720_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 03/12/2023] [Accepted: 03/31/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Kunkala Lavanya
- Department of Neurology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - P. Vijaya Shankar
- Department of Neurology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - K. Visvanathan
- Department of Neurosurgery, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - S. Sundar
- Department of Neurology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - P. Philohazeena
- Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
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Wu BS, Ge YJ, Zhang W, Chen SD, Xiang ST, Zhang YR, Ou YN, Jiang YC, Tan L, Cheng W, Suckling J, Feng JF, Yu JT, Mao Y. Genome-wide association study of cerebellar white matter microstructure and genetic overlap with common brain disorders. Neuroimage 2023; 269:119928. [PMID: 36740028 DOI: 10.1016/j.neuroimage.2023.119928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The cerebellum is recognized as being involved in neurocognitive and motor functions with communication with extra-cerebellar regions relying on the white matter integrity of the cerebellar peduncles. However, the genetic determinants of cerebellar white matter integrity remain largely unknown. METHODS We conducted a genome-wide association analysis of cerebellar white matter microstructure using diffusion tensor imaging data from 25,415 individuals from UK Biobank. The integrity of cerebellar white matter microstructure was measured as fractional anisotropy (FA) and mean diffusivity (MD). Identification of independent genomic loci, functional annotation, and tissue and cell-type analysis were conducted with FUMA. The linkage disequilibrium score regression (LDSC) was used to calculate genetic correlations between cerebellar white matter microstructure and regional brain volumes and brain-related traits. Furthermore, the conditional/conjunctional false discovery rate (condFDR/conjFDR) framework was employed to identify the shared genetic basis between cerebellar white matter microstructure and common brain disorders. RESULTS We identified 11 genetic loci (P < 8.3 × 10-9) and 86 genes associated with cerebellar white matter microstructure. Further functional enrichment analysis implicated the involvement of GABAergic neurons and cholinergic pathways. Significant polygenetic overlap between cerebellar white matter tracts and their anatomically connected or adjacent brain regions was detected. In addition, we report the overall genetic correlation and specific loci shared between cerebellar white matter microstructural integrity and brain-related traits, including movement, cognitive, psychiatric, and cerebrovascular categories. CONCLUSIONS Collectively, this study represents a step forward in understanding the genetics of cerebellar white matter microstructure and its shared genetic etiology with common brain disorders.
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Affiliation(s)
- Bang-Sheng Wu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Jun Ge
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shi-Tong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yu-Chao Jiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China; Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - John Suckling
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Department of Computer Science, University of Warwick, Coventry CV4 7AL, UK
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Ying Mao
- Department of Neurosurgery and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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Pyrgelis ES, Agapiou E, Angelopoulou E. Holmes tremor: an updated review. Neurol Sci 2022; 43:6731-6740. [DOI: 10.1007/s10072-022-06352-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/13/2022] [Indexed: 10/15/2022]
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Gadot R, Shofty B, Najera RA, Anand A, Banks G, Khan AB, LoPresti MA, Vanegas Arroyave N, Sheth SA. Case Report: Dual Target Deep Brain Stimulation With Externalized Programming for Post-traumatic Complex Movement Disorder. Front Neurosci 2021; 15:774073. [PMID: 34819837 PMCID: PMC8606815 DOI: 10.3389/fnins.2021.774073] [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: 09/10/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Movement disorders can be common, persistent, and debilitating sequelae of severe traumatic brain injury. Post-traumatic movement disorders are usually complex in nature, involving multiple phenomenological manifestations, and can be difficult to control with medical management alone. Deep brain stimulation (DBS) has been used to treat these challenging cases, but distorted brain anatomy secondary to trauma can complicate effective targeting. In such cases, use of diffusion tractography imaging and inpatient testing with externalized DBS leads can be beneficial in optimizing outcomes. Case Description: We present the case of a 42-year-old man with severe, disabling post-traumatic tremor who underwent bilateral, dual target DBS to the globus pallidus internus (GPi) and a combined ventral intermediate nucleus of the thalamus (Vim)/dentato-rubro-thalamic tracts (DRTT) target. DRTT fiber tracts were reconstructed preoperatively to assist in surgical targeting given the patient’s distorted anatomy. Externalization and survey of the four leads extra-operatively with inpatient testing allowed for internalization of the leads that demonstrated benefit. Six months after surgery, the patient’s tremor and dystonic burden had decreased by 67% in the performance sub-score of The Essential Tremor Rating Scale (TETRAS). Conclusion: A patient-tailored approach including target selection guided by individualized anatomy and tractography as well as extra-operative externalized lead interrogation was shown to be effective in optimizing clinical outcome in a patient with refractory post-traumatic tremor.
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Affiliation(s)
- Ron Gadot
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Ben Shofty
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Ricardo A Najera
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Adrish Anand
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Garrett Banks
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, United States
| | - Abdul Basit Khan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Melissa A LoPresti
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | | | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
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Kakei S, Manto M, Tanaka H, Mitoma H. Pathophysiology of Cerebellar Tremor: The Forward Model-Related Tremor and the Inferior Olive Oscillation-Related Tremor. Front Neurol 2021; 12:694653. [PMID: 34262527 PMCID: PMC8273235 DOI: 10.3389/fneur.2021.694653] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Lesions in the Guillain-Mollaret (G-M) triangle frequently cause various types of tremors or tremor-like movements. Nevertheless, we know relatively little about their generation mechanisms. The deep cerebellar nuclei (DCN), which is a primary node of the triangle, has two main output paths: the primary excitatory path to the thalamus, the red nucleus (RN), and other brain stem nuclei, and the secondary inhibitory path to the inferior olive (IO). The inhibitory path contributes to the dentato-olivo-cerebellar loop (the short loop), while the excitatory path contributes to the cerebrocerebellar loop (the long loop). We propose a novel hypothesis: each loop contributes to physiologically distinct type of tremors or tremor-like movements. One type of irregular tremor-like movement is caused by a lesion in the cerebrocerebellar loop, which includes the primary path. A lesion in this loop affects the cerebellar forward model and deteriorates its accuracy of prediction and compensation of the feedback delay, resulting in irregular instability of voluntary motor control, i.e., cerebellar ataxia (CA). Therefore, this type of tremor, such as kinetic tremor, is usually associated with other symptoms of CA such as dysmetria. We call this type of tremor forward model-related tremor. The second type of regular tremor appears to be correlated with synchronized oscillation of IO neurons due, at least in animal models, to reduced degrees of freedom in IO activities. The regular burst activity of IO neurons is precisely transmitted along the cerebellocerebral path to the motor cortex before inducing rhythmical reciprocal activities of agonists and antagonists, i.e., tremor. We call this type of tremor IO-oscillation-related tremor. Although this type of regular tremor does not necessarily accompany ataxia, the aberrant IO activities (i.e., aberrant CS activities) may induce secondary maladaptation of cerebellar forward models through aberrant patterns of long-term depression (LTD) and/or long-term potentiation (LTP) of the cerebellar circuitry. Although our hypothesis does not cover all tremors or tremor-like movement disorders, our approach integrates the latest theories of cerebellar physiology and provides explanations how various lesions in or around the G-M triangle results in tremors or tremor-like movements. We propose that tremor results from errors in predictions carried out by the cerebellar circuitry.
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Affiliation(s)
- Shinji Kakei
- Department of Anatomy and Physiology, Jissen Women's University, Tokyo, Japan
| | - Mario Manto
- Service de Neurologie, Médiathèque Jean Jacquy, CHU-Charleroi, Charleroi, Belgium
- Service des Neurosciences, University of Mons, Mons, Belgium
| | - Hirokazu Tanaka
- Faculty of Information Technology, Tokyo City University, Tokyo, Japan
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
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Tater P, Pandey S. Post-stroke Movement Disorders: Clinical Spectrum, Pathogenesis, and Management. Neurol India 2021; 69:272-283. [PMID: 33904435 DOI: 10.4103/0028-3886.314574] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Involuntary movements develop after 1-4% of strokes and they have been reported in patients with ischemic and hemorrhagic strokes affecting the basal ganglia, thalamus, and/or their connections. Hemichorea-hemiballism is the most common movement disorder following a stroke in adults while dystonia is most common in children. Tremor, myoclonus, asterixis, stereotypies, and vascular parkinsonism are other movement disorders seen following stroke. Some of them occur immediately after acute stroke, some can develop later, and others may have delayed onset progressive course. Proposed pathophysiological mechanisms include neuronal plasticity, functional diaschisis, and age-related differences in brain metabolism. There are no guidelines regarding the management of post-stroke movement disorders, mainly because of their heterogeneity.
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Affiliation(s)
- Priyanka Tater
- Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, India
| | - Sanjay Pandey
- Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, India
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Pal P, Holla V, Chaithra S, Prasad S. Delayed cervicobrachial segmental dystonia secondary to ipsilateral cerebellar infarction. ANNALS OF MOVEMENT DISORDERS 2021. [DOI: 10.4103/aomd.aomd_32_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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An Observational Study of Social Interaction Skills and Behaviors in Cornelia de Lange, Fragile X and Rubinstein-Taybi Syndromes. J Autism Dev Disord 2020; 50:4001-4010. [PMID: 32189229 PMCID: PMC7560922 DOI: 10.1007/s10803-020-04440-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We directly assessed the broader aspects of sociability (social enjoyment, social motivation, social interaction skills and social discomfort) in individuals with Cornelia de Lange (CdLS), fragile X (FXS) and Rubinstein-Taybi syndromes (RTS), and their association with autism characteristics and chronological age in these groups. Individuals with FXS (p < 0.01) and RTS (p < 0.01) showed poorer quality of eye contact compared to individuals with CdLS. Individuals with FXS showed less person and more object attention than individuals with CdLS (p < 0.01). Associations between sociability and autism characteristics and chronological age differed between groups, which may indicate divergence in the development and aetiology of different components of sociability across these groups. Findings indicate that individuals with CdLS, FXS and RTS show unique profiles of sociability.
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KCND3-Related Neurological Disorders: From Old to Emerging Clinical Phenotypes. Int J Mol Sci 2020; 21:ijms21165802. [PMID: 32823520 PMCID: PMC7461103 DOI: 10.3390/ijms21165802] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/11/2020] [Indexed: 12/12/2022] Open
Abstract
KCND3 encodes the voltage-gated potassium ion channel subfamily D member 3, a six trans-membrane protein (Kv4.3), involved in the transient outward K+ current. KCND3 defect causes both cardiological and neurological syndromes. From a neurological perspective, Kv4.3 defect has been associated to SCA type 19/22, a complex neurological disorder encompassing a wide spectrum of clinical features beside ataxia. To better define the phenotypic spectrum and course of KCND3-related neurological disorder, we review the clinical presentation and evolution in 68 reported cases. We delineated two main clinical phenotypes according to the age of onset. Neurodevelopmental disorder with epilepsy and/or movement disorders with ataxia later in the disease course characterized the early onset forms, while a prominent ataxic syndrome with possible cognitive decline, movement disorders, and peripheral neuropathy were observed in the late onset forms. Furthermore, we described a 37-year-old patient with a de novo KCND3 variant [c.901T>C (p.Ser301Pro)], previously reported in dbSNP as rs79821338, and a clinical phenotype paradigmatic of the early onset forms with neurodevelopmental disorder, epilepsy, parkinsonism-dystonia, and ataxia in adulthood, further expanding the clinical spectrum of this condition.
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Chang MC, Seo JP. Injury of the dentato-rubro-thalamic tract in a patient with intentional tremor after mild traumatic brain injury: a case report. Brain Inj 2020; 34:1283-1286. [PMID: 32735460 DOI: 10.1080/02699052.2020.1802656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES We imaged the dentato-rubro-thalamic tract (DRTT) and cortico-ponto-cerebellar tract (CPCT) using diffusion tensor tractography (DTT) to evaluate the cortico-cerebellar-cortical circuit in a patient with tremor in both hands after mild TBI. We found bilateral DRTT injury in the DTT. METHOD A 50-year-old male presented with action tremor in both hands 1 week after mild TBI. One month before the visit, the patient had a head injury from a fall on a bus. The patient lost consciousness for 1 min and experienced post-traumatic amnesia for approximately 5 min after the accident. His Glasgow Coma Scale score was 15. The action tremor presented with a frequency of 3 Hz in both hands. No specific lesion was observed with a conventional brain MRI. RESULTS DTT, performed 1.5 months after TBI, showed that the right DRTT was not reconstructed and the left DRTT had thinned. However, CPCT integrity was well-preserved in both hemispheres. The tremor disappeared after oral treatment with 30 mg/day indenol. The patient's tremor would have been caused by disruption of the bilateral DRTT following mild TBI. CONCLUSION DRTT and CPCT analysis using DTT would be useful for diagnosing abnormal movement problems, including tremor and ataxia, in patients following mild TBI.
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Affiliation(s)
- Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University , Taegu, Republic of Korea
| | - Jeong Pyo Seo
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University , Taegu, Republic of Korea
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Compagnat M, Daviet JC, Batcho C, Vuillerme N, Salle JY, David R, Mandigout S. Oxygen Cost During Walking in Individuals With Stroke: Hemiparesis Versus Cerebellar Ataxia. Neurorehabil Neural Repair 2020; 34:289-298. [PMID: 32089099 PMCID: PMC7168805 DOI: 10.1177/1545968320907076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background. Understanding the factors that limit mobility in stroke patients is fundamental for proposing appropriate rehabilitation strategies. A high oxygen cost during walking (Cw) has a strong impact on the community ambulation of hemiparetic patients. The Cw in poststroke cerebellar ataxia is poorly evaluated, unlike hemiparetic gait. Objective. To compare the oxygen cost/self-selected walking speed (S) relationship in stroke individuals with cerebellar ataxia or hemiparetic gait. Methods. Thirty-three subjects were included (14 cerebellar stroke, 19 hemispheric stroke), with stroke confirmed by brain imaging and able to walk without human assistance. We measured Cw using the Metamax3B. The relationship between Cw and self-selected walking speed was modelled by logistic regression and then compared between the cerebellar and hemispheric groups. Results. No significant difference was found between the 2 groups for all characteristics of the population, except motor impairments, spasticity, and ataxia (P < .01). We identified 2 separate Cw/S relationships with different logistic regression equations for the 2 groups. Faster than 0.4 m s−1, Cw was 30.6% to 39.9% higher in patients with cerebellar stroke in comparison with hemispheric stroke individuals. The Cw was correlated with ataxia (r = 0.88; P < .001) in the cerebellar group, whereas there was a correlation with motor impairments (r = −0.61; P < .01), spasticity (r = 0.59; P < .01), and ataxia (r = 0.81; P < .01) in hemispheric stroke individuals. Conclusion. The Cw in poststroke cerebellar ataxia is significantly higher compared with hemiparetic patients at an equivalent walking speed. The impact on community walking needs to be explored in stroke survivors with cerebellar stroke.
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Affiliation(s)
- Maxence Compagnat
- University of Limoges, Limoges, France.,University Hospital Center of Limoges, Limoges, France
| | - Jean-Christophe Daviet
- University of Limoges, Limoges, France.,University Hospital Center of Limoges, Limoges, France
| | - Charles Batcho
- Centre intégré universitaire de santé et de services sociaux de la Capitale Nationale (CIUSSS-CN), Quebec, Quebec, Canada.,Université Laval, Quebec, Quebec, Canada
| | - Nicolas Vuillerme
- University of Grenoble Alpes, AGEIS, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Jean-Yves Salle
- University of Limoges, Limoges, France.,University Hospital Center of Limoges, Limoges, France
| | - Romain David
- University Hospital Center of Limoges, Limoges, France
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16
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Kim JY, Seo JP, Chang MC. Ataxic Hemiparesis after Corona Radiata Infarct: Diffusion Tensor Imaging Correlation of Corticoponto-cerebellar Tract Injury. Transl Neurosci 2020; 11:1-3. [PMID: 32042469 PMCID: PMC6999082 DOI: 10.1515/tnsci-2020-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/02/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jun Young Kim
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea
| | - Jeong Pyo Seo
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea
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17
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The Rehapiano-Detecting, Measuring, and Analyzing Action Tremor Using Strain Gauges. SENSORS 2020; 20:s20030663. [PMID: 31991705 PMCID: PMC7038321 DOI: 10.3390/s20030663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 02/02/2023]
Abstract
We have developed a device, the Rehapiano, for the fast and quantitative assessment of action tremor. It uses strain gauges to measure force exerted by individual fingers. This article verifies the device's capability to measure and monitor the development of upper limb tremor. The Rehapiano uses a precision, 24-bit, analog-to-digital converter and an Arduino microcomputer to transfer raw data via a USB interface to a computer for processing, database storage, and evaluation. First, our experiments validated the device by measuring simulated tremors with known frequencies. Second, we created a measurement protocol, which we used to measure and compare healthy patients and patients with Parkinson's disease. Finally, we evaluated the repeatability of a quantitative assessment. We verified our hypothesis that the Rehapiano is able to detect force changes, and our experimental results confirmed that our system is capable of measuring action tremor. The Rehapiano is also sensitive enough to enable the quantification of Parkinsonian tremors.
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18
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POLR3A variants with striatal involvement and extrapyramidal movement disorder. Neurogenetics 2020; 21:121-133. [PMID: 31940116 PMCID: PMC7064625 DOI: 10.1007/s10048-019-00602-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/27/2019] [Indexed: 01/10/2023]
Abstract
Biallelic variants in POLR3A cause 4H leukodystrophy, characterized by hypomyelination in combination with cerebellar and pyramidal signs and variable non-neurological manifestations. Basal ganglia are spared in 4H leukodystrophy, and dystonia is not prominent. Three patients with variants in POLR3A, an atypical presentation with dystonia, and MR involvement of putamen and caudate nucleus (striatum) and red nucleus have previously been reported. Genetic, clinical findings and 18 MRI scans from nine patients with homozygous or compound heterozygous POLR3A variants and predominant striatal changes were retrospectively reviewed in order to characterize the striatal variant of POLR3A-associated disease. Prominent extrapyramidal involvement was the predominant clinical sign in all patients. The three youngest children were severely affected with muscle hypotonia, impaired head control, and choreic movements. Presentation of the six older patients was milder. Two brothers diagnosed with juvenile parkinsonism were homozygous for the c.1771-6C > G variant in POLR3A; the other seven either carried c.1771-6C > G (n = 1) or c.1771-7C > G (n = 7) together with another variant (missense, synonymous, or intronic). Striatal T2-hyperintensity and atrophy together with involvement of the superior cerebellar peduncles were characteristic. Additional MRI findings were involvement of dentate nuclei, hila, or peridentate white matter (3, 6, and 4/9), inferior cerebellar peduncles (6/9), red nuclei (2/9), and abnormal myelination of pyramidal and visual tracts (6/9) but no frank hypomyelination. Clinical and MRI findings in patients with a striatal variant of POLR3A-related disease are distinct from 4H leukodystrophy and associated with one of two intronic variants, c.1771-6C > G or c.1771-7C > G, in combination with another POLR3A variant.
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19
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Layne KA, Wood DM, Dargan PI. Gadolinium-based contrast agents – what is the evidence for ‘gadolinium deposition disease’ and the use of chelation therapy? Clin Toxicol (Phila) 2019; 58:151-160. [DOI: 10.1080/15563650.2019.1681442] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kerry A. Layne
- General Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - David M. Wood
- General Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Paul I. Dargan
- General Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
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20
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Dec-Ćwiek M, Tutaj M, Pietraszko W, Libionka W, Krupa M, Moskała M, Rudzińska-Bar M, Słowik A, Pera J. Posterior Subthalamic Area Deep Brain Stimulation for Treatment of Refractory Holmes Tremor. Stereotact Funct Neurosurg 2019; 97:183-188. [DOI: 10.1159/000502563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 08/08/2019] [Indexed: 11/19/2022]
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21
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Rojas NG, Cesarini M, Etcheverry JL, Da Prat G, Viera Aramburu T, Gatto EM. Holmes Tremor Partially Responsive to Topiramate: A Case Report. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2018; 8:565. [PMID: 30191084 PMCID: PMC6123836 DOI: 10.7916/d82c0ffn] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 05/31/2018] [Indexed: 01/04/2023]
Abstract
Background Holmes tremor is a rare symptomatic movement disorder, characterized by a combination of resting, postural, and intention tremor. It is usually caused by lesions in the brainstem, thalamus, and cerebellum. Despite pharmacological advances, its treatment remains a challenge; many medications have been used with various degrees of effectiveness. Stereotactic thalamotomy and deep brain stimulation in the ventralis intermedius nucleus have been effective surgical procedures in cases refractory to medical treatment. Case Report Here we report a young woman with topiramate-responsive Holmes tremor secondary to a brainstem cavernoma. Discussion Herein we report a Holmes tremor responsive to Topiramate.
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Affiliation(s)
- Natalia González Rojas
- Instituto Neurociencias Buenos Aires (INEBA), Departamento de Neurología - área de movimientos anormales, Buenos Aires, Argentina
| | - Martin Cesarini
- Instituto Neurociencias Buenos Aires (INEBA), Departamento de Neurología - área de movimientos anormales, Buenos Aires, Argentina
| | - José Luis Etcheverry
- Instituto Neurociencias Buenos Aires (INEBA), Departamento de Neurología - área de movimientos anormales, Buenos Aires, Argentina
| | - Gustavo Da Prat
- Instituto Neurociencias Buenos Aires (INEBA), Departamento de Neurología - área de movimientos anormales, Buenos Aires, Argentina
| | - Tomás Viera Aramburu
- Instituto Neurociencias Buenos Aires (INEBA), Departamento de Neurología - área de movimientos anormales, Buenos Aires, Argentina
| | - Emilia Mabel Gatto
- Instituto Neurociencias Buenos Aires (INEBA), Departamento de Neurología - área de movimientos anormales, Buenos Aires, Argentina
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22
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Abstract
Dystonia is a heterogeneous disorder characterized by involuntary muscle contractions, twisting movements, and abnormal postures in various body regions. It is widely accepted that the basal ganglia are involved in the pathogenesis of dystonia. A growing body of evidence, however, is challenging the traditional view and suggest that the cerebellum may also play a role in dystonia. Studies on animals indicate that experimental manipulations of the cerebellum lead to dystonic-like movements. Several clinical observations, including those from secondary dystonia cases as well as neurophysiologic and neuroimaging studies in human patients, provide further evidence in humans of a possible relationship between cerebellar abnormalities and dystonia. Claryfing the role of the cerebellum in dystonia is an important step towards providing alternative treatments based on noninvasive brain stimulation techniques.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Italy.
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23
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Rubral Tremor Associated with Klinefelter Syndrome; a Case Report and Literature Review. ARCHIVES OF NEUROSCIENCE 2017. [DOI: 10.5812/archneurosci.55065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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24
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Ueno T, Nishijima H, Arai A, Tomiyama M. Acute hemorrhagic cerebellar infarction presenting with isolated head titubation. J Neurol Sci 2017; 372:456-458. [PMID: 27816184 DOI: 10.1016/j.jns.2016.10.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/10/2016] [Accepted: 10/27/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Tatsuya Ueno
- Department of Neurology, Aomori, Prefectural Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori 030-8551, Japan.
| | - Haruo Nishijima
- Department of Neurology, Aomori, Prefectural Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori 030-8551, Japan
| | - Akira Arai
- Department of Neurology, Aomori, Prefectural Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori 030-8551, Japan
| | - Masahiko Tomiyama
- Department of Neurology, Aomori, Prefectural Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori 030-8551, Japan
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