Review
Clinical Neurology
Eoin Mulroy, Nirosen Vijiaratnam, Alexis De Roquemaurel, Kailash P. Bhatia, Ludvic Zrinzo, Thomas Foltynie, Patricia Limousin
Summary: High frequency deep brain stimulation (DBS) has become a mainstream therapy for medically-refractory dystonia syndromes, but presents unique challenges in patient selection and programming, due to the heterogeneous nature of dystonia and the lack of immediate clinical indicators for efficacy. Physicians may feel less confident in managing DBS for dystonia compared to other indications.
PARKINSONISM & RELATED DISORDERS
(2021)
Article
Clinical Neurology
Carolina Candeias da Silva, Wilson Fung, Mojgan Hodaie, Alfonso Fasano
Summary: Cervical dystonia is a common adult-onset focal dystonia that can affect sleep quality. Deep brain stimulation (DBS) is an effective treatment for cervical dystonia, although its impact on sleep is not well understood. We present a case of an unusual form of insomnia in a patient with cervical dystonia following DBS surgery, which resolved after surgical revision of the extension wire.
Article
Multidisciplinary Sciences
Andreas Horn, Martin M. Reich, Siobhan Ewert, Ningfei Li, Bassam Al-Fatly, Florian Lange, Jonas Roothans, Simon Oxenford, Isabel Horn, Steffen Paschen, Joachim Runge, Fritz Wodarg, Karsten Witt, Robert C. Nickl, Matthias Wittstock, Gerd-Helge Schneider, Philipp Mahlknecht, Werner Poewe, Wilhelm Eisner, Ann-Kristin Helmers, Cordula Matthies, Joachim K. Krauss, Gunther Deuschl, Jens Volkmann, Andrea A. Kuhn
Summary: This study retrospectively investigated the clinical results of deep brain stimulation (DBS) for cervical and generalized dystonia in 80 patients. The researchers modeled the optimal stimulation sites based on imaging and found that the optimal treatment for cervical dystonia involved modulation of the striatopallidofugal axis, while pallidothalamic bundles were responsible for optimal treatment of generalized dystonia. Additionally, the study showed a common network substrate in the form of connectivity to the cerebellum and somatomotor cortex for both types of dystonia.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2022)
Review
Neurosciences
Stefanie Perl, Anika Luettig, Rudiger Koehling, Angelika Richter
Summary: This review provides an overview of DBS research in animal models of dystonia, discussing the research aims, opportunities and limitations of different animal models, and technical challenges.
NEUROBIOLOGY OF DISEASE
(2022)
Article
Neurosciences
Vinith Johnson, Robert Wilt, Roee Gilron, Juan Anso, Randy Perrone, Martijn Beudel, Dan Pina-Fuentes, Jeremy Saal, Jill L. Ostrem, Ian Bledsoe, Philip Starr, Simon Little
Summary: The study utilized a novel, sensing-enabled deep brain stimulator device implanted in a patient with cervical dystonia to record neural data and conduct a proof-of-principle trial. It found that low-frequency oscillations are related to dystonia and demonstrated the potential for a novel adaptive stimulation strategy.
EXPERIMENTAL NEUROLOGY
(2021)
Article
Clinical Neurology
Roxanne Lofredi, Ute Scheller, Aurika Mindermann, Lucia K. Feldmann, Joachim K. Krauss, Assel Saryyeva, Gerd-Helge Schneider, Andrea A. Kuehn
Summary: This study observed that movement speed gradually increased after cessation of pallidal stimulation in dystonia patients. The association between movement slowness and beta oscillations indicates symptom-specific oscillatory patterns in the motor circuit, which has implications for improving deep brain stimulation therapy.
MOVEMENT DISORDERS
(2023)
Article
Clinical Neurology
Roxanne Lofredi, Ute Scheller, Aurika Mindermann, Lucia K. Feldmann, Joachim K. Krauss, Assel Saryyeva, Gerd-Helge Schneider, Andrea A. Kuehn
Summary: Pallidal deep brain stimulation (DBS) can alleviate symptoms in dystonia patients, but it may also cause movement slowness. This study found that after the cessation of pallidal stimulation, the movement speed of dystonia patients increased over time. The beta oscillations in the pallidum were found to be associated with the variance in movement speed.
MOVEMENT DISORDERS
(2023)
Review
Clinical Neurology
Audrey K. S. Soo, Arianna Ferrini, Manju A. Kurian
Summary: Targeted precision medicine is becoming increasingly important in treating genetic childhood movement disorders, with personalized approaches including repurposing existing treatments and developing new therapies. Close collaboration between clinicians, researchers, affected families, and stakeholders in the wider community is crucial for successfully delivering these precision therapies to children with movement disorders.
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
(2021)
Review
Clinical Neurology
Adilijiang Aihemaitiniyazi, Huawei Zhang, Yue Hu, Tiemin Li, Changqing Liu
Summary: This study is the first meta-analysis demonstrating significant improvements in health-related quality of life in patients with acquired dystonia following deep brain stimulation (DBS). Both physical and mental aspects of life quality showed significant improvements after DBS.
NEUROLOGICAL SCIENCES
(2023)
Article
Food Science & Technology
Carolina Gorodetsky, Paula Azevedo, Carolina Candeias da Silva, Alfonso Fasano
Summary: In a retrospective study of dystonia patients, approximately half underwent deep brain stimulation (DBS) surgery, with reasons for declining DBS including patient refusal, functional dystonia, and successful use of AbobotulinumtoxinA after failed treatment with other botulinum neurotoxins. The study emphasizes the importance of structured patient education to increase DBS acceptance, careful evaluation for functional dystonia, and the potential benefit of changing botulinum toxin formulations.
Review
Clinical Neurology
Michael Grabel, Aristide Merola
Summary: GPi-DBS can be an effective therapeutic option for severe cases of TD resistant to oral pharmacological therapies, although rare cases of symptom worsening or lack of improvement have also been reported.
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Cecile Delorme, Emmanuel Roze, Carine Karachi, Marie Vidailhet, Elodie Hainque
Summary: This case study documented a 44-year-old patient with a wide phenotypic spectrum of generalized dystonia associated with TUBB4A gene mutations. After undergoing bipallidal deep brain stimulation surgery, a significant reduction in dystonia severity was observed, particularly in the cervical and facial regions.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Letter
Clinical Neurology
Yunhao Wu, Yixin Pan, Peng Huang, Tao Wang, Chencheng Zhang, Bomin Sun, Dianyou Li, Hongxia Li, Yiwen Wu
Summary: Lingual dystonia is a rare disease that severely affects daily activities. Previous studies have shown the efficacy of GPi-DBS on patients with refractory lingual symptoms, but high-level evidence is lacking. Our retrospective study on six lingual dystonia patients treated with subthalamic DBS demonstrates its immediate and long-lasting efficacy.
PARKINSONISM & RELATED DISORDERS
(2021)
Review
Clinical Neurology
Stephen Tisch
Summary: This review discusses the factors contributing to the variability in dystonia deep brain stimulation (DBS) outcomes, including dystonia-related factors and DBS-related factors. Recent findings include differential DBS benefits in different genotypes, experience with subthalamic nucleus (STN) DBS and DBS for Meige syndrome, understanding of DBS side effects, and new techniques for predicting clinical outcomes. Understanding these factors may help in patient selection and predicting surgical outcomes.
CURRENT OPINION IN NEUROLOGY
(2022)
Article
Clinical Neurology
Florian Lange, Carolina Soares, Jonas Roothans, Rita Raimundo, Hazem Eldebakey, Benedikt Weigl, Robert Peach, Christine Daniels, Thomas Musacchio, Jens Volkmann, Maria Jose Rosas, Martin M. Reich
Summary: Deep brain stimulation is effective for alleviating dystonia motor symptoms, but delayed symptom control and lack of therapeutic biomarkers and optimal programming settings complicate postoperative management. This study prospectively tested machine-predicted programming settings and found that they significantly reduced dystonia symptoms compared to clinical programming.
Correction
Clinical Neurology
Ahmed Mohamed Elhfnawy, Doaa Elsalamawy, Mervat Abdelraouf, Mira Schliesser, Jens Volkmann, Felix Fluri
ACTA NEUROLOGICA BELGICA
(2023)
Review
Clinical Neurology
Guenther Deuschl, Jos S. Becktepe, Michiel Dirkx, Dietrich Haubenberger, Anhar Hassan, Rick C. Helmich, Muthuraman Muthuraman, Pattamon Panyakaew, Petra Schwingenschuh, Kirsten E. Zeuner, Rodger J. Elble
Summary: The various forms of tremor are now classified based on clinical characteristics and etiology. Electrophysiology, as an extension of clinical examination, is valuable in diagnosing and characterizing different types of tremor. It also plays a crucial role in understanding the pathophysiology of tremor.
CLINICAL NEUROPHYSIOLOGY
(2022)
Article
Clinical Neurology
Katina Aleksovska, Claudio L. A. Bassetti, Thomas Berger, Vanessa Carvalho, Joao Costa, Guenther Deuschl, Kristian S. Frederiksen, Joke Jaarsma, Teia Kobulashvili, Maurizio Leone, Lucia Pavlakova, Michele Romoli, Luca Vignatelli
Summary: This paper aims to establish a set of criteria for prioritizing topics for future European Academy of Neurology (EAN) guidelines. Through literature review, a Delphi consensus procedure, and voting, a set of approved criteria were determined, and the first 30 topics were selected. The process involved both a bottom-up approach with community involvement and a top-down approach with board member selection.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Henrieke L. Frequin, Jason Schouten, Constant V. M. Verschuur, Sven R. Suwijn, Judith A. Boel, Bart Post, Bastiaan R. Bloem, Johannes J. van Hilten, Teus van Laar, Gerrit Tissingh, Alexander G. Munts, Joke M. Dijk, Gunther Deuschl, Anthony Lang, Marcel G. W. Dijkgraaf, Rob J. de Haan, Rob M. A. de Bie
Summary: The study found that levodopa had similar effects on bradykinesia, rigidity, and tremor in patients with early Parkinson's disease. The improvements in symptoms were larger at 22 weeks compared to 4 weeks. At 80 weeks, fewer patients in the early-start group experienced motor response fluctuations.
Article
Clinical Neurology
Robin Wolke, Olga Gavriliuc, Oliver Granert, Guenther Deuschl, Nils G. Margraf
Summary: Using computer vision technology, 3D human body models are generated from regular photographs to evaluate postural disorders. The accuracy and applicability of this method are validated by comparing with the gold standard. The generated 3D models are not affected by the camera angle and provide a comprehensive analysis.
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)
Letter
Clinical Neurology
Gunther Deuschl, Angelo Antonini, Joao Costa, Katarzyna Smilowska, Daniela Berg, Jean-Christophe Corvol, Giovanni Fabbrini, Joaquim Ferreira, Tom Foltynie, Pablo Mir, Anette Schrag, Klaus Seppi, Pille Taba, Evzen Ruzicka, Marianna Selikhova, Nicholas Henschke, Gemma Villanueva, Elena Moro
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Review
Clinical Neurology
Martin Regensburger, Chi Wang Ip, Zacharias Kohl, Christoph Schrader, Peter P. Urban, Jan Kassubek, Wolfgang H. Jost
Summary: Inhibitors of monoamine oxidase B (MAO-B) and catechol-O-methyltransferase (COMT) are important strategies in Parkinson's disease treatment. Several drugs have been available on the market for more than a decade, while others have been approved more recently. Various post-authorization studies have provided comprehensive data on their use and characteristics in real-life clinical practice. This article summarizes the current knowledge on these medications and discusses their clinical value in Parkinson's disease, as well as practical considerations and ongoing studies.
JOURNAL OF NEURAL TRANSMISSION
(2023)
Article
Clinical Neurology
Johannes Meyne, Mirjam Domschikowski, Johannes Hensler, Ann-Kristin Helmers, Daniela Berg, Guenther Deuschl, Steffen Paschen
Summary: The study found that patients with previous deep brain stimulation (DBS) surgery can undergo intravenous thrombolysis (IVT) and endovascular mechanical thrombectomy therapy (MT) for acute ischemic stroke, without bleeding complications, at least 6 months after the surgery.
JOURNAL OF NEUROLOGY
(2023)
Letter
Clinical Neurology
Guenther Deuschl, Angelo Antonini, Joao Costa, Katarzyna Smilowska, Daniela Berg, Jean-Christophe Corvol, Giovanni Fabbrini, Joaquim Ferreira, Tom Foltynie, Pablo Mir, Anette Schrag, Klaus Seppi, Pille Taba, Evzen Ruzicka, Marianna Selikhova, Nicholas Henschke, Gemma Villanueva, Elena Moro
MOVEMENT DISORDERS
(2023)
Editorial Material
Clinical Neurology
Guenther Deuschl
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Clinical Neurology
Tobias Binder, Florian Lange, Nicolo Pozzi, Thomas Musacchio, Christine Daniels, Thorsten Odorfer, Patrick Fricke, Cordula Matthies, Jens Volkmann, Philipp Capetian
Summary: This study investigated the potential advantages of beta-guided programming in STN-DBS for Parkinson's disease. The results showed that beta-guided programming had similar clinical efficacy compared to clinically and image-guided programming, but required significantly less time. This new method has the potential to improve current clinical practice in DBS programming.
Article
Clinical Neurology
Dana Brinker, Oliver Granert, Felix Goevert, Inken Toedt, Alexander Baumann, Kirsten E. Zeuner, Robin Wolke, Guenther Deuschl, Jos S. Becktepe
Summary: This study aims to explore alterations of brain grey matter in patients with essential tremor (ET) combined with dystonic soft signs (ET + ds). The results showed a significant increase of grey matter in the right lentiform nucleus in ET + ds and tremor associated with manifest dystonia (TAWD) compared to healthy controls and ET patients without dystonic soft signs (ET-ds). Additionally, an increase of cortical grey matter in the middle frontal gyrus was observed in ET + ds. The hypertrophy of the lentiform nucleus in ET + ds was correlated with disease severity and duration.
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Clinical Neurology
Steffen Paschen, Jos S. Becktepe, Markus A. Hobert, Kirsten E. Zeuner, Ann-Kristin Helmers, Daniela Berg, Gunther Deuschl
Summary: The current analysis of clinical symptomatology is not sufficient to predict surgical success for patients with combined tremor and dystonia syndromes. Other criteria are needed to determine the best target for deep brain stimulation, and rescue surgery may be considered for severely disabled patients if the initial target fails.
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)
Article
Clinical Neurology
Jacopo Pasquini, Gunther Deuschl, Alessandro Pecori, Stefano Salvadori, Roberto Ceravolo, Nicola Pavese
Summary: This study conducted a comprehensive longitudinal analysis on tremor in de-novo PD patients, revealing that tremor severity increases over time and the response to medication varies. The findings provide an evidence-based framework for future pathophysiological and interventional studies on PD tremor.
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)
Article
Clinical Neurology
Robin Wolke, Jos Steffen Becktepe, Steffen Paschen, Ann-Kristin Helmers, Dorothee Kuebler-Weller, Jinyoung Youn, Dana Brinker, Hagai Bergman, Andrea A. Kuehn, Alfonso Fasano, Guenther Deuschl
Summary: The efficacy of deep brain stimulation of the subthalamic nucleus (STN-DBS) for Parkinson's disease varies among patients. The levodopa challenge can be used to predict individual responses, but its accuracy is limited.
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)
