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Neurology AND Movement disorders [keywords]
- What We Know Currently about Mirror Neurons. [Journal Article]
- Curr Biol 2013 Dec 2; 23(23):R1057-62.
Mirror neurons were discovered over twenty years ago in the ventral premotor region F5 of the macaque monkey. Since their discovery much has been written about these neurons, both in the scientific literature and in the popular press. They have been proposed to be the neuronal substrate underlying a vast array of different functions. Indeed so much has been written about mirror neurons that last year they were referred to, rightly or wrongly, as "The most hyped concept in neuroscience". Here we try to cut through some of this hyperbole and review what is currently known (and not known) about mirror neurons.
- A Case of Paranoid Schizophrenia and Severe Antipsychotic-Induced Parkinson's Disorder Treated with a Combination of Olanzapine and Lurasidone. [JOURNAL ARTICLE]
- Innov Clin Neurosci 2013 9; 10(9-10):10-11.
- Deep brain stimulation for tremor resulting from acquired brain injury. [JOURNAL ARTICLE]
- J Neurol Neurosurg Psychiatry 2013 Dec 4.
To evaluate the efficacy of deep brain stimulation (DBS) in the treatment of tremor resulting from acquired brain injury (ABI).A series of eight consecutive patients with post-ABI tremor were treated with DBS of the ventro-oralis posterior (VOP)/zona incerta (ZI) region, and subsequently underwent blinded assessments using Bain's tremor severity scale.VOP/ZI DBS produced a mean reduction in tremor severity of 80.75% based on Bain's tremor severity scale, with significant reductions in all five component tremor subscores: rest, postural, kinetic, proximal and distal. No adverse neurological complications were reported, although one patient experienced exacerbation of pre-existing gait ataxia.VOP/ZI stimulation is demonstrated here to be an effective and safe approach for the treatment of post-ABI tremor in the largest series published at the time of writing.
- Altruism and my Nine Gallons of Blood. [Journal Article]
- R I Med J (2013) 2013; 96(12):10-1.
- Ocular motor disorders. [JOURNAL ARTICLE]
- Curr Opin Neurol 2013 Dec 2.
Studying eye movements can provide insight into how the normal brain works, how diseases affect eye movements, and how eye movement abnormalities can be used to study diseases and/or their treatments. In this review, we concentrate on recent studies looking at abnormalities of saccades in various diseases.Various saccadic abnormalities have been found in Parkinson's disease, Huntington's disease, dementia, cerebellar disease, schizophrenia, and several other conditions. In some of these, saccadic abnormalities appear to be capable of distinguishing different subtypes (e.g., progressive supranuclear palsy from idiopathic Parkinson's disease, Alzheimer's disease from frontotemporal dementia, or one type of spinocerebellar ataxia from another). Several studies have looked at functional associations of saccadic abnormalities (e.g., reading in spinocerebellar ataxia or recovery from stroke), which may prove clinically useful. Studies on microsaccades have revealed abnormalities in various diseases, and suggest that they may provide a useful marker of fatigue.Saccadic eye movements provide an excellent way of studying the human motor system in health and disease, as well as providing insight into various aspects of cognitive function. Assessment of saccades in the laboratory and at the bedside is likely to become increasingly useful clinically.
- [Anti-N-methyl-D-aspartic acid receptor encephalitis: clinical analysis of 7 cases]. [English Abstract, Journal Article]
- Zhonghua Yi Xue Za Zhi 2013 Aug 20; 93(31):2508-10.
To summarize the clinical manifestations, immunotherapeutic response and prognosis of anti-N-methyl-D-aspartic acid (NMDA) receptor encephalitis.We analyzed the clinical features, tumor markers, serum/cerebrospinal fluid (CSF) antibodies of seven cases with anti-NMDA receptor encephalitis. And the prognosis of different treatments was observed.Seven patients presented with significant psychiatric symptoms, memory loss, epilepsy, movement disorders and decrease consciousness. And some patients required assisted ventilation because of dysautonomia. All electroencephalographs showed slow wave activity without epileptic form discharges. Magnetic resonance imaging was normal or showed T2W and Flair-phase high signal in limbic system, cortex, thalamus. And CSF and serum anti-NMDA receptor antibodieswere positive (n = 6).Anti-NMDA receptor encephalitis is a kind of fatal but treatable condition. And timely diagnosis and treatment may yield a favorable prognosis.
- [Comparison of cognitive functions and neuropsychiatric symptoms between patients with Parkinson's disease dementia and Alzheimer's disease]. [English Abstract, Journal Article]
- Zhonghua Yi Xue Za Zhi 2013 Aug 20; 93(31):2459-62.
To compare the cognitive functions and neuropsychiatric symptoms of Parkinson's disease dementia (PDD) versus Alzheimer's disease (AD).Patients fulfilling the diagnostic and statistical manual of mental disorders, 4(th) edition (DSM-IV) dementia diagnosis criteria were recruited into this case-control study. AD patients were diagnosed with the criteria of National Institute of Neurologic and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) while PDD was based upon the standards of Movement Disorder Society (MDS) Task Force. According to clinical dementia rating (CDR) score, they were divided into mild dementia (CDR score = 0.5/1) and moderate-to-severe dementia groups (CDR score = 2/3). World Health Organization-University of California, Los Angeles, auditory verbal learning test (WHO-UCLA AVLT), clock drawing test (CDT) and neuropsychiatric inventory (NPI) were performed.No significant difference in immediate memory, delayed memory or long-delayed recognition score was observed between PDD and AD patients (P > 0.05). CDT score was significantly lower in PDD patients (mild dementia group: 0.9 ± 0.9; moderate-to-severe dementia group: 0.6 ± 0.9) than that of AD patients (mild dementia group: 1.5 ± 0.7, P < 0.001; moderate-to-severe dementia group: 1.1 ± 0.6, P = 0.027) and this difference was more significant in mild dementia group. More than 70% of PDD patients reported at least one neuropsychiatric symptom. And also, in mild dementia group, compared with AD patients (frequency: 43.2% (16/37), NPI score = 5.7 ± 11.9), a higher frequency of neuropsychiatric symptoms and higher NPI scores were observed in PDD patients (frequency: 71.40% (25/35), NPI score = 8.4 ± 9.8).More severe impairment in visuospatial ability and executive function was present in PDD patients compared with AD patients. And neuropsychiatric symptoms were more common and severe in PDD patients.
- Movement disorders: Tourette syndrome-beyond swearing and sex? [JOURNAL ARTICLE]
- Nat Rev Neurol 2013 Dec 3.
- Antiepileptic drugs and tourette syndrome. [Journal Article]
- Int Rev Neurobiol 2013.:373-89.
Tourette syndrome is a neurodevelopmental disorder characterized by the chronic presence of multiple motor tics and at least one vocal/phonic tic for the duration of 1 year. The clinical picture of patients with Tourette syndrome is often complicated by tic-related behavioral problems and associated psychopathology. The pathophysiology of Tourette syndrome is not thoroughly understood, however converging evidence from neuroimaging studies suggests abnormalities within the frontostriatal pathways which are mediated by several neurotransmitters. The pharmacological management of the tic symptoms focuses on the dopaminergic and noradrenergic pathways and aims to improve the health-related quality of life of patients. The most common medications are neuroleptics and atypical antipsychotics, which have a strong D2 blocking action. Also, preliminary studies have documented the efficacy of antiepileptic drugs in controlling tics. Thus far, two anticonvulsants (topiramate and levetiracetam) have been tested with a randomized, double-blind, placebo-controlled procedure in the treatment of tics. A study has reported an improvement in the control of tics with topiramate. This pharmacological agent was also reported to be well tolerated by the patients. However, the most frequent observed topiramate side effects (such as somnolence, cognitive problems, and weight loss) could not have manifested because of the short trial duration. Levetiracetam has shown conflicting results. A study found significant improvements in the control of tics, also associated with improvement in school performance. These results, however, were not replicated in other studies. Further investigations are therefore needed to assess the real efficacy of antiepileptic drugs in the treatment of tics.
- Identifying axial and cognitive correlates in patients with Parkinson's disease motor subtype using the instrumented Timed Up and Go. [JOURNAL ARTICLE]
- Exp Brain Res 2013 Nov 30.
Parkinson's disease (PD) is clinically highly heterogeneous, often divided into tremor dominant (TD) and postural instability gait difficulty (PIGD). To better understand these subtypes and to help stratify patients, we applied an objective marker, i.e., an instrumented version of the traditional "Timed Up and Go" test (iTUG). It is not known whether the iTUG is sensitive to PD motor phenotypes or what are its behavioral and cognitive correlates. Subjects performed the iTUG wearing a body-fixed sensor. Subcomponents were studied including walking, transitions and turning. Gait, balance and cognitive function and the associations between iTUG, behavioral and cognitive domains were assessed. We also compared two representative subtypes, with minimal symptom overlap, referred to here as predominant PIGD (p-PIGD) and predominant TD (p-TD). One hundred and six patients with PD performed the iTUG. Significant correlations were found between iTUG measures and the PIGD score, but not with TD score. Thirty p-PIGD and 31 p-TD patients were identified. Both groups were similar with respect to age and disease duration (p > 0.75). The p-PIGD patients took significantly longer to complete the iTUG (p = 0.026), used more steps (p = 0.031), albeit with similar step duration (p = 0.936). In the sit-to-stand transition, the p-PIGD patients exhibited lower anterior-posterior jerk (p = 0.04) and lower pitch range (p = 0.012). During the turn, the p-PIGD patients had a lower yaw amplitude (p < 0.038). Cognitive domains were correlated with iTUG measures in the p-PIGD patients, but not in the p-TD. These findings demonstrate that a single sensor can identify axial and cognitive correlates using subcomponents of the iTUG and reveals subtle alterations between the PD motor subtypes.