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Neuropharmacology Oct 2023Many patients with Parkinson's disease (PD) experiencing l-DOPA-induced dyskinesia (LID) receive adjunct treatment with dopamine agonists, whose functional impact on LID...
Many patients with Parkinson's disease (PD) experiencing l-DOPA-induced dyskinesia (LID) receive adjunct treatment with dopamine agonists, whose functional impact on LID is unknown. We set out to compare temporal and topographic profiles of abnormal involuntary movements (AIMs) after l-DOPA dose challenges including or not the dopamine agonist ropinirole. Twenty-five patients with PD and a history of dyskinesias were sequentially administered either l-DOPA alone (150% of usual morning dose) or an equipotent combination of l-DOPA and ropinirole in random order. Involuntary movements were assessed by two blinded raters prior and every 30 min after drug dosing using the Clinical Dyskinesia Rating Scale (CDRS). A sensor-recording smartphone was secured to the patients' abdomen during the test sessions. The two raters' CDRS scores were highly reliable and concordant with models of hyperkinesia presence and severity trained on accelerometer data. The dyskinesia time curves differed between treatments as the l-DOPA-ropinirole combination resulted in lower peak severity but longer duration of the AIMs compared with l-DOPA alone. At the peak of the AIMs curve (60-120 min), l-DOPA induced a significantly higher total hyperkinesia score, whereas in the end phase (240-270 min), both hyperkinesia and dystonia tended to be more severe after the l-DOPA-ropinirole combination (though reaching statistical significance only for the item, arm dystonia). Our results pave the way for the introduction of a combined l-DOPA-ropinirole challenge test in the early clinical evaluation of antidyskinetic treatments. Furthermore, we propose a machine-learning method to predict CDRS hyperkinesia severity using accelerometer data.
Topics: Humans; Antiparkinson Agents; Dopamine Agonists; Dyskinesia, Drug-Induced; Dystonia; Hyperkinesis; Levodopa; Oxidopamine; Parkinson Disease
PubMed: 37315840
DOI: 10.1016/j.neuropharm.2023.109630 -
Toxins Apr 2022Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the... (Review)
Review
Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential diagnoses require neurological and dental knowledge. This study aimed to review scientific advances in botulinum toxin therapy for these conditions. The results indicated that botulinum toxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of movement disorders in the stomatognathic system require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approach must be necessary to ensure accurate diagnosis and proper treatment.
Topics: Botulinum Toxins; Botulinum Toxins, Type A; Dyskinesias; Dystonia; Dystonic Disorders; Humans; Movement Disorders; Stomatognathic System
PubMed: 35448891
DOI: 10.3390/toxins14040282 -
Journal of Neural Transmission (Vienna,... Apr 2013Levodopa/Carbidopa, respectively, Levodopa/Benserazide is the most effective treatment for Parkinson's disease and during the progress of the disease, patients will... (Review)
Review
Levodopa/Carbidopa, respectively, Levodopa/Benserazide is the most effective treatment for Parkinson's disease and during the progress of the disease, patients will inevitably need to be treated with it. Nonetheless, after a certain time period most of the patients experience side effects. Mainly disturbing are motor and non-motor fluctuations and dyskinesia. Numerous options from changing the medication regimen, to continuos dopaminergic drug delivery via apomorphine or Duodopa pumps and stereotactical interventions are available. The physician's responsibility is to choose the right therapeutic procedure for each timepoint of the patient's disease. In this review, we provide an up to date overview of the available strategies.
Topics: Antiparkinson Agents; Carbidopa; Dopamine Agonists; Drug Combinations; Dyskinesias; Humans; Levodopa; Parkinson Disease
PubMed: 23474822
DOI: 10.1007/s00702-013-1008-y -
The Western Journal of Medicine Oct 1976Orofacial or tardive dyskinesias are involuntary repetitive movements of the mouth and face. In most cases, they occur in older psychotic patients who are in... (Review)
Review
Orofacial or tardive dyskinesias are involuntary repetitive movements of the mouth and face. In most cases, they occur in older psychotic patients who are in institutions and in whom long-term treatment with antipsychotic drugs of the phenothiazine and butyrophenone groups is being carried out. These dyskinesias are frequent in occurrence and characteristically are irreversible. Several biochemical mechanisms have been proposed as causes, including hypersensitivity or partially deneverated brain dopamine receptors and low affinity of the offending drugs for brain muscarinic cholinergic receptors. Clinical therapy has been attempted primarily with drugs that antagonize dopamine receptors or deplete brain dopamine. The benefits of drug treatment have been variable and lack of consistent improvement has been discouraging. Early recognition of dyskinesia should be attempted, and the dose reduced or the drug omitted at the first sign.
Topics: Antipsychotic Agents; Brain; Dyskinesia, Drug-Induced; Female; Humans; Male; Middle Aged; Receptors, Dopamine
PubMed: 23611
DOI: No ID Found -
Schizophrenia Bulletin Jul 2010Several studies have reported the presence of dyskinesia and parkinsonism in antipsychotic-naive patients with schizophrenia as well as in their first-degree relatives.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies have reported the presence of dyskinesia and parkinsonism in antipsychotic-naive patients with schizophrenia as well as in their first-degree relatives. These movement disorders may therefore form an integral part of the illness and its (genetic) liability.
METHOD
A systematic search was conducted in the Medline, EMBASE, and PsychINFO databases to identify studies reporting on dyskinesia and parkinsonism assessed in antipsychotic-naive patients with schizophrenia (n = 213) and controls (n = 242) and separately in nonill first-degree relatives (n = 395) and controls (n = 379). Effect sizes were pooled using random-effect models to calculate odds ratios (ORs) to compare the risk of these movement disorders among patients and healthy relatives each with matched controls.
RESULTS
Antipsychotic-naive schizophrenia was found to be strongly associated with dyskinesia (OR: 3.59, 95% confidence interval [CI]: 1.53-8.41) and parkinsonism (OR: 5.32, 95% CI: 1.75-16.23) compared with controls. Dyskinesia and parkinsonism were also significantly more prevalent in healthy first-degree relatives of patients with schizophrenia as compared with healthy controls (OR: 1.38, 95% CI: 1.06-1.81, and OR: 1.37, 95% CI: 1.05-1.79, respectively).
CONCLUSION
The results suggest that movement disorders, and by inference abnormalities in the nigrostriatal pathway, are not only associated with schizophrenia itself but may also be related to the (genetic) risk of developing the disease.
Topics: Comorbidity; Corpus Striatum; Dyskinesias; Genetic Predisposition to Disease; Humans; Neural Pathways; Odds Ratio; Parkinsonian Disorders; Reference Values; Risk; Schizophrenia; Substantia Nigra
PubMed: 18990712
DOI: 10.1093/schbul/sbn146 -
The American Journal of Managed Care Mar 2008The nonmotor neuropsychiatric symptoms of Parkinson's disease, particularly depression, psychosis, and cognitive impairment/dementia, are major contributors to... (Review)
Review
The nonmotor neuropsychiatric symptoms of Parkinson's disease, particularly depression, psychosis, and cognitive impairment/dementia, are major contributors to disability and a decline in quality of life. Their effect on patients may be more disabling than motor symptoms. Increasing awareness of the importance of recognizing and treating neuropsychiatric symptoms of this disease in the medical community is a focus of specialists and organizations. This article looks at useful screening measures to help clinicians recognize neuropsychiatric symptoms and offers suggestions for their effective treatment.
Topics: Dyskinesias; Humans; Mental Disorders; Parkinson Disease; Sickness Impact Profile
PubMed: 18402509
DOI: No ID Found -
European Review For Medical and... Jul 2015Movement disorders are neurological conditions affecting the ability to produce and control voluntary as well as involuntary movements, and may be categorized into... (Review)
Review
Movement disorders are neurological conditions affecting the ability to produce and control voluntary as well as involuntary movements, and may be categorized into akinetic/rigid and hyperkinetic disorders. The hyperkinetic disorders are generally perceived as being the most difficult to diagnose correctly. They are manifested by excessive, abnormal involuntary movements, and are referred to as dyskinesias. The conditions are further designated paroxysmal dyskinesias when the abnormal movements occur episodically, followed by a rapid return to normality without impaired consciousness between episodes. The events can be precipitated by sudden voluntary movements, or may occur spontaneously at rest, or precipitated by exertion or sleep. Most conditions are either inherited or sporadic, and some cases are associated with specific conditions. Although clinical scenarios can be confusing, considerable advances in the phenotype characterisation and genetic studies have provided important information that allowed simplifying the clinical definitions and diagnosis of the paroxysmal dyskinesias. These advances have helped understand the pathophysiology of these disorders and their variants.
Topics: Animals; Chorea; Humans; Movement Disorders; Phenotype; Sleep
PubMed: 26214782
DOI: No ID Found -
Movement Disorders : Official Journal... Mar 2017Historically, the syndrome of primary paroxysmal dyskinesias was considered a group of disorders as a result of ion channel dysfunction. This proposition was primarily... (Review)
Review
Historically, the syndrome of primary paroxysmal dyskinesias was considered a group of disorders as a result of ion channel dysfunction. This proposition was primarily based on the discovery of mutations in ion channels, which caused other episodic neurological disorders such as epilepsy and migraine and also supported by the frequent association between paroxysmal dyskinesias and epilepsy. However, the discovery of the genes responsible for the 3 classic forms of paroxysmal dyskinesias disproved this ion channel theory. On the other hand, novel gene mutations implicating ion channels have been recently reported to produce episodic movement disorders clinically similar to the classic paroxysmal dyskinesias. Here, we review the clinical and pathophysiological aspects of the paroxysmal dyskinesias, further proposing a pathophysiological framework according to which they can be classified as synaptopathies (proline-rich transmembrane protein 2 and myofibrillogenesis regulator gene), channelopathies (calcium-activated potassium channel subunit alpha-1 and voltage-gated sodium channel type 8), or transportopathies (solute carrier family 2 member 1). This proposal might serve to explain similarities and differences among the various paroxysmal dyskinesias in terms of clinical features, treatment response, and natural history. © 2017 International Parkinson and Movement Disorder Society.
Topics: Channelopathies; Dyskinesias; Epilepsy; Humans
PubMed: 28090678
DOI: 10.1002/mds.26901 -
Movement Disorders : Official Journal... Jan 2015Levodopa replacement therapy has long provided the most effective treatment for Parkinson's disease (PD). We review how this dopamine (DA) precursor enhances... (Review)
Review
Levodopa replacement therapy has long provided the most effective treatment for Parkinson's disease (PD). We review how this dopamine (DA) precursor enhances dopaminergic transmission by providing a greater sphere of neurotransmitter influence as a result of the confluence of increased quantal size and decreased DA reuptake, as well as loading DA as a false transmitter into surviving serotonin neuron synaptic vesicles. We further review literature on how presynaptic dysregulation of DA release after l-dopa might trigger dyskinesias in PD patients.
Topics: Animals; Dopamine; Dopamine Agents; Dyskinesia, Drug-Induced; Humans; Levodopa; Neurons; Parkinson Disease; Presynaptic Terminals
PubMed: 25450307
DOI: 10.1002/mds.26103 -
Tremor and Other Hyperkinetic Movements... 2018Paroxysmal movement disorders are rare and heterogeneous genetic conditions characterized by the recurrence of transient involuntary movements. (Review)
Review
BACKGROUND
Paroxysmal movement disorders are rare and heterogeneous genetic conditions characterized by the recurrence of transient involuntary movements.
PHENOMENOLOGY SHOWN
The phenomenology of a paroxysmal kinesigenic dyskinesia in a young professional athlete.
EDUCATIONAL VALUE
Providing basic clinical and genetic elements for the early recognition and diagnosis of a rare movement disorder.
Topics: Adult; Chorea; Diagnosis, Differential; Heterozygote; Humans; Male; Membrane Proteins; Mutation; Nerve Tissue Proteins
PubMed: 30622840
DOI: 10.7916/D8S488X0