Long-Term Outcomes of Patients with Pre-Existing Essential Tremor After SARS-CoV-2 Infection.

Background/objectives: Although COVID-19 has been linked to worse outcomes in patients with neurological disorders, its impact on those with essential tremor (ET) remains unclear. To investigate clinical outcomes of ET patients with and without COVID-19 three and a half years post-pandemic.

Methods: 1074 ET patients were evaluated in this retrospective study in the Montefiore Health System from January 2016 to July 2023.

Essential Tremor accentuates the pattern of tremor-band coherence between upper-limb muscles.

Although Essential Tremor is one of the most common movement disorders, current treatment options are relatively limited. Peripheral tremor suppression methods have shown potential, but we do not currently know which muscles are most responsible for patients' tremor, making it difficult to optimize suppression methods. The purpose of this study was to quantify the relationships between the tremorogenic activity in muscles throughout the upper limb.

Tic Disorders, Anti-Tic Medications, and Risk of Atopy.

Objective: To clarify patterns of comorbid atopic disorders in children with tic disorders compared to controls, and to evaluate whether medications commonly used for treatment of tics and attention deficit hyperactivity disorder (ADHD) are associated with differing risks of atopy.

Background: Inflammatory mechanisms are increasingly recognized as playing a role in a range of neuropsychiatric disorders. The association between tic disorders, ADHD, obsessive-compulsive disorder (OCD) and atopic disorders is uncertain.

Distribution of tremorogenic activity among the major superficial muscles of the upper limb in persons with Essential tremor.

Objective: Peripheral tremor suppression has the potential to reduce tremor, but we do not currently know where best to intervene. The purpose of this study was to characterize the distribution of tremorogenic activity among upper-limb muscles.

Methods: Surface electromyography was recorded from the 15 major superficial muscles of the upper limb while 25 patients with Essential Tremor performed postural and kinetic tasks.

Gender disparity and abuse in functional movement disorders: a multi-center case-control study.

Background: To determine gender differences in rates of sexual and physical abuse in functional movement disorders compared to controls and evaluate if the gender disparity of functional movement disorders is associated with abuse history.

Methods: We performed a retrospective case-control study of self-reported trauma data from 696 patients (512 women) with functional movement disorders from six clinical sites compared to 141 controls (98 women) and population data. Chi-square was used to assess gender and disorder associations; logistic regression was used to model additive effects of abuse and calculate the attributable fraction of abuse to disorder prevalence.

Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda.

Functional neurological disorder (FND) was of great interest to early clinical neuroscience leaders. During the 20th century, neurology and psychiatry grew apart - leaving FND a borderland condition. Fortunately, a renaissance has occurred in the last two decades, fostered by increased recognition that FND is prevalent and diagnosed using "rule-in" examination signs.

Distribution of tremor among the major degrees of freedom of the upper limb in subjects with Essential Tremor.

Objective: Although Essential Tremor is one of the most common movement disorders, we do not currently know which muscles are most responsible for tremor. Determining this requires multiple steps, one of which is characterizing the distribution of tremor among the degrees of freedom (DOF) of the upper limb.

Methods: Upper-limb motion was recorded while 22 subjects with ET performed postural and kinetic tasks involving a variety of limb configurations.

Effects of gene variation and childhood trauma on the clinical and circuit-level phenotype of functional movement disorders.

Background: Functional movement disorders (FMDs), part of the wide spectrum of functional neurological disorders (conversion disorders), are common and often associated with a poor prognosis. Nevertheless, little is known about their neurobiological underpinnings, particularly with regard to the contribution of genetic factors. Because FMD and stress-related disorders share a common core of biobehavioural manifestations, we investigated whether variants in stress-related genes also contributed, directly and interactively with childhood trauma, to the clinical and circuit-level phenotypes of FMD.

Functional Speech and Voice Disorders: Case Series and Literature Review.

Background: Functional disorders of speech and voice, subtypes of functional movement disorders, represent abnormalities in speech and voice that are thought to have an underlying psychological cause. These disorders exhibit several positive and negative features that distinguish them from organic disorders.

Methods And Results: We describe the clinical manifestations of functional disorders of speech and voice, and illustrate these features using six clinical cases.

Pseudobulbar Affect in Parkinsonian Disorders: A Review.

Pseudobulbar affect (PBA) is a neurological symptom of inappropriate and uncontrollable laughter or crying that occurs secondary to a variety of neurological conditions, including parkinsonian disorders. PBA is a socially and emotionally debilitating symptom that has been estimated to affect 3.6% to 42.

Gray matter differences in patients with functional movement disorders.

Objective: To explore alterations in gray matter volume in patients with functional movement disorders.

Methods: We obtained T1-weighted MRI on 48 patients with clinically definite functional movement disorders, a subset of functional neurologic symptom disorder characterized by abnormal involuntary movements, and on 55 age- and sex-matched healthy controls. We compared between-group differences in gray matter volume using voxel-based morphometry across the whole brain.

Impaired self-agency in functional movement disorders: A resting-state fMRI study.

Objective: To investigate the neural mechanisms underlying impaired self-agency in patients with functional movement disorders using resting-state functional MRI (fMRI).

Methods: We obtained resting-state fMRI on 35 patients with clinically definite functional movement disorders and 35 age- and sex-matched healthy controls. Between-group differences in functional connectivity from the right temporo-parietal junction (TPJ), a region previously demonstrated to play a critical role in self-agency by comparing internal predictions of movement with actual external events, were assessed using t tests.

Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

Background: Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem.

Objective: To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects.

A biological measure of stress levels in patients with functional movement disorders.

Introduction: While the presence of co-existing psychological stressors has historically been used as a supportive factor in the diagnosis of functional neurological disorders, many patients with functional neurological disorders deny the presence of these stressors. The stress response circuitry in these patients remains largely unexplored.

Methods: We performed an observational study examining biological stress levels in patients with functional movement disorders as compared with matched healthy controls.

The "Whack-a-Mole" Sign in Functional Movement Disorders.

Making the diagnosis of functional movement disorders can be challenging. Identifying positive physical signs and diagnostic maneuvers is critical to this process. Distractibility, entrainability, and variability are examples of classic physical findings in these patients.

Enhanced derivation of mouse ESC-derived cortical interneurons by expression of Nkx2.1.

Forebrain GABAergic interneurons are divided into subgroups based on their neurochemical markers, connectivity and physiological properties. Abnormal interneuron function is implicated in the pathobiology of neurological disorders such as schizophrenia, autism, and epilepsy. Studies on interneuron development and their role in disease would benefit from an efficient mechanism for the production and selection of specific interneuron subgroups.

Related F-box proteins control cell death in Caenorhabditis elegans and human lymphoma.

Cell death is a common metazoan cell fate, and its inactivation is central to human malignancy. In Caenorhabditis elegans, apoptotic cell death occurs via the activation of the caspase CED-3 following binding of the EGL-1/BH3-only protein to the antiapoptotic CED-9/BCL2 protein. Here we report a major alternative mechanism for caspase activation in vivo involving the F-box protein DRE-1.

Ceramide biogenesis is required for radiation-induced apoptosis in the germ line of C. elegans.

Ceramide engagement in apoptotic pathways has been a topic of controversy. To address this controversy, we tested loss-of-function (lf) mutants of conserved genes of sphingolipid metabolism in Caenorhabditis elegans. Although somatic (developmental) apoptosis was unaffected, ionizing radiation-induced apoptosis of germ cells was obliterated upon inactivation of ceramide synthase and restored upon microinjection of long-chain natural ceramide.

Timing of the onset of a developmental cell death is controlled by transcriptional induction of the C. elegans ced-3 caspase-encoding gene.

Temporal control of programmed cell death is necessary to ensure that cells die at only the right time during animal development. How such temporal regulation is achieved remains poorly understood. In some Caenorhabditis elegans somatic cells, transcription of the egl-1/BH3-only gene promotes cell-specific death.