Real-World Driving Data Indexes Dopaminergic Treatment Effects in Parkinson's Disease.

Background: Driving is a complex, everyday task that impacts patient agency, safety, mobility, social connections, and quality of life. Digital tools can provide comprehensive real-world (RW) data on driver behavior in patients with Parkinson's disease (PD), providing critical data on disease status and treatment efficacy in the patient's own environment.

Objective: This pilot study examined the use of driving data as a RW digital biomarker of PD symptom severity and dopaminergic therapy effectiveness.

Digital driving data can track driving exposure and quality of life in Parkinson's disease.

Objective: Parkinson's disease (PD) impairs motor and non-motor functions. Driver strategies to compensate for impairments, like avoiding driving in risky environments, may reduce on-road risk at the cost of decreasing driver mobility, independence, and quality of life (QoL). It is unclear how PD symptoms link to driving risk exposure, strategies, and QoL.

Plantar Grasp sign as a screening tool for Orthostatic Tremor (OT).

Introduction: Orthostatic tremor (OT) is a rare neurological disorder characterized by a sensation of instability while standing. Very few clinical signs have been described for OT to date. Finding other symptoms and signs could prove valuable for this hard-to-recognized disease.

Medical Education 4.0: A Neurology Perspective.

Medical education faces a difficult challenge today; an exponential increase in knowledge and the rise and rise of disruptive technologies are making traditional education obsolete. As the world nears the era of Industry and Healthcare 4.0, the medical community needs to keep up and prepare physicians for a hyper-connected digital world.

Deep brain stimulation for refractory obsessive-compulsive disorder: A review and analysis of the FDA MAUDE database.

Background: Deep brain stimulation (DBS) is used as a treatment option for patients diagnosed with a form of obsessive-compulsive disorder (OCD) that is highly resistant to conventional treatment methods. In 2009, DBS was granted a humanitarian device exemption-approval by the Food and Drug Administration after promising preliminary data. Monitoring of long-term safety data through post market surveillance of adverse events has not yet been conducted for DBS in OCD patients.

Role of Specialized Pro-resolving Mediators in Reducing Neuroinflammation in Neurodegenerative Disorders.

Alzheimer's disease (AD) and Parkinson's disease (PD) are neurodegenerative disorders that affect millions of individuals worldwide. As incidence of these conditions increases with age, there will undoubtedly be an increased prevalence of cases in the near future. Neuroinflammation is a hallmark in the development and progression of neurodegenerative diseases and prevention or resolution of chronic neuroinflammation may represent a novel approach to treatment.

Chemodenervation for Oromandibular Dystonia Utilizing Botulinum Toxins.

Oromandibular dystonia (OMD) is a chronic focal dystonia that involves the mouth, jaw, and tongue. It may cause repetitive or sustained dystonic movements, which can be very disabling for patients. It is usually a life-long disorder with numerous treatment options that are, most often, partially curative.

Electroencephalography in Orthostatic Tremor: A Prospective Study of 30 Patients.

Background: Orthostatic tremor (OT) is characterized by a sensation of instability while standing, associated with high frequency (1318 Hz) tremor in the legs. Small retrospective series have reported electroencephalography (EEG) findings in OT with discordant results.

Methods: We prospectively enrolled 30 OT subjects.

Deep brain stimulation for Parkinson's disease in Pakistan: Current status, opportunities and challenges.

Parkinson's disease is a slowly progressive neurodegenerative disease that commonly affects people aged 60 years and above. So far, no treatment has been shown to halt or slow the progression of the disease and our options are limited to symptomatic management. Levodopa is the most preferred antiparkinsonian medication that provides excellent control of symptoms early in the disease.

Ataxia Prevalence in Primary Orthostatic Tremor.

Background: The exact pathophysiology of primary Orthostatic Tremor (OT) is unknown. A central oscillator is assumed, and previous imaging studies show involvement of cerebellar pathways. However, the presence of ataxia on clinical exam is disputed.

Role of Artificial Intelligence in TeleStroke: An Overview.

Teleneurology has provided access to neurological expertise and state-of-the-art stroke care where previously they have been inaccessible. The use of Artificial Intelligence with machine learning to assist telestroke care can be revolutionary. This includes more rapid and more reliable diagnosis through imaging analysis as well as prediction of hospital course and 3-month prognosis.

Training in Neurology: Rapid implementation of cross-institutional neurology resident education in the time of COVID-19.

In-person resident didactics are traditionally limited to the faculty within a single institution. Tele-education efforts have been implemented in neurology to various degrees historically, but the coronavirus disease 2019 (COVID-19) pandemic has necessitated a broad and immediate overhaul in neurology didactic training. To respond to the immediate need for resident didactics, we created a rapid onset, volunteer tele-education didactic series publicized on online forums to the American Academy of Neurology A.

Approach to exaggerated startle reflex: a case of hyperekplexia minor.

A broad set of conditions may present with an exaggerated startle reflex in clinics. This, combined with the overall rarity of these disorders, may pose diagnostic uncertainty in the mind of the treating physician. Herein, we report a case of a patient who presented to us with the complaint of exaggerated startle reflex and outline a simple approach towards characterisation of these disorders.

Recognizing Movement Disorder Emergencies - A Practical Review For Non-Neurologist.

Neurology still remains one of the most underserved specialties of medicine in Pakistan with roughly one neurologist per million people. Movement disorders (MD) are neurological problems that interfere with patient's motor abilities and diagnosis is typically clinical. In this review, we describe a practical approach to common MD emergencies that may be encountered by a non-neurologist physician, emphasizing on formulating a working diagnosis and their immediate management.

Current Practices for Outpatient Initiation of Levodopa-Carbidopa Intestinal Gel for Management of Advanced Parkinson's Disease in the United States.

In 2015, the US Food and Drug Administration approved levodopa-carbidopa intestinal gel (LCIG; also known as carbidopa-levodopa enteral suspension in the US) for the treatment of motor fluctuations in patients with advanced Parkinson's disease. LCIG provides a continuous infusion of levodopa and carbidopa by means of a portable pump and percutaneous endoscopic gastrojejunostomy tube. The delivery system has a two-fold pharmacokinetic advantage over orally administered carbidopa/levodopa.

Smartphone Apps Provide a Simple, Accurate Bedside Screening Tool for Orthostatic Tremor.

Background: Orthostatic Tremor (OT) is characterized by the presence of a sensation of instability while standing, associated with high frequency (13-18 Hz) lower extremity tremor. Diagnosis is confirmed with surface electromyography (EMG). An accurate screening tool that could be used in the routine clinical setting, without any specialized equipment, would be useful in earlier detection of OT and judicial use of additional testing.

Rationale and patient selection for interventional therapies in Parkinson's disease.

Parkinson's disease (PD) is increasing in prevalence due to a growing elderly population. Although there is no cure, there are exercise therapies and medications for mild to moderate disease. For more advanced disease, infusion or surgical interventions including deep brain stimulation surgery, levodopa carbidopa intestinal gel, and subcutaneous apomorphine infusion are considered.

Orthostatic Tremor: Pathophysiology Guiding Treatment.

Purpose Of Review: Orthostatic tremor (OT) is a rare disorder characterized by tremor and a feeling of unsteadiness while standing that resolve upon walking or sitting. A pathognomonic 13-18 Hz tremor is seen on surface EMG while standing. Though its clinical features have been better defined over time, much of its pathophysiology remains unknown and treatment options are limited.

Movement Disorders and Deep Brain Stimulation in the Middle East.

Background: Deep brain stimulation (DBS) is a well-established neuromodulation therapy for advanced Parkinson disease, essential tremor and dystonia. In as much as this therapy is being developed in the Middle East, a better understanding of the incidence and prevalence of movement disorders, health care, and social framework is required for the region.

Methods: We reviewed current literature on the incidence and prevalence of various movement disorders in the Middle East amenable to DBS surgery.

Pathogenesis of Primary Orthostatic Tremor: Current Concepts and Controversies.

Background: Orthostatic tremor (OT), a rare and complex movement disorder, is characterized by rapid tremor of both legs and the trunk while standing. These disappear while the patient is either lying down or walking. OT may be idiopathic/primary or it may coexist with several neurological conditions (secondary OT/OT plus).

Comprehensive, blinded assessment of balance in orthostatic tremor.

Introduction: Orthostatic Tremor (OT) is a movement disorder characterized by a sensation of unsteadiness and tremors in the 13-18 Hz range present upon standing. The pathophysiology of OT is not well understood but there is a relationship between the sensation of instability and leg tremors. Despite the sensation of unsteadiness, OT patients do not fall often and balance in OT has not been formally assessed.

Utilization of rehabilitation therapy services in Parkinson disease in the United States.

Objective: To examine rehabilitation therapy utilization for Parkinson disease (PD).

Methods: We identified 174,643 Medicare beneficiaries with a diagnosis of PD in 2007 and followed them through 2009. The main outcome measures were annual receipt of physical therapy (PT), occupational therapy (OT), or speech therapy (ST).