Publications by authors named "Gironell A"

Objective: The effects of stimulation frequency on verbal fluency (VF) following subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) are not well understood. The present study examines the impact stimulation frequency has on VF following bilateral STN-DBS in PD.

Methods: Prospective study of 38 consecutive patients with PD with low frequency STN-DBS (LFS) (n = 10) and high frequency STN-DBS (HFS) (n = 14), and a non-operated PD control group consisting of patients with fluctuating response to dopaminergic medication (n = 14) homogeneous in age, education, disease duration, and global cognitive function.

View Article and Find Full Text PDF

In the last decades there has been progress in the treatment of essential tremor (TE) especially in the surgical field and to a lesser extent in the pharmacological field. We carry out a review of the currently available treatments. The first intervention is the use of non-pharmacological and non-surgical strategies (general advice, occupational therapy, speech therapy, psychotherapy).

View Article and Find Full Text PDF

Introduction: The existence of non-motor symptoms in essential tremor (ET) and the appearance of a new condition, ET-plus, are two controversial issues.

Aims: To offer a review of the current status of these two topics.

Development: We performed an analysis of the studies conducted on non-motor symptoms in ET and of the articles for and against the use of the term ET-plus.

View Article and Find Full Text PDF

Background: We describe our experience of using perampanel to treat essential tremor (ET) over 12 months.

Methods: We enrolled 50 ET patients in an open-label trial. Perampanel was titrated to 4 mg/day as adjuvant therapy.

View Article and Find Full Text PDF

Dysfunction in gamma-aminobutyric acid (GABA) neurotransmission has emerged as a prime suspect for the underlying neurochemical dysfunction in essential tremor (ET). This dysfunction has been termed the GABA hypothesis. We review findings to date supporting the 4 steps in this hypothesis in studies of cerebrospinal fluid, pathology, genetics, animal models, imaging, computational models, and human drugs, while not overlooking the evidence of negative studies and controversies.

View Article and Find Full Text PDF

Background: For specialists in charge of Parkinson's disease (PD), one of the most time-consuming tasks of the consultations is the assessment of symptoms and motor fluctuations. This task is complex and is usually based on the information provided by the patients themselves, which in most cases is complex and biased. In recent times, different tools have appeared on the market that allow automatic ambulatory monitoring.

View Article and Find Full Text PDF

Mild cognitive impairment in Parkinson's disease (PD-MCI) is associated with consistent structural and functional brain changes. Whether different approaches for diagnosing PD-MCI are equivalent in their neural correlates is presently unknown. We aimed to profile the neuroimaging changes associated with the two endorsed methods of diagnosing PD-MCI.

View Article and Find Full Text PDF

Introduction: Essential tremor (ET) is one of the most common movement disorders. Despite its high prevalence and heritability, its genetic etiology remains elusive with only a few susceptibility genes identified and poorly replicated. Our aim was to find novel candidate genes involved in ET predisposition through whole exome sequencing.

View Article and Find Full Text PDF

Background And Purpose: Impulsivity is an aspect of personality and a major component of multiple neuropsychiatric conditions. In Parkinson's disease, it has been associated with the expression of impulse control disorders, a highly prevalent non-motor complication. Even though multiple tests of impulsivity have been used in this context, the impact of test choice has not been addressed.

View Article and Find Full Text PDF

Background: Impulse control disorders (ICD) are a common and disrupting complication of Parkinson's disease (PD) treatment. Although their relationship with dopaminergic activity is well studied, their brain metabolic correlates are mostly unknown.

Methods: In this work we studied brain metabolism using brain F-FDG-PET.

View Article and Find Full Text PDF

Background: Primary orthostatic tremor (POT) is a rare disorder for which current treatments are largely ineffective. Following up on our recent report of complete resolution of POT symptoms in a patient using low doses of perampanel, we describe our experience of perampanel in 20 patients.

Methods: Twenty patients whose neurologists prescribed perampanel were recruited.

View Article and Find Full Text PDF

Cognitive decline is a major disabling feature in Parkinson's disease (PD). Multimodal imaging studies have shown functional disruption in neurocognitive networks related to cognitive impairment. However, it remains unknown whether these changes are related to gray matter loss, or whether they outline network vulnerability in the early stages of cognitive impairment.

View Article and Find Full Text PDF

Background: Propriospinal myoclonus is an infrequent type of hyperkinetic movement that can be commonly idiopathic but also may occur after spinal cord lesions.

Phenomenology Shown: We describe an 8-year-old female showing repetitive flexor and extensor arrhythmic brief jerks of the trunk, compatible with propriospinal myoclonus secondary to cervical myelopathy.

Educational Value: Isolated propriospinal myoclonus may be the clinical sign that leads to the diagnosis of incipient myelopathy.

View Article and Find Full Text PDF

Background: The current classification of tremor types in Parkinson disease (PD) is potentially confusing, particularly for mixed tremor, and there is no label for pure resting tremor. With a view to better defining the clinical phenomenological classification of these tremors, our group relabeled the different types as follows: pure resting tremor (type I); mixed resting and action tremor with similar frequencies (type II) divided, according to action tremor presentation, into II-R when there is a time lag and II-C otherwise; pure action tremor (type III); and mixed resting and action tremor with differing frequencies (type IV). We performed a descriptive study to determine prevalence and clinical correlates for this new tremor classification.

View Article and Find Full Text PDF

Impulse control disorders (ICDs) are a common complication of Parkinson's disease (PD) receiving dopamine agonist (DAA) Impulsivity is considered an underlying mechanism but evidence of this relationship is scarce. To explore the relationship between impulsivity and the presence and severity of ICD in PD. Prospective cross-sectional study of consecutive PD outpatients.

View Article and Find Full Text PDF

Background: Primary orthostatic tremor (POT) is an infrequent disorder whose physiopathology is unknown. Current medication is largely ineffective or only offers mild benefits.

Case Report: A 75-year-old female with refractory POT treated with 4 mg/day of perampanel achieved complete symptom resolution.

View Article and Find Full Text PDF

Introduction: Advanced Parkinson's disease (PD) entails complications, such as motor fluctuations. In Spain, medical attention for such cases is often provided in movement disorder units (MDU).

Aim: To gain further knowledge of the diagnostic resources and therapeutic approach of MDU.

View Article and Find Full Text PDF

Background And Purpose: The incidence, underlying physiopathology, features and association with lesion topography of visual hallucinations in acute stroke have scarcely been investigated.

Methods: Patients with a diagnosis of acute stroke (ischaemic or haemorrhagic) in any vascular territory, admitted within 24 h after the onset of symptoms, were consecutively included in the study. Patients with a previous history of psychosis or cognitive impairment were excluded.

View Article and Find Full Text PDF

Background: T-type calcium channel activation has been postulated to underlie rhythmicity in the olivo-cerebellar system that is implicated in ET. Ethosuximide reduces T-type calcium currents and can suppress tremor in two animal models of ET. We explored the effects of ethosuximide in subjects with ET in an open-label trial using both clinical scales and accelerometric recordings measures.

View Article and Find Full Text PDF

Introduction: Essential tremor is the most frequent movement disorder in adults. It has been considered a benign disease, but can result in significant physical and psychosocial disability. Pharmacological treatment is still not very satisfactory.

View Article and Find Full Text PDF

The pathophysiology and the exact anatomy of essential tremor (ET) is not well known. One of the pillars that support the cerebellum as the main anatomical locus in ET is neurochemistry. This review examines the link between neurochemical abnormalities found in ET and cerebellum.

View Article and Find Full Text PDF

Objectives: The description of minor hallucinatory phenomena (presence, passage hallucinations) has widened the spectrum of psychosis in Parkinson's disease (PD). Minor hallucinatory phenomena seem to antedate the development of more severe hallucinations. Early detection of minor hallucinations may be useful for screening patients with more severe endophenotypes.

View Article and Find Full Text PDF