Improving tremor response to focused ultrasound thalamotomy.

MRI-guided high-intensity focused ultrasound thalamotomy is an incisionless therapy for essential tremor. To reduce adverse effects, the field has migrated to treating at 2 mm above the anterior commissure-posterior commissure plane. We perform MRI-guided high-intensity focused ultrasound with an advanced imaging targeting technique, four-tract tractography.

Focused ultrasound using a novel targeting method four-tract tractography for magnetic resonance-guided high-intensity focused ultrasound targeting.

Magnetic resonance-guided high-intensity focused ultrasound thalamotomy is a Food and Drug Administration-approved treatment for essential tremor. The target, the ventral intermediate nucleus of the thalamus, is not visualized on standard, anatomic MRI sequences. Several recent reports have used diffusion tensor imaging to target the dentato-rubro-thalamic-tract.

Lateralization of Motor Signs Affects Symptom Progression in Parkinson Disease.

Asymmetry of motor signs is a cardinal feature of Parkinson disease which may impact phenotypic expression. To investigate the relationship between lateralization of motor signs and symptom progression and severity during longitudinal observation for up to 4 years in a naturalistic study. We analyzed data prospectively collected during the NINDS Parkinson Disease Biomarker Project (PDBP).

The spiral axis: A comparison of unaffected first-degree relatives of essential tremor cases vs. controls.

We previously observed that during a spiral drawing task, in essential tremor (ET) cases, the tremor wave forms align along a single predominant axis. This interesting clinical feature can distinguish ET from dystonia cases. We now investigate whether the unaffected relatives of ET cases also express this trait, albeit perhaps in a milder form.

Keeping up with the clinical advances: tardive dyskinesia.

Tardive dyskinesia (TD) was first described in 1964, but treatment for this sometimes poorly characterized condition lagged decades as it was labored by medico-legal implications. TD has often been lumped with other medication-induced disorders and incorrectly classified as extrapyramidal symptoms. TD is likely to be under-recognized for many of these reasons.

The role of extended-release amantadine for the treatment of dyskinesia in Parkinson's disease patients.

Levodopa is the most efficacious treatment for Parkinson's disease (PD). Long-term treatment with levodopa is limited due to dyskinesia. Dyskinesia in PD can be socially and functionally disabling.