bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand tremor in patients with spasmodic torticollis
Authors: Deuschl Günther , Heinen Florian , Guschlbauer Brigitte , Schneider Sybilla , Glocker Franz X. , Lücking Carl H. 
Published: May 2005

AbstractThe occurrence of hand tremors in patients with spasmodic torticollis (ST) was investigated in 55 patients by clinical and quantitative measurements. Ten patients had first‐order or second‐order relatives affected with postural tremor. Although 40% of the patients had a medical history and clinical findings for mild postural and action tremor of the hands, only four had moderate tremor amplitudes. One patient had a severe tremor, including resting tremor, and two had mild voice tremor. A positive correlation was found between hand and head tremor. Patients with hand tremor were younger at the onset of ST than were those without. The mean amplitudes of postural tremor were only slightly higher than for the controls and much smaller than those found in classic essential tremor. The tremor caused only mild disabilities. The tremor frequencies were indistinguishable from physiologic tremor. Further analysis of the tremor records showed evidence for physiologic tremor mechanisms only. We conclude that slightly enhanced postural hand tremors are common in ST but have a low amplitude and are only rarely clinically relevant for ST patients. Although the present data support the notion of an enhanced risk of postural tremor in families of patients affected with ST, none of the criteria allowed the separation of the hand tremor of ST from other postural/action tremors and especially from enhanced physiologic tremor. Thus, the present data do not support the classification of hand tremor in ST as either “dystonic” or essential tremor.
Lateralization of the p22/n30 component of somatosensory evoked potentials of the median nerve in patients with cervical dystonia
Authors: Kǎovský Petr , Streitová Hana , Dufek Jaroslav , Rektor Ivan 
Published: May 2005

AbstractSomatosensory evoked potentials (SEPs) of the median nerve were recorded in 40 patients suffering from cervical dystonia and in 40 healthy volunteers as a control. Before recording the median nerve SEPs, polymyographic recordings were performed in all patients with cervical dystonia. The activity of cervical muscles was recorded, and the leading muscle of cervical dystonia was determined. Patients were divided into two groups according to the results of polymyography. The leading muscle was sternocleidomastoid in the first group and the splenius capitis in the second group. Patient SEPs were recorded during abnormal head rotation. SEPs in 20 healthy volunteers were recorded with the head in the middle position. SEPs of another 20 healthy volunteers were recorded with the head rotated 60° to the right. The mean peak‐to‐peak amplitude values of the precentral P22/N30 complex and the mean ratio of the P22/N30 amplitudes between both hemispheres were calculated in the F3 (F4) and C3′ (C4′) electrode positions in all four groups. No significant lateralization of the precentral P22/N30 component was found in either group of healthy volunteers. In dystonic patients in whom the sternocleidomastoid was determined as the leading muscle of dystonia, a statistically significant lateralization of the P22/N30 component toward the ipsilateral side of the leading muscle was found. In the group with the splenius capitis determined as the leading muscle of dystonia, a statistically significant lateralization of the P22/N30 component toward the contralateral side of the leading muscle was found. The possibility that the precentral cortex is activated differently in cervical dystonia patients who have different muscle patterns of dystonia is discussed.
Neurophysiological investigations in patients with head tremor
Authors: Valls‐Solé Josep , Tolosa Eduardo S. , Nobbe Fritz , Diéguez Elena , Mun̄oz Esteban , Sanz Pilar , Valldeoriola Francesc 
Published: May 2005

AbstractWe studied 30 patients whose primary complaint was head tremor in an attempt to characterize neurophysiological aspects of their abnormal movement. Based on family medical history and physical examination, 23 patients had definite or probable essential tremor (essential head tremor, EHT). The remaining seven had mild dystonic signs accompanying their head tremor (head tremor plus dystonic signs, HT + DS). We recorded head movement and the electromyographic (EMG) activity of the sternomastoid and splenius capitis muscles, determined the spontaneous blinking rate, and measured the excitability recovery curve of the blink reflex and of the masseteric inhibitory reflex. All patients had tremor bursts at a frequency ranging between 3 and 9 Hz in at least one of the muscles examined. The predominant pattern seen when patients were sitting relaxed and facing forward was that of synchronized EMG bursts in both splenius capitis muscles. Maintenance of extreme head postures demonstrated two types of additional abnormalities: type 1 (enhancement of tremor), which was observed in 11 patients (47.8%) with EHT and in two (28.5%) with HT + DS; and type 2 (activation of neck muscles not required for maintenance of the posture), which was observed in two patients (8.7%) with EHT and in five (71.5%) with HT + DS (X2 = 26.4; p < 0.001). Mean blinking rate per minute was 24.9 ± 14.6 in patients with EHT and 42.3 ± 10.5 in patients with HT + DS (paired t test, p = 0.001). The blink reflex and masseteric inhibitory reflex excitability recovery curves showed an abnormal interneuronal excitability enhancement in seven (30.4%) of the 23 patients with EHT and in two (28.5%) of the seven with HT + DS (X2 = 3.1; p > 0.05). Abnormal patterns of EMG activity of the neck muscles correlated well with the presence of mild dystonic signs. However, the analysis of brainstem interneuronal excitability did not enable recognition of those patients with head tremor who could potentially develop cervical dystonia. The enhancement of brainstem interneuronal excitability found in −30% of patients with head tremor could be related to plastic changes triggered by increased activity of the cranial muscles.
Performance of sequential arm movements with and without advance knowledge of motor pathways in Parkinson's disease
Authors: Currà Antonio , Berardelli Alfredo , Agostino Rocco , Modugno Nicola , Puorger Cristiana Conti , Accornero Neri , Manfredi Mario 
Published: May 2005

AbstractPatients with Parkinson's disease are slower than normal subjects in executing sequential arm movements, and their bradykinesia worsens as the execution of motor sequences progresses. In parkinsonian and normal subjects, we studied the execution of two types of fast sequential arm movements. The subjects had to perform a motor sequence following with their arm a path marked by six targets on a screen In one experimental condition, they performed the motor sequence without advance knowledge of its path and executed each submovement in response to the consecutive appearance of the targets on the screen (unknown motor sequences). In the other condition, all the targets appeared simultaneously on the screen before the subject moved, and the subject internally determined when to execute each submovement (known motor sequences). Patients were slower than normal subjects in executing both sequences. Patients and normal subjects were faster in executing known than unknown sequences, but the patients' percentage of total movement time diminished less. During the unknown condition, both groups tended to lengthen submovement duration whereas, during the known condition, both groups tended to correct this trend. Patients performed submovements during both sequences with longer acceleration phases. The submovement symmetry ratio of the velocity profile changed according to the direction of movement (up or down). We conclude that these findings depend mainly on the mode of movement execution. They also suggest that patients with Parkinson's disease have more difficulty in executing internally determined than externally triggered sequential movements.
Chorea in fifty consecutive patients with rheumatic fever
Authors: Cardoso Francisco , Eduardo Carlos , Silva A. P. , Mota Cleonice C. C. 
Published: May 2005

AbstractRheumatic fever (RF) remains a significant public health problem in developing countries. Although its incidence has been declining in developed areas, several outbreaks of RF have been identified in the United States since 1985. To study the prevalence and clinical features of Sydenham's chorea (SC), a well‐recognized expression of RF, we examined 50 consecutive patients with RF seen at our Pediatric Cardiology Clinic. Chorea was rated on a scale of 0‐‐4(0 = no chorea; and 4 = severe chorea, patient unable to walk). Chorea, active or in remission, occurred in 13 patients (26%). The male‐to‐female ratio was 1.08 among the total population and 0.86 among the SC group. The mean age of the 50 patients at onset of RF was 8.4 years and the standard deviation (SD) 3.1 years. Carditis was diagnosed in 84% of patients with and without chorea, but arthritis was more common in the latter group (83.8%) than in the SC group (30.8%). The mean age at onset of SC was 9.2 years (SD 2.7). Involuntary movement, noticed by nine patients, was the most common initial symptom. Chorea went into remission in eight patients after 9.9 months (SD 13.4). Chorea was rated 3 in ten patients, 1 in two patients, and 4 in one patient. Among the five patients with active SC, three had hemichorea and two had generalized chorea. We recognized abnormal saccades in 80% of patients with active chorea, whereas just 13.5% of patients without chorea displayed this abnormality. SC remains an important cause of chorea in countries plagued by RF.
Perception of spatial orientation in spasmodic torticollis. Part 2: The visual vertical
Authors: Anastasopoulos D. , Bhatia K. , Bronstein A. M. , Marsden C. D. , Gresty M. A. 
Published: May 2005

AbstractTwenty‐nine patients with idiopathic spasmodic torticollis (ST) and matched normal control subjects were asked to align a target line to perceived earth vertical [visual vertical (VV)]. Settings were made against a whole‐field random‐dot background that was either stationary or rotating around the line of sight, and subjects performed the task upright and lying horizontally on their sides. Normal subjects were tested both head upright and after assuming a voluntary head tilt. Patients with ST set the VV close to true upright with a minimal deviation toward tilt of the head in contrast to normal subjects assuming a head tilt who set the VV in the opposite direction to the head tilt (Müller ‘E’ effect). Settings against the spinning disk were biased in the direction of rotation similarly for both subject groups. Settings made against static or spinning disk performed when subjects lay horizontally were tilted in the direction of recumbence (Aubert ‘A’ effect) similarly for both subject groups. When attempting to set the target line parallel to the long axis of the face, patients with head tilt set the line to upright, whereas normal subjects correctly estimated their tilts. One hypothesis offered to explain these results is that the patients referenced only their upright trunk for vertical and did not make use of neck proprioceptive or vestibular signals of head tilt so that all settings were made as if the trunk and head were upright. Alternatively, patients may have used only otolith signals as the reference for upright, and these are recalibrated in ST patients with head tilt. The pathological deviation becomes accepted as upright posture, and VVs and facial orientation are estimated as if the head were upright. In either case the findings indicate abnormal processing of the perception of visual verticality in ST patients.
Severe constipation in parkinson's disease relieved by botulinum toxin
Authors: Albanese Alberto , Maria Giorgio , Bentivoglio Anna Rita , Brisinda Giuseppe , Cassetta Emanuele , Tonali Pietro 
Published: May 2005

AbstractA parkinsonian patient with severe outlet‐type constipation was treated with injection of botulinum toxin into the puborectalis muscle. A total of 30 units (Botox) was injected in two sites. Resting anal pressure, maximum voluntary contraction, and pressure on straining were evaluated before treatment and 4, 8, 12, and 16 weeks afterward. Pressure values declined following treatment, the decline of pressure on straining ending by week 12. Proctography performed 8 weeks after treatment showed improvement in the anorectal angle and evacuation of barium paste. The clinical benefit lasted for ˜12 weeks. The present data show that botulinum toxin is a promising tool for treating outlet‐type constipation in Parkinson's disease.
BotB (botulinum Toxin type B): Evaluation of safety and tolerability in botulinum toxin type A‐Resistant cervical dystonia patients (preliminary study)
Authors: Truong Daniel D. , Cullis Paul A. , O'Brien Christopher F. , Koller Martin , Villegas Timothy P. , Wallace Jan D. 
Published: May 2005

AbstractBotulinum toxin (BTX) injection is considered the treatment of choice for patients with cervical dystonia (torticollis). We conducted a pilot, open‐label, dose‐escalation study with BTX type B in 12 patients who no longer responded clinically to injections with BTX type A. At the doses tested, BTX type B was safe and well tolerated without evidence of dose‐limiting toxicity in this patient population. Mild‐to‐moderate adverse events generally resolved quickly and included asthenia, pain, nausea, dysphagia, hypertonia, and tremor. No serious adverse events or antibodies to type‐B treatment were reported. Low‐dosing‐session (100‐‐899 units) and high‐dosing‐session (900–1,500 units) groups were defined based on units administered per dosing session. Toronto Western Spasmodic Torticollis Rating Scale‐Severity Scale (TWSTRS‐Severity), Patient Analogue Pain Scale, and Physician and Patient Global Assessment Scales were measured during this study. The TWSTRS‐Severity mean maximum percent improvement from baseline demonstrated a 9.9% versus 28.8% difference between the low‐dose and high‐dose groups, respectively. Effectiveness was noted for the high‐dose group on the Patient Analogue Pain Scale but not on the Global Assessment Scales.
Cervical and facial myoclonus associated with dolichoectasia of the left vertebral artery
Authors: Munñoz Esteban J. , Vila Nicholas , Valls‐Solé Joseph , Tolosa Eduardo 
Published: May 2005

AbstractA 52‐year‐old man presented with rapid jerking movements of his head to the right and clonic involuntary twitches involving his left eyelid and cheek. Electromyographic (EMG) recordings were consistent with left sternocleidomastoid and facial asynchronous myoclonus. Magnetic resonance imaging showed the presence of a dolichoectatic left vertebral artery displacing the medulla. Facial involvement and the asynchronism between cervical and facial myoclonus did not support a medullary origin for the movements. A direct compression of the eleventh and seventh cranial nerves by the dolichoectatic left vertebral artery may be the mechanism responsible for myoclonus in our patient.
Tremor in latin texts of dutch physicians: 16th‐18th centuries
Authors: Koehler Peter J. , Keyser Antoine 
Published: May 2005

AbstractIn his monographAn essay on the shaking palsy(1817), James Parkinson mentioned tremor and propulsion to be the most important signs of the disease that he was describing. In this article, we study aspects of the history of one of the signs that he mentioned, that is,tremorand see how the meaning of this term evolved since its description by Galen, particularly in the period from the 16th to the 18th centuries. We'll pay attention to the development of a distinction made between action tremor and rest tremor. Work by the following authors is covered: Pratensis and Forestus (16th century); Tulp, Van Beverwijck, and Sylvius (17th century); and Boerhaave and Van Swieten (18th century). Not all authors made the distinction, originally noticed by Galen, between action tremor and rest tremor. Parkinson tremor probably was observed but was classified among the tremors of the elderly. The meaning ofpalpitationchanged through the ages and finally was applied only to pathologic heart and artery pulsations. Sylvius and Van Swieten were the only authors in this study who clearly distinguished between action tremor and rest tremor. They are discussed in Parkinson's monograph.
Postprandial hypotension and parkinsonian state in parkinson's disease
Authors: Chaudhuri K. Ray , Ellis Catherine , Love‐Jones Sarah , Thomaides Thomas , Clift Susan , Mathias Christopher J. , Parkes J. David 
Published: May 2005

AbstractAbnormal postprandial cardiovascular responses such as postprandial hypotension (PPH) occur in primary autonomic failure and contribute significantly to morbidity. The extent and frequency of PPH and its relationship to the parkinsonian state in idiopathic Parkinson's disease (IPD) is unknown. By studying 20 patients with IPD (without autonomic failure) and 16 age‐matched controls after both groups ingested a standard isocaloric balanced liquid meal we have shown that supine PPH complicates IPD and is reduced to marked worsening of the parkinsonian state as measured by a cumulative score of tremor, rigidity, bradykinesia, posture, and gait, Furthermore, significant postural hypotension is unmasked that results in posturnal intolerance due to presyncopal symptoms. Our study in posturnal intolerance due to presyncopal symptoms. Our study indicates that, in patients with IPD, ingestion of a meal may lead to abnormal postprandial cardiovascular responsea and aggravation of the parkinsonian state. The underlying mechanisms are unclear, although vasodilatory gut peptides released in response to food ingestion may be contributory.
Differential modification of dopamine transporter and tyrosine hydroxylase mRNAs in midbrain of subjects with parkinson's, alzheimer's with parkinsonism, and alzheimer's disease
Authors: Joyce Jeffrey N. , Smutzer Gregory , Whitty Christopher J. , Myers Amanda , Bannon Michael J. 
Published: May 2005

AbstractThe molecular characteristics of midbrain dopamine (DA) neurons have been extensively studied in Parkinson's disease (PD). No such studies of the characteristics of midbrain DA neurons in Alzheimer's disease (AD) or Alzheimer's disease with parkinsonism (AD/Park) have been published. We examined the levels of tyrosine hydroxylase (TH) protein, and the expression of TH and dopamine transporter (DAT) mRNAs, in midbrain neurons of PD, AD, and AD/Park cases. In PD, the loss of TH protein in the ventral tier of the substantia nigra pars compacta (SNpc) of the PD group is accompanied by severe losses in the number of neurons that express TH mRNA and DAT mRNA (74% loss). Remaining neurons show a shift to higher concentrations of TH mRNA but a shift to lower concentrations of DAT mRNA per cell. Hence, there is evidence that compensation in the remaining neurons can elevate concentrations of TH mRNA and lower DAT mRNA. Alternatively, there may be a predilection for a loss of neurons with high levels of DAT mRNA and low TH mRNA levels within the SNpc of PD cases. There was no change in TH protein but an elevation of TH mRNA concentrations per neuron without any change in concentrations of DAT mRNA in the AD group. The AD/Park group did not exhibit changes in the level of TH protein, but showed a small loss (26%) of neurons in the SNpc and a greater loss in other regions of the midbrain (43–53%). Remaining DA neurons showed a marked shift to lower concentrations of DAT mRNA per neuron and a nonsignificant shift in cellular concentration of TH mRNA to higher levels. This is consistent with our previous work showing that with AD/Park there is a significant reduction in the number of DAT sites located on DA terminals in the striatum, but the midbrain neurons have not died. Our results indicate that the differential regulation of mRNAs encoding TH and DAT is similar in the parkinsonian disorders (PD and AD/Park) even though the degree of cell death is very different. This might suggest that compensatory events occur in these DA neurons in AD/Park that are similar to those in PD and that result in differential effects on mRNAs encoding TH and DAT proteins.
Proton magnetic resonance spectroscopy in parkinson's disease and atypical parkinsonian disorders
Authors: Federico Francesco , Simone Isabella L. , Lucivero Vincenzo , Iliceto Giovanni , de Mari Michele , Giannini Paolo , Mezzapesa Domenico M. , Tarantino Alfredo , Lamberti Paolo 
Published: May 2005

AbstractProton magnetic resonance spectroscopy (1H‐MRS), localized to the lentiform nucleus, was carried out in 12 patients with idiopathic Parkinson's disease (IPD), seven patients with multiple‐system atrophy (MSA), seven patients with progressive supranuclear palsy (PSP), and 10 healthy age matched controls. The study assessed the level of N‐acetylaspartate (NAA), creatine–phosphocreatine (Cr), and choline (Cho) in the putamen and globus pallidus of these patients. NAA/Cho and NAA/Cr ratios were significantly reduced in MSA and PSP patients. No significant difference was found between IPD patients and controls. These results suggest an NAA deficit, due to neuronal loss, in the lentiform nucleus of MSA and PSP patients. 1H‐MRS is a noninvasive technique that can provide useful information regarding striatal neuronal loss in basal ganglia of patients with atypical parkinsonian disorders and represents a potential tool for diagnosing these disorders.
Dependency in parkinson's disease: A population‐based survey in nondemented elderly subjects
Authors: Tison François , Barberger‐Gateau Pascale , Dubroca Bénédicte , Henry Patrick , Dartigues Jean‐François 
Published: May 2005

AbstractLittle epidemiological data are available on the dependency status of elderly patients with Parkinson's disease (PD) living in the community. This study assessed the activities of daily living (ADL), the instrumental activities of daily living (IADL), and mobility in a representative sample of elderly nondemented PD subjects (n = 20), compared to a control population (n = 2,697). We found a significantly higher level of dependency in the PD sample based on ADL, IADL, and mobility scales. Half of the PD subjects were dependent for ADL (versus 13.2% for controls), 80% were dependent for IADL (versus 28% for controls), and 20% had their mobility restricted to their home (versus 1.5% for controls). The proportion of PD patients tended to be higher in those more depressed or with more severe motor symptoms. PD patients were not found to be more isolated socially or from family than was the control group and, in any case, dependency seemed not to be associated with isolation. When adjusting for age, sex, depressive symptoms, Mini Mental Status examination score, and dyspnea, PD remained significantly associated with dependency. PD thus constitutes a significant factor of dependency in elderly subjects living at home. Institutionalization occurred over four times more frequently in the PD group than in the general population, but no specific factor of institutionalization was noted.