Enrique Martinez

About half of patients with normal pressure hydrocephalus and parkinsonism have an abnormal DaT SPECT. But they do not have nigrosomal loss like in PD!

Is their parkinsonism from mechanical disruption rather than neurodegeneration?

Check out this cool study!

www.neurology.org/doi/full/10....

I know what you are thinking: 💲leep 💲tudies are super expensive and labor intensive

And they are.

But these phenotypes are based off a standardized questionnaire📋

This is awesome for implementation in clinical studies! 🔥

Other symptoms that progress faster in patient early RBD:

😐 Apathy
☹️ Depresion
😰 Anxiety
😵‍💫 Hallucinations
🎰 Impulse control disorders
🫀Autonomic impairment

Patients with early RBD get earlier cognitive impairment and dementia.

Check out the rates of mild cognitive impairment and dementia even within 5 years

That was not supposed to happen until much later in the disease! 😱

Check out this paper I just dropped on non-motor phenotypes in Parkinson's disease with my bosses

We found that patients with early REM sleep behavior in Parkinson's predicts WORSE non-motor symptoms.

rdcu.be/d7QV2

Effective Target Sites in Thalamic Stimulation for Focal Hand Dystonia Abstract. Introduction: Functional thalamic surgery is known for alleviating isolated focal hand dystonia; however, the optimal target site in the thalamus is not determined. This study aimed to ident...

DBS at the GPi and STN works well for dystonia, with most output reaching the Vo nucleus of the thalamus.

Why not target that?

Hashimoto and friends shared 4 cases of focal hand dystonia treated with thalamic DBS, showing most benefit near the Vo—same as for dystonic tremor!

🔔 New drug for PD-MCI! 🔔

💊 M1 Receptor–Positive Allosteric Modulator.

👥 46 patients | 🕒 6 wks on /6 wksoff
🧷 Safe overall | 🚷 No gait changes
🧠 Cognitive improvement (?)

Could it be real-life significant? Rivastigmine only works in PD dementia—this could be a first!

tinyurl.com/rjxxwbxe

We love how effective DBS is to treat myoclonus dystonia syndrome.

Patients with a SGCE mutation have one of the B E S T responses.

Pauly M shared the case of KCCN2 mutation who did not improve significantly after GPi-DBS.

Should we test SGCE-negative patients before DBS?

tinyurl.com/msp6t8fa