1,721,100 research outputs found
Functional Movement Disorder as a Prodromal Symptom of Parkinson's Disease-Clinical and Pathophysiological Insights
Full text linkFunctional movement disorder (FMD) is a common manifestation of functional neurological disorder. FMD can occur alongside other neurological conditions, but especially in patients with established Parkinson's disease (PD). An interesting observation emerging across cohort studies and case series is that FMD can precede the diagnosis of PD, suggesting that FMD may itself be a prodromal symptom of neurodegeneration. Such a notion would have significant clinical implications for the assessment and management of people with FMD, particularly with respect to decisions around the use of auxiliary investigations, counselling, and follow-up. In this Viewpoint we review the evidence concerning the temporal relationship between FMD and PD. We discuss the potential explanations and mechanisms for FMD as a prodromal symptom of PD, and highlight clinical considerations and important outstanding questions in the field. (c) 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Divine perfection and human potentiality: trinitarian anthropology in Hilary of Poitiers' De Trinitate
Full text linkNo figure of fourth-century Christianity seems to be at once so well known and so clouded in mystery as Hilary of Poitiers. His work as an historian provides invaluable knowledge of the mid-fourth century, and he was praised as a theologian throughout late antiquity. Today, however, discussions of his theology are founded upon less solid ground. This is largely due to methodological issues. Modern scholarship has often read Hilary through anachronistic historical and theological categories which have rendered his thought incomprehensible. Recent scholars have sought to overcome this and to reexamine Hilary within his own historical, polemical, and theological context. Much remains to be said, however, in regard to Hilary's actual theological contribution within these contextual parameters. This thesis contends that in all of Hilary's polemical and constructive argumentation in De Trinitate, which is essentially trinitarian, he is inherently and necessarily developing an anthropology. In all he says about the divine, he is saying as much about what it means to be human. This thesis therefore seeks to reenvision Hilary's overall theological project in terms of the continual, and for him necessary, anthropological corollary of trinitarian theology-to reframe it in terms of a 'trinitarian anthropology'. My contention is that the coherence of Hilary's thought depends upon his understanding of divine-human relations. I will demonstrate this through following Hilary's main lines of trinitarian argument, out of which flows his anthropological vision. These main lines of argument, namely, divine generation, divine infinity, divine unity, the divine image, and divine humanity, each unfold into a progressive picture of humanity from potentiality to perfection. This not only provides a new paradigm for understanding Hilary's own thought, but invites us to reexamine our approach to fourth-century theology entirely, as it disavows any reading of the trinitarian controversies in conceptual abstraction. Further, theological and religious anthropology are widely discussed in contemporary scholarship, and Hilary's profound exploration of divine-human relations, and what it means to be a human being as a result, has much to offer both historical and contemporary concerns
A Pilot Study of Botulinum Toxin for Jerky, Position-Specific, Upper Limb Action Tremor
Full text linkBackground: We aimed to investigate the efficacy and safety of botulinum toxin (BT) injections for jerky action tremor of the upper limb.
Methods: We performed an uncontrolled, prospective study of electromyography (EMG)-guided BT injections for jerky, position-specific, upper limb action tremor. The primary outcome was clinical global impression at 3–6 weeks after baseline.
Results: Eight patients with jerky, position-specific action tremor involving the upper limb were consecutively recruited. After a median follow-up of 4.4 weeks (interquartile range [IQR] 3.6–6 weeks), four of them rated themselves as “improved” and two as “much improved.” Five of these six subjects reported improvements in specific activities of daily living (bringing liquids to mouth, feeding, shaving, and dressing). Upper limb subscore of the Fahn–Tolosa–Marin Tremor Rating Scale (FTM) significantly decreased from 4.5 (4–6) to 3 (2–5) (p = 0.01).
Discussion: This pilot, prospective cohort study suggests that EMG-guided BT injections may improve jerky, position-specific, upper limb action tremor. Placebo-controlled studies evaluating larger samples of patients are warranted to confirm these findings
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Psychogenic nonepileptic seizures and movement disorders: A comparative review
No full textPurpose of review: Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists.Recent findings: Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations.Summary: Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients
Functional neurological disorder and placebo and nocebo effects: shared mechanisms
No full textFunctional neurological disorder (FND) is characterized by neurological symptoms that cannot be explained by a structural neurological cause. Among the different aetiological models that have been proposed for FND, of note is the Bayesian predictive coding model, which posits that perception relies on top-down cortical predictions (priors) to infer the source of incoming sensory information. This model can also apply to non-pathological experiences, such as placebo and nocebo effects, wherein sensory information is shaped by prior expectations and learning. To date, most studies of the relationship between placebo and nocebo effects and FND have focused on the use of placebos for diagnosis and treatment of FND. Here, we propose that this relationship might go beyond diagnosis and therapy. We develop a framework in which shared cognitive, personality and neuroanatomical factors justify the consideration of a deeper link between FND and placebo and nocebo effects. This new perspective might offer guidance for clarification of the pathogenesis of FND and for the identification of potential biomarkers and therapeutic targets
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