Movement Disorders Clinical Practice

When should you switch off DBS in late‑stage Parkinson’s? This study of 25 LSPD patients shows some stay stable on meds alone, but 40% need rapid rescue therapy—especially those with <10.5 yrs of DBS. Take‑home: Evaluate fall‑risk, DBS duration, and residual benefit before discontinuation. loom.ly/eCRCTUI

Pump therapies in PD aren’t the slam‑dunk we think. SC foslevodopa–foscarbidopa: 1 in 3 quit in 4 weeks—mostly by choice, not side effects. Big lesson: motor gains ≠ patient satisfaction. loom.ly/HtLmQSs

Dominant HSP isn’t one disease — and this MDSGene mega‑review proves it. Across 2,177 cases, ATL1, SPAST & REEP1 show strikingly different ages at onset, phenotypic signatures & variant biology. Early childhood onset? Think ATL1 Bimodal onset + truncating variants? SPAST Upper‑limb weakness & skeletal features? REEP1 loom.ly/oPbBHBI

New MDCP Pearl: Using a Brief Body Sway Assessment Device to Track Balance Differences across the Huntington's Disease Integrated Staging System Spectrum.@movedisorder loom.ly/7CZFC68

New MDCP Pearl: Prognostic Value of Parkinson's Disease Subtypes in the LABS-PD Cohort: Functional Ability, Quality of Life and Mortality. doi.org/10.1002/mdc3.7…

Significant weight loss in PD isn’t “expected ageing” — it’s a progression alarm. In COPPADIS, >10% loss was 2× more common in PwP and flagged worse motor complications, mood decline, dysphagia, cognitive drop‑off & major QoL hit. loom.ly/bYwVYH8

Methodically classifying genetic variants of hereditary spastic paraplegia allowed MDS’s Genetic Nomenclature in Movement Disorders Study Group to compare clinical features among patients with HSP-ATL1, HSP-SPAST or HSP-REEP1. @movedisorders …mentdisorders.onlinelibrary.wiley.com/doi/10.1002/md…

Chronic watery diarrhoea in a patient on oral levodopa/DDCI-think microscopic colitis(MC)! This under‑recognised, drug‑associated complication typically resolve after discontinuing or switching the DDCI,or switching to an alternative treatment such as s/c Foslevodopa/Foscarbidopa loom.ly/b0uW2iM

Sex hormones shape PD. • Women: more tremor, dyskinesia, mood & GI symptoms; fluctuations around menstrual cycle & menopause matter. • Men: faster motor/cognitive decline & stronger inflammatory/α‑syn burden. • Low lifetime estrogen exposure (early menopause, oophorectomy) = higher PD risk & severity. Clinical tip: Always ask about reproductive history + hormonal milestones loom.ly/w3RfMag

When motor fluctuations persist despite optimized use of levodopa + MAO‑B + COMT + DA agonists (± amantadine), think Refractory Motor Complications (RMC). Before jumping to DBS/infusions, ensure true best‑medical therapy has been tried. Pearls: maximize dosing frequency, use ER/OD formulations, educate on timing + food interactions. loom.ly/V5k3oN8

Charcot at 200 This new review revisits how Charcot shaped modern neurology—defining Parkinson’s disease, distinguishing tremors, describing ALS, and founding the blueprint for today’s academic neuro centers through his anatomo‑clinical method and visual documentation. loom.ly/0cZ67tM

In myoclonus–dystonia (SGCE), impaired convergence—with preserved divergence—provides a clean, pathway‑specific signature of dorsal vermis Purkinje cell dysfunction, offering a simple oculomotor clue to cerebellar involvement. loom.ly/yyip2ZQ

Stimulants in cerebellar ataxia? 🧠 In this patient‑reported study, alertness (95%), fatigue (90%), and executive function (80%) all improved with stimulant therapy—supported by a 26% improvement in PROM‑Ataxia Mental scores. When evaluating cerebellar disorders, screen for fatigue, mental fog, and CCAS features—these may be modifiable and have meaningful QoL impact! @SchmahmannLab …mentdisorders.onlinelibrary.wiley.com/doi/10.1002/md…

STN‑DBS improves motor function but ~50% of patients feel their communication gets worse, even when language & cognition tests stay stable. Remember: use CPIB, counsel early about speech risks, and assess motor speech + mood—not just fluency scores. …mentdisorders.onlinelibrary.wiley.com/doi/10.1002/md…

For people with Parkinson’s, quality of life is personal, adaptable, and shaped by what supports their well-being. Health can help or hinder it. Listening to these perspectives can improve care, interventions, and how we measure what truly matters. loom.ly/H4PJcTU

New MDCP Pearl: Prognostic Value of Parkinson's Disease Subtypes in the LABS-PD Cohort: Functional Ability, Quality of Life and Mortality. loom.ly/yEAIZ68

"Listen, the patient is telling you the diagnosis." Voice and speech changes are common in atypical Parkinsonian disorders. However, evaluating and treating them can be challenging. This review aims to provide clinicians with a practical guideline to improve patient care. loom.ly/URAjhlA

Our new systematic review and network meta-analysis shows that rasagiline may modestly improve global cognitive performance in Parkinson’s disease, while MAO-B inhibitors overall show limited effects on specific cognitive domains. loom.ly/YANW3BY

Is Early Oophorectomy a Hidden Parkinson’s Risk? Systematic review shows 32% higher PD risk after premenopausal bilateral oophorectomy, with hints of greater risk at younger ages. Even hysterectomy with ovarian conservation isn’t risk-free. Counseling & ERT strategies may need a rethink. Read more: loom.ly/4GFiRIs

Features emphasized in phase 1 development of the @movedisorders PD e-Diary included sensitivity to change, customizable or predefined item banks, personal and research modes, and feedback reports. #COA loom.ly/-xuzyqQ