Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease.

Abstract Background and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. Introduction Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. Material and methods We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. Results Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. Conclusion We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD

Clinical and MRI characterization of apraxic syndrome in corticobasal degeneration: A single-case study

Objective: To identify the cortical and subcortical distribution of atrophy and the disorganization of white matter bundles underlying the apraxic disorders in a patient with corticobasal degeneration (CBD). Method: Patient underwent appropriate neuropsychological tasks aimed at identifying the nature of the apraxic disorder and morphometric structural MRI with whole-brain voxel-wise analysis. Results: Progressive limbkinetic apraxia (LKA) with onset in the right upper limb with subsequent extension to the limbs, trunk, orofacial district, and eye movements was documented, associated with element of ideomotor apraxia (IMA). The MRI study showed grey matter atrophy extending to much of the frontal cortex bilaterally, including the precentral cortex, and into the inferior parietal regions. Caudate and putamen were involved on the left. Significant clusters of white matter atrophy were found in the bilateral superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF) and corpus callosum (CC). Sensory evoked potentials (SEPs) and motor evoked potentials (MEPs) were normal. Conclusion: Previous observations in CBD indicate lack of inhibitory control from the sensory to the primary motor cortex with dysfunctional frontoparietal and cortico-motoneuron projections. Our neuroimaging data are partially consistent with these observations suggesting that the apraxic disorder in our patient might be produced by the disconnection of the primary motor cortex from the parietal areas that prevents selection and control of muscle movements, in the presence of preserved cortico-motoneuron as demonstrated by normal PEM. Apraxic disorders in CBD are high-level deficits of movement control that spare the motoneuron

Gender may be related to the side of the motorsyndrome and cognition in idiopathic Parkinson\u2019sdisease

Parkinson's disease s a well recognise

Classification of Neurorehabilitation treatments: Preliminary results of a Multicentre Italian Study

Objective: To taxonomize the contents of neurorehabilitation programs and categorize goals and treatments provided to people with Parkinson Disease(PD) and Multiple Sclerosis(MS) to understand their impact on the outcomes. Background: Few researches investigated the importance of the com- ponents of a neurorehabilitation program on clinical outcome in everyday clinical practice[1,2]. Moreover, there is no standard method to categorize rehabilitative interventions, making difficult to explain why subjects improve and which of the various treatments is more effective. A multi- centre network was formed to collect data using a taxonomy tool devel- oped to provide information on the goals of rehabilitation and to categorize rehabilitation interventions. Methods: Subjects with PD and MS were evaluated pre and post inter- vention and a taxonomy tool was completed by physiotherapists at the end of the rehabilitation program. To provide a broad overview, treatments were categorized as \u201cTask oriented\u201d or \u201cImpairment oriented\u201d. In addition, subjects who improved 20% or more on the Modified Barthel Index (MBI) were defined as responders. Frequency analysis was performed to understand prevalence of goals and treatments and logistic models were used to provide Odd Ratio(OR) with 95% CI to provide degree of associa- tion between treatment and outcome. Results: We report preliminary data of 54 subjects (18 PD, 36 MS) from 1 of the 11 centres involved in this project. 1060 hours of physio- therapy were analysed. Gait was the main goal for both PD(54%) and MS(40.5%) followed by body transfers for PD(12%) and upper limb func- tion for MS(23.5%). Most frequent treatments were gait(27.6%) and bal- ance(17.7%) training for PD, while robotic therapy(25.6%) and gait training (13.3%) were mostly used for MS. MBI results showed 28% of PD were responders compared with 10% of MS subjects OR=3.8 (0.7-23.6;p=0.1). \u201cTask oriented\u201d treatment provided to 36% of PD and 19% of MS showed better results on the MBI, OR=17(12-355;p = 0.002) compared with the \u201cImpairment oriented\u201d treatment. Conclusions: Gait was the main goal of rehabilitation for PD and MS and the most frequently provided treatments were gait training and robot therapy. Preliminary results showed that improvements in functional out- come were more likely in PD subjects and in those who received Task ori- ented treatment. References: 1)Dijkers MP, Hart T, Tsaousides T, Whyte J, Zanca JM. Treatment taxonomy for rehabilitation: past, present, and prospects. Arch Phys Med Rehabil. 2014 Jan; 95: S6-16. 2)Rasova K, Freeman J, Martinkova P, Pavlikova M, Cattaneo D, Jonsdottir J, Henze T, Baert I, Van Asch P, Santoyo C, Smedal T, Beiske AG, Stachowiak M, Kovalewski M, Nedeljkovic U, Bakalidou D, Guerreiro JM, Nilsag\ue5rd Y, Dimitrova EN, Habek M, Armutlu K, Donz\ue9 C, Ross E, Ilie AM, Marti c A, Romberg A, Feys P. The organisation of physiotherapy for peo- ple with multiple sclerosis across Europe: a multicentre questionnaire sur- vey. BMC Health Serv Res. 2016;16:552

Theory of mind: A clue for the interpretation of functional movement disorders

Objectives: Functional movement disorders (FMD) refer to a heterogeneous group of manifestations incongruent with known neurological diseases. Functional neuroimaging studies in FMD indicate the overlap between cerebral regions in which abnormal activation occurs and those considered crucial for theory of mind (ToM), the ability to attribute mental states. The aim of this study was to explore whether FMD might be related to ToM disorders to the extent that they reduce the ability to make inferences about the mental states underlying motor behaviour during social interaction. Materials & Methods: Eighteen subjects with FMD and 28 matched healthy controls (HC) were given a ToM battery. The severity of FMD was rated by the Simplified-FMD Rating Scale (S-FMDRS). Dissociative symptoms were evaluated by the Dissociative Experiences Scale (DES-II). Results: FMD scored worse than the HC in most ToM tasks: second-order False Beliefs (p =.005), Faux-Pas Recognition Test (p <.001) and Reading the Mind in the Eyes Test (p =.020); control questions elicited normal scores. The DES-II indicated dissociative-borderline psychopathology and negatively correlated with accuracy on the second-order False Belief (Spearman's rho = −.444; p =.032); the positive correlation between DES-II and severity of motor symptoms (S-FMDRS) approached significance (Spearman's rho test =.392; p =.054). ToM disorders were not correlated with S-FMDRS, due to the typical variability in FMD over time with regard to the severity of symptoms and the district of body involved. Conclusions: Our results are consistent with the hypothesis that FMD are related to ToM deficits, and future studies are needed to define the specific nature of this relationship