Dorsal GPi/GPe Stimulation Induced Dyskinesia in a Patient with Parkinson’s Disease

Clinical vignette: A 68-year-old man with Parkinson’s disease (PD) had bilateral GPi DBS placed for management of his motor fluctuations. He developed stimulation-induced dyskinesia (SID) with left dorsal GPi stimulation. Clinical dilemma: What do we know about SID in PD patients with GPi DBS? What are the potential strategies used to maximize the DBS therapeutic benefit and minimize the side effects of stimulation? Clinical solution: Avoiding the contact implicated in SID and programming more ventral contacts, using lower voltage, frequency and pulse width and programming in bipolar configuration all appear to help minimize the SID and provide appropriate symptomatic motor control. Gap in knowledge: Little is known about SID in patients with PD who had GPi DBS therapy. More studies using volume of tissue activated and diffusion tensor imaging MRI are needed to localize specific tracts in or around the GPi that may be implicated in SID

Group therapeutic singing improves clinical motor scores in persons with Parkinson's disease

Background: Previous reports suggest that group therapeutic singing (GTS) may have a positive effect on motor symptoms in persons with Parkinson's disease (PD). Objective: To determine the effect of a single session of GTS on clinical motor symptoms. Methods: Clinical motor symptom assessment was completed immediately before and after 1 hour of GTS in 18 participants. Results: A significant decrease in average scores for gait and posture and tremor, but not speech and facial expression or bradykinesia was revealed. Conclusion: These results support the notion that GTS is a beneficial adjuvant therapy for persons with PD that warrants further research.This article is published as Stegemoller E, Forsyth E, Patel B, Elkouzi A. Group therapeutic singing improves clinical motor scores in persons with Parkinson's disease. BMJ Neurol Open. 2022 Aug 3;4(2):e000286. doi: 10.1136/bmjno-2022-000286. Posted with permission. Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permission