http://www.cognitiveneuroscience.it/wp-content/uploads/2015/10/Rossini_CliNeuro_2015.pdf

Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application: An updated report from an I.F.C.N. Committee

In this review, we consider the potential functional role of beta-band oscillations, which at present is not yet well understood. We discuss evidence from recent studies on top-down mechanisms involved in cognitive processing, on the motor system and on the pathophysiology of movement disorders that suggest a unifying hypothesis: beta-band activity seems related to the maintenance of the current sensorimotor or cognitive state. We hypothesize that beta oscillations and/or coupling in the beta-band are expressed more strongly if the maintenance of the status quo is intended or predicted, than if a change is expected. Moreover, we suggest that pathological enhancement of beta-band activity is likely to result in an abnormal persistence of the status quo and a deterioration of flexible behavioural and cognitive control.

Beta-band oscillations--signalling the status quo?

Objective
To present the International Parkinson and Movement Disorder Society (MDS) Clinical Diagnostic Criteria for Parkinson9s disease.
Background
Although several diagnostic criteria for Parkinson9s disease have been proposed, none have been officially adopted by an official Parkinson society. Moreover, the commonest-used criteria, the UK brain bank, were created more than 25 years ago. In recognition of the lack of standard criteria, the MDS initiated a task force to design new diagnostic criteria for clinical Parkinson9s disease.
Methods/Results
The MDS-PD Criteria are intended for use in clinical research, but may also be used to guide clinical diagnosis. The benchmark is expert clinical diagnosis; the criteria aim to systematize the diagnostic process, to make it reproducible across centers and applicable by clinicians with less expertise. Although motor abnormalities remain central, there is increasing recognition of non-motor manifestations; these are incorporated into both the current criteria and particularly into separate criteria for prodromal PD. Similar to previous criteria, the MDS-PD Criteria retain motor parkinsonism as the core disease feature, defined as bradykinesia plus rest tremor and/or rigidity. Explicit instructions for defining these cardinal features are included. After documentation of parkinsonism, determination of PD as the cause of parkinsonism relies upon three categories of diagnostic features; absolute exclusion criteria (which rule out PD), red flags (which must be counterbalanced by additional supportive criteria to allow diagnosis of PD), and supportive criteria (positive features that increase confidence of PD diagnosis). Two levels of certainty are delineated: Clinically-established PD (maximizing specificity at the expense of reduced sensitivity), and Probable PD (which balances sensitivity and specificity).
Conclusion
The MDS criteria retain elements proven valuable in previous criteria and omit aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of PD expands, criteria will need continuous revision to accommodate these advances. Disclosure: Dr. Postuma has received personal compensation for activities with Roche Diagnostics Corporation and Biotie Therapies. Dr. Berg has received research support from Michael J. Fox Foundation, the Bundesministerium fur Bildung und Forschung (BMBF), the German Parkinson Association and Novartis GmbH.

MDS Clinical Diagnostic Criteria for Parkinson's Disease (S19.001)

http://www.mag2health.com/wp-content/uploads/CLINPH-Guidelines-rTMS.pdf

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)

https://biblio.ugent.be/publication/8650534/file/8672654.pdf

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018)

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. There are several models both of basal ganglia (BG) function and their dysfunction in PD. Degeneration of the nigrostriatal dopaminergic pathway is the key pathological feature of PD, leading to classical motor symptoms, such as bradykinesia and rigidity. A dysfunction of structures other than BG, including cerebellum and brainstem, may be involved in the generation of tremor and axial symptoms, while the degeneration of non-dopaminergic neurotransmitter systems is a likely contributing factor of non-motor symptoms. BG models provide hypotheses testable by electrophysiological research in humans. In PD patients with implanted deep brain stimulators, activity from BG nuclei, i.e. the subthalamic nucleus the internal pallidal segment, and from the peduncolopontine nucleus may be directly recorded using depth electrodes. Non-invasive electrophysiological techniques allow the investigation of dysfunctional BG through interconnections with motor cortical areas, brainstem and spinal structures. Electrophysiological studies have revealed functional abnormalities at every level of the central nervous systems, including BG nuclei, motor cortex, cerebellum, brainstem and spinal cord. Despite the progress in electrophysiological characterization of PD, with particular advances in understanding the role of pathological BG oscillatory activity in generating bradykinesia, there is still a large gap in understanding the pathophysiological relevance of other electrophysiological findings in PD. Better insight into the relationship between electrophysiological abnormalities and motor and non-motor symptoms in PD is likely to have important clinical implications.

Interfacing basal ganglia models and Parkinson's disease phenomenology: How can we translate the findings of electrophysiological studies from research to clinic

Abstract The approach and diagnosis of patients with tremor may be challenging for clinicians. According to the most recent consensus statement by the Task Force on Tremor of the International Parkinson Movement Disorder Society, the differentiation between action (i.e., kinetic, postural, intention), resting, and other task- and position-specific tremors is crucial to this goal. In addition, patients with tremor must be carefully examined for other relevant features, including the topography of the tremor, since it can involve different body areas and possibly associate with neurological signs of uncertain significance. Following the characterization of major clinical features, it may be useful to define, whenever possible, a particular tremor syndrome and to narrow down the spectrum of possible etiologies. First, it is important to distinguish between physiological and pathological tremor, and, in the latter case, to differentiate between the underlying pathological conditions. A correct approach to tremor is particularly relevant for appropriate referral, counseling, prognosis definition, and therapeutic management of patients. The purpose of this review is to outline the possible diagnostic uncertainties that may be encountered in clinical practice in the approach to patients with tremor. In addition to an emphasis on a clinical approach, this review discusses the important ancillary role of neurophysiology and innovative technologies, neuroimaging, and genetics in the diagnostic process.

Diagnostic Uncertainties in Tremor

/pdf/reply-to-intensification-of-an-essential-tremor-by-sars-cov-3d44h1dg.pdf

Matteo Bologna

Papers

Interfacing basal ganglia models and Parkinson's disease phenomenology: How can we translate the findings of electrophysiological studies from research to clinic

Diagnostic Uncertainties in Tremor

Reply to “Intensification of an Essential Tremor by SARS-CoV-2”