Showing papers by "Susan H. Fox published in 2023"
TL;DR: In this paper , the authors reported 7 patients with idiopathic Parkinson's disease who developed speech-induced cranio-facial-predominant myoclonus with dysarthria and speech arrests.
Abstract: Background Amantadine is a widely prescribed medication in Parkinson's disease (PD). A distinctive craniofacial distribution of myoclonus with speech impairment is an underrecognized iatrogenic complication in amantadine-treated PD patients. Cases We report 7 patients with idiopathic PD (disease duration, 6-21 years) who developed speech-induced craniofacial-predominant myoclonus with “stuttering-like” dysarthria and speech arrests days to months after amantadine initiation or dose increase. Renal insufficiency was identified as a risk factor in four cases. In all cases, reduction or discontinuation of amantadine markedly attenuated the myoclonus and restored speech intelligibility. Literature Review Amantadine can induce subcortical segmental or generalized myoclonus. A report in 1996 of “vocal myoclonus” in an amantadine-treated PD patient was the first observation of a focal distribution of myoclonus, particularly affecting speech. Since then, very few cases of craniofacial myoclonus with speech impairment have been reported, none with accompanying video. With one exception, the craniofacial distribution was part of a generalized pattern of amantadine-induced myoclonus. Comorbid renal insufficiency is a recognized risk factor. Conclusions Speech-induced craniofacial myoclonus, with marked “stuttering-like” dysarthria and speech arrests, is a disabling iatrogenic complication in PD that resolves upon amantadine discontinuation. This article is protected by copyright. All rights reserved.
TL;DR: The Pain in Dystonia Scale (PIDS) as mentioned in this paper was developed to evaluate pain in adults with idiopathic dystonia (AOID) and validated in cervical dystonias.
Abstract: BACKGROUND
A better understanding of pain in adult-onset idiopathic dystonia (AOID) is needed to implement effective therapeutic strategies.
OBJECTIVE
To develop a new rating instrument for pain in AOID and validate it in cervical dystonia (CD).
METHODS
Development and validation of the Pain in Dystonia Scale (PIDS) comprised three phases. In phase 1, international experts and participants with AOID generated and evaluated the preliminary items for content validity. In phase 2, the PIDS was drafted and revised by the experts, followed by cognitive interviews to ensure self-administration suitability. In phase 3, the PIDS psychometric properties were assessed in 85 participants with CD and retested in 40 participants.
RESULTS
The final version of PIDS evaluates pain severity (by body-part), functional impact, and external modulating factors. Test-retest reliability showed a high-correlation coefficient for the total score (0.9, P < 0.001), and intraclass correlation coefficients were 0.7 or higher for all items in all body-parts subscores. The overall PIDS severity score showed high internal consistency (Cronbach's α, 0.9). Convergent validity analysis revealed a strong correlation between the PIDS severity score and the Toronto Western Spasmodic Torticollis Rating Scale pain subscale (0.8, P < 0.001) and the Brief Pain Inventory-short form items related to pain at time of the assessment (0.7, P < 0.001) and impact of pain on daily functioning (0.7, P < 0.001).
CONCLUSION
The PIDS is the first specific questionnaire developed to evaluate pain in all patients with AOID, here, demonstrating high-level psychometric properties in people with CD. Future work will validate PIDS in other forms of AOID. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
TL;DR: In this paper , pain is common in Parkinson's disease (PD), but effective therapies are limited, and effective treatments are difficult to find. And effective therapies for PD are limited.
Abstract: Pain is common in Parkinson's disease (PD), but effective therapies are limited.