Tardive Dyskinesia and Abnormal Tongue Movements

1981 ◽  
Vol 139 (6) ◽  
pp. 526-528 ◽  
Author(s):  
Edmond H. Pi ◽  
George M. Simpson
Keyword(s):  
Tardive Dyskinesia ◽  
Rating Scale ◽  
Buccal Cavity ◽  
Tongue Protrusion ◽  
Tongue Movements ◽  
Movement Test

SummaryForty-two subjects, 20 with and 22 without clinically diagnosed tardive dyskinesia (TD), were rated for TD on the scale of Simpson et al. They also performed a tongue protrusion test and had the presence of tongue movements within the buccal cavity observed. Fifty per cent of the severe or definite TD subjects as classified by rating scale were unable to maintain tongue protrusion for a minimum of 30 seconds, and 85 per cent of them had abnormal tongue movements. In 45 per cent of the possible TDs and in 9 per cent of the doubtful subjects, the movement test was also positive.

Bilateral Pallidal Stimulation with Directional Leads for Primary Focal Lingual Dystonia

2020 ◽  
pp. 1-5
Author(s):  
Takashi Asahi ◽  
Kiyonobu Ikeda ◽  
Jiro Yamamoto ◽  
Hiroyuki Tsubono ◽  
Yuko Muro ◽  
...  
Keyword(s):  
Rating Scale ◽  
Medication History ◽  
Tongue Protrusion ◽  
Limited Effect ◽  
Oral Medications ◽  
Pallidal Stimulation ◽  
Lingual Dystonia ◽  
Tongue Movements ◽  
History Of ◽  
Deep Brain

There have been limited studies regarding stereotactic and functional neurosurgery for lingual dystonia. Here, we report a patient with primary lingual dystonia who showed significant improvement after bilateral deep brain stimulation (DBS). A 42-year-old woman presented with a 5- to 6-year history of tongue protrusion; however, she lacked a significant medical or medication history before onset. She presented with gradually worsening symptoms and was diagnosed with idiopathic lingual dystonia. Her tongue was injected with botulinum toxin on 6 occasions; however, it had a limited effect. Oral medications were ineffective. She underwent DBS since her involuntary tongue movements were causing nocturnal breathing problems. Directional leads were bilaterally inserted into the internal segment of the globus pallidus (GPi). The directional part of each lead was inserted at the GPi bottom on both sides. The posteromedial contacts were used to deliver stimulation. After 1.5 years, the patient’s Burke-Fahn-Marsden dystonia rating scale score improved from 9 to 1.5 and 2 to 1 for movement and disability, respectively. This case demonstrated the effectiveness of bilateral GPi-DBS. Placing the directional part of the lead in the GPi bottom could improve the stimulation effects.

Functional Properties of Neurons in the Primate Tongue Primary Motor Cortex During Swallowing

1997 ◽  
Vol 78 (3) ◽  
pp. 1516-1530 ◽  
Author(s):  
Ruth E. Martin ◽  
Gregory M. Murray ◽  
Pentti Kemppainen ◽  
Yuji Masuda ◽  
Barry J. Sessle
Keyword(s):  
Motor Cortex ◽  
Functional Properties ◽  
Primary Motor Cortex ◽  
Motor Behavior ◽  
Critical Role ◽  
Electromyographic Activity ◽  
Related Activity ◽  
Tongue Protrusion ◽  
Significant Difference ◽  
Tongue Movements

Martin, Ruth E., Gregory M. Murray, Pentti Kemppainen, Yuji Masuda, and Barry J. Sessle. Functional properties of neurons in the primate tongue primary motor cortex during swallowing. J. Neurophysiol. 78: 1516–1530, 1997. Recent studies conducted in our laboratory have suggested that the tongue primary motor cortex (i.e., tongue-MI) plays a critical role in the control of voluntary tongue movements in the primate. However, the possible involvement of tongue-MI in semiautomatic tongue movements, such as those in swallowing, remains unkown. Therefore the present study was undertakein in attempts to address whether tongue-MI plays a role in the semiautomatic tongue movements produced during swallowing. Extracellular single neuron recordings were obtained from tongue-MI, defined by intracortical microstimulation (ICMS), in two awake monkeys as they performed three types of swallowing (swallowing of a juice reward after successful tongue task performance, nontask-related swallowing of a liquid bolus, and nontask-related swallowing of a solid bolus) as well as a trained tongue-protrusion task. Electromyographic activity was recorded simultaneously from various orofacial and laryngeal muscles. In addition, the afferent input to each tongue-MI neuron and ICMS-evoked motor output characteristics at each neuronal recording site were determined. Neurons were considered to show swallow and/or tongue-protrusion task-related activity if a statistically significant difference in firing rate was seen in association with these behaviors compared with that observed during a control pretrial period. Of a total of 80 neurons recorded along 40 microelectrode penetrations in the ICMS-defined tongue-MI, 69% showed significant alterations of activity in relation to the swallowing of a juice reward, whereas 66% exhibited significant modulations of firing in association with performance of the trained tongue-protrusion task. Moreover, 48% showed significant alterations of firing in relation to both swallowing and the tongue-protrusion task. These findings suggest that the region of cortex involved in swallowing includes MI and that tongue-MI may play a role in the regulation of semiautomatic tongue movement, in addition to trained motor behavior. Swallow-related tongue-MI neurons exhibited a variety of swallow-related activity patterns and were distributed throughout the ICMS-defined tongue-MI at sites where ICMS evoked a variety of types of tongue movements. These findings are consistent with the view that multiple efferent zones for the production of tongue movements are activated in swallowing. Many swallow-related tongue-MI neurons had an orofacial mechanoreceptive field, particularly on the tongue dorsum, supporting the view that afferent inputs may be involved in the regulation of the swallowing synergy.

Functional properties of single neurons in the face primary motor cortex of the primate. II. Relations with trained orofacial motor behavior

1992 ◽  
Vol 67 (3) ◽  
pp. 759-774 ◽  
Author(s):  
G. M. Murray ◽  
B. J. Sessle
Keyword(s):  
Motor Cortex ◽  
Cortical Neurons ◽  
Primary Motor Cortex ◽  
Motor Behavior ◽  
Afferent Input ◽  
Single Neurons ◽  
Tongue Protrusion ◽  
Input And Output ◽  
The Face ◽  
Tongue Movements

1. The previous paper has described in detail the input and output features of single neurons located at sites within primate face motor cortex from which intracortical microstimulation (ICMS, less than or equal to 20 microA) evoked tongue movements at the lowest threshold ("tongue-MI" sites); for comparative purposes, we also reported on the input and output features of a smaller number of neurons recorded at sites from which ICMS could evoke jaw movements ("jaw-MI" sites), facial movements ("face-MI" sites), or, at a few sites, tongue movements and, at the same threshold intensity, either a jaw movement or a facial movement. 2. Our findings of an extensive and diverse representation of sites within face motor cortex of monkeys for the generation of elemental components of tongue movement, and the relatively few sites from which jaw-closing movements could be evoked, were consistent with our recent observations that reversible, cooling-induced inactivation of the face motor cortex severely impaired the performance by monkeys of a tongue-protrusion task but had only relatively minor effects on the performance of a biting task. In an attempt to establish a neuronal correlate for these different behavioral relations, the present study has documented the task-related activities of those single neurons that were characterized in the previous paper in terms of afferent input and ICMS-defined output features. 3. Each task required the development and maintenance by each monkey of a fixed force level for a minimum period of time to obtain a fruit-juice reward. During one or both of these tasks, we characterized the activities of 231 single face motor cortical neurons that were located at the above-mentioned ICMS-defined sites. Neurons were said to be related to a particular task if they showed statistically significant differences in firing rates during the task in comparison with a control pretrial period (PTP). 4. In tongue-MI, there was a significantly higher proportion of neurons (63% of 156 neurons tested) that were related to the tongue-protrusion task than to the biting task (15% of 65). However, in jaw-MI the proportion of neurons that were biting task-related (63% of 19) was significantly higher than the proportion related to the tongue-protrusion task (11% of 9); the proportion of biting task-related neurons at ICMS-defined jaw-closing sites was also higher than that at jaw-opening sites.(ABSTRACT TRUNCATED AT 400 WORDS)

Assessment of Tardive Dyskinesia in Psychiatric Outpatients Using a Standardized Rating Scale

1981 ◽  
Vol 15 (1) ◽  
pp. 33-37 ◽  
Author(s):  
J. M. Rey ◽  
G. E. Hunt ◽  
G. F. S. Johnson
Keyword(s):  
Tardive Dyskinesia ◽  
Neurological Disorders ◽  
Rating Scale ◽  
Involuntary Movement ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Neuroleptic Treatment ◽  
Psychiatric Outpatients ◽  
History Of ◽  
Australian Sample

Psychiatric outpatients were assessed for dyskinetic movements using the abnormal involuntary movement scale (AIMS). The prevalance of tardive dyskinesia in an Australian sample of 66 patients was 44% which is similar to reported prevalence in other countries. Although the prevalence was significantly higher in patients over 45 years of age and with more than a 5 year history of neuroleptic medication, there were no significant correlations between presence of dyskinesias and age, sex or duration of neuroleptic treatment. Organic factors such as neurological disorders, ECT or alcoholism were not related to dyskinetic movements, nor was the use of anticholinergic or tricyclic antidepressant medication. The AIMS is a reliable rating scale for dyskinetic movements and could be used more widely as a screening instrument for early detection of tardive dyskinesia.

Subjective awareness of tardive dyskinesia and insight in schizophrenia

2011 ◽  
Vol 26 (5) ◽  
pp. 293-296 ◽  
Author(s):  
R. Emsley ◽  
D.J.H. Niehaus ◽  
P.P. Oosthuizen ◽  
L. Koen ◽  
B. Chiliza ◽  
...  
Keyword(s):  
Mental Illness ◽  
Tardive Dyskinesia ◽  
Rating Scale ◽  
Subscale Score ◽  
Domain Specific ◽  
Subjective Awareness ◽  
Syndrome Scale ◽  
Mild Impairment ◽  
Negative Syndrome ◽  
Insight Into

AbstractBackgroundLack of awareness of tardive dyskinesia (TD) and poor insight into mental illness are common in schizophrenia, raising the possibility that these phenomena are manifestations of a common underlying dysfunction.MethodsWe investigated relationships between low awareness of TD and poor insight into mental illness in 130 patients with schizophrenia and TD. We also examined selected demographic and clinical correlates of these two phenomena.ResultsSixty-six (51%) patients had no or low awareness of TD and 94 (72%) had at least mild impairment of insight into their mental illness. Low awareness of TD was not significantly correlated with greater impairment of insight into mental illness. Regression analyses indicated that the Positive and Negative Syndrome Scale (PANSS) disorganised factor (β = 0.72, t = 11.88, p < 0.01) accounted for 52% of the variance in insight into mental illness (adjusted R2 = 0.55) (F[2, 127] = 81.00, p < 0.01) and the Extrapyramidal Symptom Rating Scale (ESRS) dyskinesia subscale score (β = 0.47, t = 6.80, p < 0.01), PANSS disorganised factor (β = −0.26, t = −3.73, p < 0.01), and ESRS parkinsonism subscale score (β = 0.31, t = 4.55, p < 0.01) together accounted for 37% of the variance in awareness of TD (adjusted R2 = 0.37) (F[3, 126] = 26.87, p < 0.01).ConclusionThe two phenomena appear to be dissociated, and may be domain-specific.

scholarly journals 77 Long-term Valbenazine Treatment in Patients with Schizophrenia/Schizoaffective Disorder or Mood Disorder and Tardive Dyskinesia

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 214-215 ◽  
Author(s):  
Jean-Pierre Lindenmayer ◽  
Stephen R. Marder ◽  
Carlos Singer ◽  
Cynthia Comella ◽  
Khody Farahmand ◽  
...  
Keyword(s):  
Adverse Events ◽  
Tardive Dyskinesia ◽  
Mood Disorder ◽  
Schizoaffective Disorder ◽  
Psychiatric Diagnosis ◽  
Rating Scale ◽  
Involuntary Movement ◽  
Depression Scale ◽  
Psychiatric Status

AbstractBackgroundPatients treated with antipsychotics, regardless of psychiatric diagnosis, are at risk for developing tardive dyskinesia (TD), a potentially debilitating drug-induced movement disorder. Valbenazine (INGREZZA; VBZ) is a novel vesicular monoamine transporter 2 (VMAT2) inhibitor approved to treat TD in adults. Data from KINECT 4 (NCT02405091) were analyzed to evaluate the long-term effects of VBZ in adults with schizophrenia/schizoaffective disorder (SZD) or mood disorder (MD) and moderate or severe TD.MethodsKINECT 4 included open-label treatment (48weeks) followed by washout (4weeks). Entry requirements included: moderate or severe TD, qualitatively assessed at screening by a blinded, external reviewer; DSM diagnosis of SZD or MD; psychiatric stability (Brief Psychiatric Rating Scale score <50). Stable concomitant psychiatric medications were allowed. Dosing was initiated at 40mg, with escalation to 80mg at Wk4 if participants had a Clinical Global Impression of Change-TD score of ≥3 (minimally improved to very much worse) and tolerated 40mg. A reduction to 40mg was allowed if 80mg was not tolerated (80/40mg); participants unable to tolerate 40mg were discontinued. Safety was the primary focus, but the Abnormal Involuntary Movement Scale (AIMS) total score (sum of items 1–7) was used to evaluate changes in TD. Mean changes from baseline (BL) in AIMS total score (rated by on-site investigators) were analyzed descriptively. Safety assessments included treatment-emergent adverse events (TEAEs) and psychiatric scales (Positive and Negative Syndrome Scale [PANSS], Calgary Depression Scale for Schizophrenia [CDSS], Montgomery-Åsberg Depression Rating Scale [MADRS], Young Mania Rating Scale [YMRS], and Columbia-Suicide Severity Rating Scale [C SSRS]).ResultsOf 163 participants in the analyses, 103 completed the study. Adverse events (n=26) was the most common reason for discontinuation. Analyses included 119 participants with SZD (40mg=37; 80mg=76; 80/40mg=6) and 44 with MD (40mg=8; 80mg=31; 80/40mg=5). At Wk48, mean improvements from BL in AIMS total score were: SZD (40mg, –10.1; 80mg,–10.7); MD (40mg, 10.2; 80mg: –11.6). AIMS total scores at Wk52 (end of washout) indicated a return toward BL levels. Compared to SZD, the MD subgroup had a higher incidence of any TEAE (84% vs 61% [all doses]) but fewer TEAEs leading to discontinuation (7% vs 18%). Urinary tract infection was the most common TEAE in the MD subgroup (18%); somnolence and headache were most common in the SZD subgroup (7% each). Psychiatric status remained stable from BL to Wk48: SZD (PANSS positive, –0.7, PANSS negative, –0.6; CDSS, –0.7); MD (MADRS, –0.3; YMRS, –0.3). Most participants (95%) had no change in C-SSRS score during the study.ConclusionSustained and clinically meaningful TD improvements were observed with VBZ, regardless of primary psychiatric diagnosis. VBZ was generally well tolerated and no notable changes in psychiatric status were observed.Funding Acknowledgements: Supported by Neurocrine Biosciences, Inc.

scholarly journals A state hospital survey of movement disorders including intention tremor

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S236-S237
Author(s):  
Nigel Bark ◽  
Sung-Ai Kim ◽  
George Eapen
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
State Hospital ◽  
Movement Disorders ◽  
Rating Scale ◽  
Involuntary Movement ◽  
Intention Tremor ◽  
State Hospitals ◽  
Brain Localization ◽  
The Difference

AimsIn a survey of movement disorders in patients in a State Hospital the finger-nose test was included because of increasing interest in the cerebellum in schizophrenia. It was expected that this would reflect the pathobiology of schizophrenia and be unrelated to the type of medication.BackgroundAbnormalities of movement and involuntary movements have gone from being considered part of schizophrenia to side-effects of medication to now demonstrably present in those who have never taken anti-psychotic medication. Soft neurological signs (SNS) are increased in schizophrenia, unrelated to medication, considered not to indicate brain localization, yet often include the finger-nose test which localizes to the cerebellum.MethodAll available patients in a State Hospital were examined for movement disorders. They were rated on the following scales: Abnormal Involuntary Movement Scale (AIMS) for Tardive Dyskinesia (TD), Simpson-Angus Neurological Rating Scale for Parkinsonism (SANRS), Barnes Akathisia Scale (BAS), a Dystonia scale and the finger-nose test.Result250 patients were included, 174 were examined or observed for movement disorder: 120 had no missing data, 54 refused part of the exam. Their mean age was 47, 62% male, 53% black, 26% Hispanic, 17% white.Medication: First Generation Antipsychotic (FGA) 35 (mean CPZ equivalent dose:1177mg), Second Generation Antipsychotic (SGA) 159 (734mg), both FGA and SGA 56 (1907mg), no antipsychotic 3; anticholinergic or amantidine: FGA 57%, SGA 16%, both FGA and SGA: 50%.Tardive Dyskinesia: all 23%, FGA 36%, SGA 25%, both 7%Parkinsonism: all 38%, FGA 43%, SGA 33%, both 34%Akathisia: all 3%, FGA 0%, SGA 4%, both 3%Pseudo-akathisia: FGA 11%, SGA 4%, both13%Dystonia: all 10%, FGA 13%, SGA 11%, both 8%Intention Tremor: all 16%, FGA 0%, SGA 21%, both 16%Half of those with Intention Tremor had Parkinsonism, a third had TD and a half were on anti-Parkinson medication.None of these differences were statistically significant at p = 0.05 though intention tremor did show a trend (p = 0.08). The difference between FGA and SGA only became significant when all movement disorders were added together with those on anticholinergics with no movement disorder.When compared with rates in similar State Hospitals in the 1970s tardive dyskinesia was now half the rate and Parkinsonism about the same.ConclusionOverall rates of movement disorder are not very different between FGA and SGA. The surprise was that intention tremor only occurred with SGAs. Why?

scholarly journals Jaw Kinematics and Tongue Protraction-Retraction during Chewing and Drinking in the Pig

2020 ◽  
Author(s):  
Rachel A. Olson ◽  
Stéphane J. Montuelle ◽  
Brad A. Chadwell ◽  
Hannah Curtis ◽  
Susan H. Williams
Keyword(s):  
Oral Cavity ◽  
Degrees Of Freedom ◽  
Central Control ◽  
Tongue Protrusion ◽  
Jaw Movements ◽  
Tooth Contact ◽  
Tongue Movements ◽  
Summary Statement ◽  
Liquid Bolus ◽  
Lower Magnitude

ABSTRACTMastication and drinking are rhythmic and cyclic oral behaviors that require interactions between the tongue, jaw, and a food or liquid bolus, respectively. During mastication, the tongue transports and positions the bolus for breakdown between the teeth. During drinking, the tongue aids in ingestion and then transports the bolus to the oropharynx. The objective of this study is to compare jaw and tongue kinematics during chewing and drinking in pigs. We hypothesize there will be differences in jaw gape cycle dynamics and tongue protraction-retraction between behaviors. Mastication cycles had an extended slow-close phase, reflecting tooth-food-tooth contact, whereas drinking cycles had an extended slow-open phase, corresponding to tongue protrusion into the liquid. Drinking jaw movements were of lower magnitude for all degrees of freedom examined (jaw protraction, yaw, and pitch), and were bilaterally symmetrical with virtually no yaw. The magnitude of tongue protraction-retraction (Tx) was greater during mastication than drinking, but there were minimal differences in the timing of maximum and minimum tongue Tx relative to the jaw gape cycle between behaviors. However, during drinking, the tongue tip is often located outside the oral cavity for the entire cycle, leading to differences in behaviors in the timing of anterior marker maximum tongue Tx. This demonstrates that there is variation in tongue-jaw coordination between behaviors. These results show that jaw and tongue movements vary significantly between mastication and drinking, which hint at differences in the central control of these behaviors.Summary statementDifferences in the magnitude and timing of tongue and jaw movements and the anteroposterior positioning of the tongue during chewing and drinking demonstrate key differences in coordination of these behaviors.

scholarly journals Deep Brain Stimulation of the Forel’s Field for Dystonia: Preliminary Results

2021 ◽  
Vol 15 ◽  
Author(s):  
Shiro Horisawa ◽  
Kotaro Kohara ◽  
Masato Murakami ◽  
Atsushi Fukui ◽  
Takakazu Kawamata ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Adverse Effects ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Tongue Protrusion ◽  
Scale Scores ◽  
1960S And 1970S ◽  
The 1960S ◽  
Deep Brain ◽  
Stimulation Of

The field of Forel (FF) is a subthalamic area through which the pallidothalamic tracts originating from the globus pallidus internus (GPi) traverse. The FF was used as a stereotactic surgical target (ablation and stimulation) to treat cervical dystonia in the 1960s and 1970s. Although recent studies have reappraised the ablation and stimulation of the pallidothalamic tract at FF for Parkinson’s disease, the efficacy of deep brain stimulation of FF (FF-DBS) for dystonia has not been well investigated. To confirm the efficacy and stimulation-induced adverse effects of FF-DBS, three consecutive patients with medically refractory dystonia who underwent FF-DBS were analyzed (tongue protrusion dystonia, cranio-cervico-axial dystonia, and hemidystonia). Compared to the Burke-Fahn-Marsden Dystonia Rating Scale-Movement Scale scores before surgery (23.3 ± 12.7), improvements were observed at 1 week (8.3 ± 5.9), 3 months (5.3 ± 5.9), and 6 months (4.7 ± 4.7, p = 0.0282) after surgery. Two patients had stimulation-induced complications, including bradykinesia and postural instability, all well controlled by stimulation adjustments.

scholarly journals Nithsdale Schizophrenia Surveys 23: movement disorders

2002 ◽  
Vol 181 (5) ◽  
pp. 422-427 ◽  
Author(s):  
Jennifer Halliday ◽  
Susan Farrington ◽  
Shiona Macdonald ◽  
Tom MacEwan ◽  
Val Sharkey ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Atypical Antipsychotic ◽  
Movement Disorders ◽  
Antipsychotic Drugs ◽  
Rating Scale ◽  
Geographical Area ◽  
Pharmacological Management ◽  
Atypical Antipsychotic Drugs ◽  
The Past ◽  
Current Prevalence

BackgroundIn the past 10 years the new atypical antipsychotic drugs have stimulated further interest in the pharmacological management of schizophrenia. The risk of movement disorders has been reported to be less with these new agents.AimsTo examine the current prevalence of movement disorders among all people with schizophrenia in a discrete geographical area, to compare the prevalence in patients receiving and not receiving atypical antipsychotic drugs; and to compare current prevalence with prevalence over the past 20 years.MethodIn Nithsdale, south-west Scotland, in 1999/2000, we replicated previous studies by using the Abnormal Involuntary Movements Scale, Simpson-Angus scale and Barnes Akathisia Rating Scale to measure tardive dyskinesia, parkinsonism and akathisia, respectively. Mental state was assessed by the Positive and Negative Syndrome Scale.ResultsIn 136 patients the prevalence of probable tardive dyskinesia was 43%, of parkinsonism 35% and of akathisia 15%. Parkinsonism was present as often in those receiving atypicals as in those receiving standard oral antipsychotics. The prevalence of tardive dyskinesia has doubled over 20 years.ConclusionsMovement disorders remain significant problems for patients despite the introduction of atypical antipsychotic drugs.

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