Cerebellar rTMS Theta Burst for Postural Instability in Progressive Supranuclear Palsy

Author(s):  
2002 ◽  
Vol 60 (4) ◽  
pp. 917-922 ◽  
Author(s):  
Paulo Eduardo Mestrinelli Carrilho ◽  
Egberto Reis Barbosa

Progressive supranuclear palsy (PSP) is an uncommon disorder characterized by marked postural instability, vertical gaze abnormalities and axial rigidity. The purpose of this study is to report the clinical features of 16 consecutive subjects seen over a 10-year period at a Movement Disorders Clinic. These subjects fulfilled criteria for probable PSP namely those of the National Institute of Neurologic Disorders and Stroke (NINDS) and the Society for PSP (SPSP). This patient-group represented 2.1% of all degenerative parkinsonians observed and the mean age of onset of the disease was 64.7 years (sd = ± 7.2). Postural instability with falls was the most frequent initial feature presented in PSP patients (62.5%). The hallmark of the disease, the supranuclear vertical gaze palsy, appeared after 2.3 years of disease onset, and only 12.5% had such manifestation at the first evaluation. Transient tremor was observed with a relatively high frequency in this group (44%), but only 19% had rest tremor. Chronic dacryocystitis, probably related to a paucity of blinking, was observed in two patients as an inaugural manifestation. In the first evaluation, only 19% of the 16 patients were diagnosed as probable PSP. The mean interval prior to the final diagnosis was 2.4 years.


2021 ◽  
Vol 14 (6) ◽  
pp. 1620
Author(s):  
Marian Dale ◽  
Austin Prewitt ◽  
Graham Harker ◽  
Alex Stevens ◽  
Patty Carlson-Kuhta ◽  
...  

2013 ◽  
Vol 32 (4) ◽  
pp. 855-860 ◽  
Author(s):  
L. Di Pancrazio ◽  
R.G. Bellomo ◽  
R. Franciotti ◽  
P. Iodice ◽  
V. Galati ◽  
...  

2020 ◽  
Author(s):  
Andrea Pilotto ◽  
Maria Cristina Rizzetti ◽  
Alberto Lombardi ◽  
Clint Hansen ◽  
Michele Biggi ◽  
...  

SUMMARYThere are no effective treatments for postural instability and falls in Progressive Supranuclear Palsy (PSP). Objective of the study was to test the efficacy of theta burst repetitive transcranial magnetic stimulation (rTMS) on postural instability in PSP. Twenty probable PSP patients underwent a session of sham or cerebellar rTMS in a cross-over design. Before and after stimulation, static balance was evaluated with instrumented (lower back accelerometer, Rehagait®, Hasomed, Germany) 30-seconds-trials in semitandem and tandem positions. In tandem and semitandem tasks, active stimulation was associated with longer time without support falls (both p=0.04). In the same tasks, device-extracted parameters revealed significant improvement in area (p=0.007), velocity (p=0.005) and acceleration and jerkiness of sway (p=0.008) in real versus sham stimulation. Cerebellar rTMS thus showed a significant effect on stability in PSP patients, when assessed with mobile digital technology, in a double-blind design. These results should motivate larger and longer trials using non-invasive brain stimulation for PSP patients.


Author(s):  
Carolin Kurz ◽  
Georg Ebersbach ◽  
Gesine Respondek ◽  
Armin Giese ◽  
Thomas Arzberger ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jung-Lung Hsu ◽  
Shih-Hsin Chen ◽  
Ing-Tsung Hsiao ◽  
Chin-Song Lu ◽  
Tzu-Chen Yen ◽  
...  

Abstract The associations of 18F-THK5351 tau positron emission tomography (PET) findings with core domains of progressive supranuclear palsy (PSP) and its diagnostic certainty have yet to be fully elucidated. The 18F-THK5351 PET patterns of 17 patients with PSP (68.9 ± 6.5 years; 8 women) were compared with those observed in 28 age-matched and sex-matched (66.2 ± 4.5 years, 18 women) control subjects (CS). Tracer accumulation—as reflected by standardized uptake value ratios (SUVRs) and z-scores—was correlated with core domains of PSP and different levels of diagnostic certainty. Compared with CS, patients with PSP showed an increased 18F-THK5351 uptake in the globus pallidus and red nucleus. Patients with PSP and oculomotor dysfunction had significantly higher SUVRs in the midbrain, red nucleus, and raphe nucleus than those without. In addition, cases who meet criteria for level 1 (highest) certainty in the postural instability domain showed significantly higher SUVRs in the frontal, parietal, precuneus, and sensory-motor cortex. Patients with probable PSP had significantly higher SUVR values than those with possible PSP in multiple cortical (i.e., frontal, parietal, temporal, anterior cingulate gyrus, precuneus, and sensory-motor gyrus) and subcortical (i.e., putamen, thalamus, and raphe nucleus) regions. Patterns of 18F-THK5351 uptake were correlated to core domains of PSP—including oculomotor dysfunction and postural instability. Moreover, the degree of diagnostic certainty for PSP was appreciably associated with 18F-THK5351 PET findings.


2014 ◽  
Vol 7 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Livia Brusa ◽  
Viviana Ponzo ◽  
Chiara Mastropasqua ◽  
Silvia Picazio ◽  
Sonia Bonnì ◽  
...  

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