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Main Topic 1: Parkinson's disease and movement disorders: expanding the boundaries of current practice by Mind Map: Main Topic 1:
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Main Topic 1: Parkinson's disease and movement disorders: expanding the boundaries of current practice

P. Krack

DeepBrain Stimulation

PD, Post operative apathy, thobois et al 2010,, Clinical predictors of postoperative apathy, Dopmaine dysregulation syndrome and impulse control disorders, Witjas 2005,, Ardouin 2006, Lim 2009, picture, picture

Gilles de La Tourette, picture, Limbic GPi vs thalamic stimulation, JL houeto 2005, ML Welter 2008, Servello 2009

OCD, A day filled with rituals, STOC study group, after DBS normal life, YBOCS scale 18-20 --> 1-1 after surgery, Mallet 2008, picture,, DBS, Greenberg 2008, Molecular psychiatry

Depression, Lozano 2008, Biol Psychiatry, Malone 2009, Biol psychiatry, stimulation of ventral capsule/ventral striatum for treatment resistent depression, Bewernick 2009, Biol psychiatry, Nucleus accumbens

Addiction, Not discussed due to time

All targets, picture, it's a mess, Neurologists are used to reason, picture circuits, Krack P, TINS 2010,, DBS from neurology to psychiatry?, picture, slide 2, What's needed?

Conclusion, DBS in psychiatry is still experimental but huge potential

J.J. Ferreira

Parkinson's disease beyond 10 years

What happens after the first 10 years of disease progress?, picture, picture with errors - Fereira JJ, pre-motor, pre-clinical, prodromal, signs and symptoms, unilateral, bilateral, etc

Hoehn Yahr Staging, milestones, picture, picture, reflecting the ideas / knowledge at the time of creation

PD progression focused on motor complications, picture, Elldopa trial, Ahlskog JE, Mov. Disord 2001

PD progression focused on clinical trials population, De Novo patients or early stage, Motor fluctuations, wearing off, PD Dementia / psychosis, picture, Clinical characteristics, "wearing-off patients", Rascol Lancet 2005, LARGO trial, DBS, 60 yrs age, 13 years of PD, Deschl NEJM 2006, PD Dementia, 72 yrs age, 9 years of PD, Emre 2004 NEJM, Express trial

After 10 years, Selection, Late stage / end-stage, Clinical staging: HY 4 and 5, Longer disease duration, specific clinical markers, Disability milestones, Other, Clinical characteristics: motor symptoms, Coelho, J. Neurol 2010, Motor symptoms, Red flags for atypical parkinsonism, picture, S. papapetropoulos, 2007, LD-induced motor complications, Non-motor complications, Coelho J Neurol 2010,, IS dementia inevitable?, picture, Placebo-adverse events at different disease stage, dyskinesias, hallucinations, Pain, Anxiety, Peripheral edema, Phenotype is different between clinical stages, Picture, Picture, Picture, Picture, Coelho 2010, Aarsland j am geriatr soc 2000, Predictors of instituionalization, falls, dementia, hallucinations, Pubmed,, Clinical markers, pictures, Time to clinical markers, disability milestones, Kempster,Brain 2007, 130,2123-2128, patterns of levodopa response in PD,, Kempster,Brain 2010: 133; 1755-1762,, Disease duration lost much relevance, Much more relevant: disability milestones, Medication, Picture, Mortality, picture - w lots of authors, Conclusions, picture, Late / end stage is an orphan domain, Initial slide on progression late stage redesigned, picture, Implications for clinical practice, picture, Implications for research

Kailash Bhatia

Ion channels & movement Disorders

Basics on Ion channels, picture, picture, Functional investigation of mutants, most abnormalities in alfa subunits

Ion channel disorder, jouveneau 2000, picture, Graves and Hanna 2005, review, classification of neurological channelopathies according to channel,

The paroxysmal dyskinesias, often diagnosis is missed, Gowers 1885, called it epilepsy, Mount and reback 1940, first clear description, Paroxysmal dystonic choreoathetosis, Lance 1977, PKC, PED, attachs 5-30 minutes, induced by prolonged exercise, PDC, long duration attacks up to 6 hrs, induced by coffee, tea, alcohol, fatigue, picture, these slides go fast...missed some nice ones. - could not even read them, Hypnogenic episodic ataxia

Episodic ataxias, There are similarities between paroxysmal dyskinesia and episodic ataxias, picture, EA type 1, EA type 2, inter-ictal pendular and gaze evoked nystagmus, Allelic disorders, 19p13 CACNLA4, picture, Houser et al, 1999,, picture, Bruno et al 2004

Pathophysiology, picture, picture, picture, epilepsy theory

Bhatia publications,,

PDC/PNKD, picture, treatment, no specific drug, anticonvulsants help rarely, Recent gene found, Oxidative stress product, Bruno et al neurology 2005, myofibrillogenesis regulator 1 gene mutations cause paroxysmal dystonic choreoathetosis, arch neurol 2004, Paroxysmal dyskinesia due to glucose transporter 1 defect, Weber, JCI 2008, GLUT1 mutations, GLUT1 deficiency

Autosomal dominant nocturnal frontal lobe epilepsy

Diagnostics, Serum and CSF glucose studies

Treatment of GLUT1 deficiency, ketogenic diet

Autoimmune channelopathis causing movement disorders, central nervous system, peripheral nerve system, Isaac's syndrome

Summary, picture, picture, picture, picture