Therapy of Movement Disorders

National Institute Of Neurological Disorders And Stroke

Investigators

Linked publications, trials & patents

Abstract

In the area of dystonia treatment, we continue to provide botulinum toxin injections to our patients while training physicians to perform these injections. We have recently completed a study comparing electrophysiologic and ultrasound guidance for injections that shows that patients prefer the latter although the efficacy is similar (NCT02326818). Past studies from our group have shown that certain rehabilitation techniques, such as motor training and sensory training can be therapeutic. We have also been developing a new scale for severity of writers cramp to help in the analysis of clinical trials and are completing an analysis of its reliability. Another protocol (in collaboration with the Parkinson Clinic) is ongoing for Deep Brain Stimulation (DBS) for focal hand dystonia (NCT0291110). New treatments are needed for essential tremor. We are looking at the possible utility and mechanism of peripheral stimulation for the treatment of essential tremor (in collaboration with the Parkinson Clinic) (NCT03027310). We have completed and published a successful pilot study of non-invasive brain stimulation for functional movement disorders (NCT03263013). The technique inhibits the overactivity of the amygdala by stimulation of an area of the dorsolateral prefrontal cortex that connects to the amygdala. A double-blind controlled trial has begun to follow-up this exciting observation (NCT05155059). We have also collaborated with the Parkinson clinic on a pilot therapeutic trial of medium-chain triglycerides in patients with Parkinson disease (NCT04584346).