Current opinions and practices in post-stroke movement disorders: Survey of movement disorders society members

Federico Rodriguez-Porcel; Harini Sarva; Juho Joutsa; Cristian Falup-Pecurariu; Aparna Wagle Shukla; Raja Mehanna; Katarzyna Śmiłowska; Giuseppe Lanza; Saša R Filipović; Ali Shalash; Margaret Ferris; Joseph Jankovic; Alberto J Espay; Sanjay Pandey; Post-Stroke Movement Disorders Study Group from the Movement Disorders Society

doi:10.1016/j.jns.2024.122925

Current opinions and practices in post-stroke movement disorders: Survey of movement disorders society members

J Neurol Sci. 2024 Mar 15:458:122925. doi: 10.1016/j.jns.2024.122925. Epub 2024 Feb 7.

Authors

Federico Rodriguez-Porcel¹, Harini Sarva², Juho Joutsa³, Cristian Falup-Pecurariu⁴, Aparna Wagle Shukla⁵, Raja Mehanna⁶, Katarzyna Śmiłowska⁷, Giuseppe Lanza⁸, Saša R Filipović⁹, Ali Shalash¹⁰, Margaret Ferris¹¹, Joseph Jankovic¹², Alberto J Espay¹³, Sanjay Pandey¹⁴; Post-Stroke Movement Disorders Study Group from the Movement Disorders Society

Affiliations

¹ Department of Neurology, Medical University of South Carolina, Charleston, SC, USA. Electronic address: [email protected].
² Parkinson's Disease and Movement Disorders Institute, Department of Neurology, Weill Cornell Medicine, NY, New York, USA.
³ Turku Brain and Mind Center, Clinical Neurosciences, University of Turku; Turku PET Centre, Neurocenter, Turku University Hospital, Turku, Finland.
⁴ Department of Neurology, Transilvania University Brasov, Romania.
⁵ Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.
⁶ Department of Neurology, University of Texas Health Science Center at Houston, TX, USA.
⁷ Department of Neurology, Silesian Center of Neurology, Katowice, Poland.
⁸ Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy; Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy.
⁹ University of Belgrade, Institute for Medical Research, Human Neuroscience Group, Belgrade, Serbia.
¹⁰ Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
¹¹ Department of Neurology Stanford University, Palo Alto, CA, USA.
¹² Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
¹³ James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
¹⁴ Department of Neurology and Stroke Medicine, Amrita Hospital, Mata Amritanandamayi Marg Sector 88, Faridabad, Delhi National Capital Region, India.

PMID: 38340409
DOI: 10.1016/j.jns.2024.122925

Abstract

Background: Post-stroke movement disorders (PSMD) encompass a wide array of presentations, which vary in mode of onset, phenomenology, response to treatment, and natural history. There are no evidence-based guidelines on the diagnosis and treatment of PSMD.

Objectives: To survey current opinions and practices on the diagnosis and treatment of PSMD.

Methods: A survey was developed by the PSMD Study Group, commissioned by the International Parkinson's and Movement Disorders Society (MDS). The survey, distributed to all members, yielded a total of 529 responses, 395 (74.7%) of which came from clinicians with experience with PSMD.

Results: Parkinsonism (68%), hemiballismus/hemichorea (61%), tremor (58%), and dystonia (54%) were by far the most commonly endorsed presentation of PSMD, although this varied by region. Basal ganglia stroke (76% of responders), symptoms contralateral to stroke (75%), and a temporal relationship (59%) were considered important factors for the diagnosis of PSMD. Oral medication use depended on the phenomenology of the PSMD. Almost 50% of respondents considered deep brain stimulation and ablative surgeries as options for treatment. The lack of guidelines for the diagnosis and treatment was considered the most important gap to address.

Conclusions: Regionally varying opinions and practices on PSMD highlight gaps in (and mistranslation of) epidemiologic and therapeutic knowledge. Multicenter registries and prospective community-based studies are needed for the creation of evidence-based guidelines to inform the diagnosis and treatment of patients with PSMD.

Keywords: Cerebrovascular; Movement disorders; Post-stroke movement disorders; Stroke.

Publication types

Multicenter Study

MeSH terms

Humans
Movement Disorders* / diagnosis
Movement Disorders* / etiology
Movement Disorders* / therapy
Prospective Studies
Stroke* / complications
Stroke* / therapy
Surveys and Questionnaires
Tremor