Deep brain stimulation and stereotactic-assisted brain graft injection targeting fronto-striatal circuits for Huntington’s disease: an update

Kinfe, Thomas M.; Vecchio, Alessandro Del; Nüssel, Martin; Zhao, Yining; Stadlbauer, Andreas; Buchfelder, Michael

doi:10.1080/14737175.2022.2091988

Expert Review of Neurotherapeutics

2022

DOI: 10.1080/14737175.2022.2091988

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Deep brain stimulation and stereotactic-assisted brain graft injection targeting fronto-striatal circuits for Huntington’s disease: an update

Thomas M. Kinfe

Alessandro Del Vecchio

Martin Nüssel

et al.

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2023

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“…Methods: The Indian Movement Disorder Registry and Biobank is a multi-centric clinical registry and DNA biorepository for Indian patients with suspected genetic movement disorders. As part of this registry, our center enrolled 570 probands and affected/unaffected family members with dystonia from Sep 2018 Clinical and demographic data were captured and stored on a REDCap platform. All patients underwent standardized videotaped neurological examinations.…”

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Hyperkinetic Movement Disorders

2023

Movement Disorders

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Symptomatic treatment options for Huntington’s disease (guidelines of the German Neurological Society)

Saft,

Burgunder,

Dose

et al. 2023

Neurol. Res. Pract.

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Introduction Ameliorating symptoms and signs of Huntington’s disease (HD) is essential to care but can be challenging and hard to achieve. The pharmacological treatment of motor signs (e.g. chorea) may favorably or unfavorably impact other facets of the disease phenotype (such as mood and cognition). Similarly, pharmacotherapy for behavioral issues may modify the motor phenotype. Sometimes synergistic effects can be achieved. In patients undergoing pragmatic polypharmacological therapy, emerging complaints may stem from the employed medications' side effects, a possibility that needs to be considered. It is recommended to clearly and precisely delineate the targeted signs and symptoms (e.g., chorea, myoclonus, bradykinesia, Parkinsonism, or dystonia). Evidence from randomized controlled trials (RCTs) is limited. Summary or definition of the topic Therefore, the guidelines prepared for the German Neurological Society (DGN) for German-speaking countries intentionally extend beyond evidence from RCTs and aim to synthesize evidence from RCTs and recommendations of experienced clinicians. Recommendations First-line treatment for chorea is critically discussed, and a preference in prescription practice for using tiapride instead of tetrabenazine is noted. In severe chorea, combining two antidopaminergic drugs with a postsynaptic (e.g., tiapride) and presynaptic mode of action (e.g., tetrabenazine) is discussed as a potentially helpful strategy. Sedative side effects of both classes of compounds can be used to improve sleep if the highest dosage of the day is given at night. Risperidone, in some cases, may ameliorate irritability but also chorea and sleep disorders. Olanzapine can be helpful in the treatment of weight loss and chorea, and quetiapine as a mood stabilizer with an antidepressant effect. Conclusions Since most HD patients simultaneously suffer from distinct motor signs and distinct psychiatric/behavioral symptoms, treatment should be individually adapted.

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Deep brain stimulation and stereotactic-assisted brain graft injection targeting fronto-striatal circuits for Huntington’s disease: an update

Cited by 2 publications

References 55 publications

Hyperkinetic Movement Disorders

Hyperkinetic Movement Disorders

Symptomatic treatment options for Huntington’s disease (guidelines of the German Neurological Society)

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