The purpose of this study is to obtain a better understanding of the pathophysiological substrate of jerky movements, with a focus on psychogenic jerks, myoclonic jerks in Myoclonus Dystonia, and tics in Gilles de la Tourette syndrome.
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
- Psychiatric disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The purpose of this study is to obtain a better understanding of the
pathophysiological substrate of jerky movements. We want to identify brain
activations and areas involved with EMG-fMRI that differentiate between MD, GTS
and psychogenic movement disorders and we want to identify different activation
patterns with EEG-EMG analysis techniques. All findings will be analyzed with
respect to common psychiatric co-morbidity, as objectified with standardized
psychiatric scales. The final goal is to use these functional studies for
future clinical practice to discriminate psychogenic and *neurological*
hyperkinetic movement disorders and guide treatment strategy.
Secondary outcome
Not applicable.
Background summary
In movement disorders practice, it is often difficult to determine the origin
of jerky movements. The differential diagnosis ranges from psychogenic origin
to genetically inherited disorders. However, all these movements are often
associated with psychiatric co-morbidity, complicating the distinction.
Study objective
The purpose of this study is to obtain a better understanding of the
pathophysiological substrate of jerky movements, with a focus on psychogenic
jerks, myoclonic jerks in Myoclonus Dystonia, and tics in Gilles de la Tourette
syndrome.
Study design
The study will entail three parts. In an inventory study, the amount of
psychogenic jerks diagnosed at our tertiary referral movement disorders
outpatient clinic as apposed to organic jerks will be clarified. Moreover, it
will provide inside into the follow up of the patients after the diagnosis
psychogenic movement disorder is made. The clinical and psychiatric part of
this study will provide more information on motor symptoms and psychiatric
co-morbidity (both using standardized scales) and will aid in interpreting the
findings of functional studies. In a functional study, several existing
techniques will be used in a novel way: electromyography during functional
magnetic resonance imaging (EMG-fMRI) and combined EEG-EMG.
Study burden and risks
All clinical, psychiatric and functional tests are generally considered to be a
small burden and risk for the participants.
In case of adverse events or unexpected, unrelated pathological findings, we
will inform the general practitioner of the patient instead of the patient
directly. Findings of our study on it*s own not benefit individual patients
directly. Our study is group-related. We expect all groups of participant to
benefit equally of the implementation of results.
Meibergdreef 9
1105AZ Amsterdam
NL
Meibergdreef 9
1105AZ Amsterdam
NL
Listed location countries
Age
Inclusion criteria
Group 1: Psychogenic movement disorders: We will include patients with *clinically established psychogenic movement disorders*, as defined by Hinson and colleagues and Williams and colleagues . This means movements incongruent with organic disease or inconsistent symptoms, in addition to the presence of other false neurological signs or multiple somatisations.
Group 2 : Gilles de la Tourette: DSM-IV diagnosis plus jerky movements of limbs.
Group 3: MD patients with proven DYT 11 mutation and DYT11 negative MD patients (the latter for EMG-fMRI only).
All patients should have jerky movements frequently.
Exclusion criteria
General exclusion criteria are neurological co-morbidity and the use of substance and/or medication that may influence study results. For the fMRI-EMG study extra exclusion criteria apply. Participants should not have metal implants (e.g. pacemaker), nor should they be pregnant. Moreover, participants with claustrofobia are excluded from fMRI investigation.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL20159.018.07 |