Post Stroke Movement Disorder Study Group

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Chair: Sanjay Pandey

Co-Chair: Federico Rodriguez-Porcel

MDS Staff Liaison: Jane Mullarkey

Goals/Mission/Main Objective(s):

Background

Post-stroke movement disorders (PSMD) are among the most common secondary movement disorders. Although prior studies have highlighted the clinical spectrum and phenomenology of PSMD, there are many important knowledge gaps worth addressing in a collaborative fashion:

• Unclear latencies between stroke and onset of abnormal movement
• Need to clarify what we mean by stroke: cerebrovascular disease associated with movement disorders include ischemic and hemorrhagic strokes, subarachnoid hemorrhage, cerebrovascular malformations, and dural arteriovenous fistulas. Which ones do we want to include? And if we will be very inclusive, should we consider changing the name to cerebrovascular related movement disorders (CVMD)?
• Rationale for vulnerability versus resilience to developing abnormal movements in selected stroke syndromes
• Need to study networks to account for the imperfect correlation between stroke localization and movement phenomenology (only in ~30% of cases).
• Clinical heterogeneity: more than one movement disorder in the same patient
• Neuroimaging heterogeneity: more than one stroke type for the same phenotype
• Prognosis: which stroke syndromes disappear, which become chronic?
• Nosology: definition of selected disorders, such as lingual dystonia, jerky hand, etc.
• Treatment: is the response to symptomatic therapies differential across PSMD phenotypes versus primary movement disorders phenotypes?

Missions/Goals

The main missions of the PSMD will be to:

• To discuss the need of a global survey to assess the current status of PSMD

• To identify regional differences in needs, problems, and gaps.
• To plan multi-centric studies to address the current knowledge gaps.