Zaburzenia ruchowe – Epidemiologia

Zaburzenia ruchowe
Epidemiologia

Zaburzenia ruchowe stanowią zróżnicowaną grupę schorzeń neurologicznych charakteryzujących się mimowolnymi ruchami, które znacząco obniżają jakość życia pacjentów. Choroba Parkinsona, najczęstsze zaburzenie ruchowe, dotyka około 1% populacji powyżej 60 roku życia, a jej częstość wzrasta do 4-5% u osób powyżej 85 lat. Na świecie żyje ponad 10 milionów chorych, z prognozowanym wzrostem liczby przypadków, szczególnie w krajach rozwijających się. Drżenie samoistne występuje u około 10% osób powyżej 60 lat, a dystonia ogniskowa ma częstość 16,4/100 000. Choroba Huntingtona i mózgowe porażenie dziecięce mają częstość odpowiednio 5-10/100 000 i 2,1/1000 żywych urodzeń. Zaburzenia ruchowe wykazują zróżnicowanie epidemiologiczne w zależności od regionu geograficznego, wieku i płci, z mężczyznami bardziej narażonymi na chorobę Parkinsona (M:K=1,5:1) oraz wyższą częstością czynnościowych zaburzeń ruchowych u kobiet (K:M=2-3:1). Wzrost zachorowań na FMD odnotowano podczas pandemii COVID-19, a zaburzenia ruchowe związane ze snem, takie jak zespół niespokojnych nóg (1-20% populacji) i okresowe ruchy kończyn podczas snu (4-11% dorosłych), są powszechne i często współwystępują.

Epidemiologia zaburzeń ruchowych

Globalna epidemiologia podstawowych zaburzeń ruchowych
Regionalne zróżnicowanie epidemiologiczne
Różnice związane z płcią i wiekiem

Epidemiologia poszczególnych typów zaburzeń ruchowych

Choroba Parkinsona
Czynnościowe zaburzenia ruchowe
Zaburzenia ruchowe związane ze snem
Inne zaburzenia ruchowe

Nadzór epidemiologiczny i badania naukowe

Wyzwania w badaniach epidemiologicznych
Inicjatywy badawcze i rejestry
Nowoczesne technologie w monitorowaniu epidemiologicznym

Wpływ na zdrowie publiczne i opiekę zdrowotną

Obciążenie systemów opieki zdrowotnej
Niedodiagnozowanie i opóźniona diagnoza
Wpływ na jakość życia i koszty socjoekonomiczne
Strategie poprawy diagnostyki i leczenia
Kolejne rozdziały

Epidemiologia zaburzeń ruchowych

Zaburzenia ruchowe stanowią grupę schorzeń neurologicznych charakteryzujących się obecnością ruchów mimowolnych. Mają one znaczący negatywny wpływ na jakość życia pacjentów i obejmują szeroki zakres jednostek chorobowych o zróżnicowanej etiologii i obrazie klinicznym. Znajomość profilu epidemiologicznego tych zaburzeń jest niezwykle istotna dla poprawy praktyk opieki zdrowotnej oraz planowania odpowiednich strategii terapeutycznych.¹²

Występowanie zaburzeń ruchowych jest powszechne w populacji ogólnej, chociaż dokładne dane epidemiologiczne dla wielu z tych schorzeń są ograniczone lub trudne do oszacowania. Rozumienie podstawowych cech epidemiologicznych tych chorób stanowi wyzwanie ze względu na zróżnicowane kryteria diagnostyczne, różnorodność obrazu klinicznego oraz często współwystępujące inne schorzenia neurologiczne.¹²

Globalna epidemiologia podstawowych zaburzeń ruchowych

W skali globalnej, choroba Parkinsona jest najczęściej diagnozowanym zaburzeniem ruchowym, z szacowaną częstością występowania na poziomie około 1% populacji powyżej 60 roku życia. Według badań epidemiologicznych, częstość występowania choroby Parkinsona wzrasta do 4-5% wśród osób powyżej 85 roku życia.¹ Obecnie na świecie z chorobą Parkinsona żyje ponad 10 milionów osób, a w Stanach Zjednoczonych liczba ta wynosi około 1,1 miliona, z prognozą wzrostu do 1,2 miliona do 2030 roku.¹

W analizach danych epidemiologicznych innych zaburzeń ruchowych obserwujemy, że drżenie samoistne jest najczęstszym typem hiperkinetycznego zaburzenia ruchowego spotykanym w praktyce klinicznej. Częstość jego występowania wzrasta z wiekiem, z szacunkami wskazującymi, że do 10% osób powyżej 60 roku życia doświadcza tego zaburzenia.¹ Dystonia natomiast występuje rzadziej, a jej częstość występowania szacuje się na 16,4 przypadków na 100 000 osób w przypadku dystonii ogniskowej (najczęściej w postaci dystonii szyjnej), podczas gdy dystonia uogólniona jest jeszcze rzadsza.¹²

Badania epidemiologiczne wskazują również na zróżnicowaną częstość występowania innych zaburzeń ruchowych:¹²

Choroba Huntingtona, będąca najczęstszą przyczyną pląsawicy, występuje u około 5-10 przypadków na 100 000 osób w Stanach Zjednoczonych, podczas gdy częstość występowania na świecie waha się od 0,4 do 5,7 na 100 000 osób
Łagodna pląsawica dziedziczna ma częstość występowania około 1 przypadku na 500 000 osób
Choroba Wilsona występuje z częstością około 30 przypadków na 1 milion osób

Regionalne zróżnicowanie epidemiologiczne

Badania epidemiologiczne wskazują na znaczące różnice w częstości występowania zaburzeń ruchowych w zależności od regionu geograficznego. W przypadku choroby Parkinsona, wyższe wskaźniki zachorowalności odnotowuje się w określonych regionach geograficznych, takich jak Pas Rdzy (części północno-zachodnich i środkowo-zachodnich Stanów Zjednoczonych), południowa Kalifornia, południowo-wschodni Teksas, centralna Pensylwania i Floryda.¹

Badania w Afryce Subsaharyjskiej sugerują niższą częstość występowania choroby Parkinsona w tym regionie w porównaniu do krajów wysokorozwiniętych, chociaż może to częściowo wynikać z ograniczonego dostępu do diagnostyki i opieki zdrowotnej.¹ Podobnie, zakażenia związane z różnymi patogenami (wirusowymi, bakteryjnymi, pasożytniczymi) mogą prowadzić do rozwoju zaburzeń ruchowych, a ich występowanie wykazuje znaczne różnice geograficzne.¹

W badaniu przeprowadzonym w Kamerunie, wśród 1126 przeanalizowanych kart pacjentów, u 35 (3,1%) zdiagnozowano zaburzenia ruchowe. Najczęstszymi postaciami klinicznymi były parkinsonizm (22,9%), dystonia (20%), drżenie móżdżkowe (17,1%) i samoistne (14,3%). Główne etiologie to choroba Parkinsona (25,7%) i udar mózgu (8,6%), podczas gdy choroba Huntingtona stanowiła 5,7% przypadków.¹

W podobnym badaniu przeprowadzonym w ośrodku opieki zdrowotnej w Abudży (Nigeria), wśród 90 pacjentów najczęstszym zaburzeniem ruchowym był parkinsonizm (62,2%), następnie dystonia (16,7%) i drżenie samoistne (7,8%). Choroba Parkinsona stanowiła 91% przypadków parkinsonizmu.¹

Różnice związane z płcią i wiekiem

Dane epidemiologiczne wskazują na istotne różnice w występowaniu zaburzeń ruchowych w zależności od płci i wieku. W przypadku choroby Parkinsona, mężczyźni są około 1,5 razy bardziej narażeni na jej rozwój niż kobiety, a głównym czynnikiem ryzyka jest wiek, choć szacuje się, że około 4% osób z tą chorobą jest diagnozowanych przed 50 rokiem życia.¹

W przypadku czynnościowych zaburzeń ruchowych (FMD – Functional Movement Disorders), które stanowią około 3-8% wizyt w klinikach zaburzeń ruchowych, średni wiek zachorowania wynosi od 46 do 53 lat, z wyraźną przewagą kobiet. Retrospektywna analiza 199 pacjentów z akademickich ośrodków referencyjnych wykazała, że częstość występowania FMD była 2-3 razy wyższa u kobiet niż u mężczyzn.¹ Metaanaliza obejmująca 4905 pacjentów z FMD wykazała, że zaburzenie to osiąga szczyt zachorowań w średnim wieku dla wszystkich fenotypów, ale pacjenci z dystonią czynnościową i osłabieniem są młodsi, podczas gdy pacjenci z zaburzeniami chodu są starsi.¹²

W badaniu brazylijskim analizującym profile pacjentów z zaburzeniami ruchowymi stwierdzono, że najczęstszymi rozpoznaniami były choroba Parkinsona (40,7%), drżenie samoistne (15,4%) i dystonia (13,1%). Pacjenci byli przeważnie rasy białej, płci żeńskiej, w wieku między 71 a 80 lat.¹²

Epidemiologia poszczególnych typów zaburzeń ruchowych

Choroba Parkinsona

Choroba Parkinsona jest drugą najczęstszą chorobą neurodegeneracyjną po chorobie Alzheimera i najczęstszym zaburzeniem ruchowym. Szacuje się, że dotyka ona około 1% populacji ogólnej, z wyraźnym wzrostem częstości występowania wraz z wiekiem.¹ Według najnowszych badań, w samych Stanach Zjednoczonych co roku diagnozuje się około 90 000 nowych przypadków, co stanowi 50% wzrost w porównaniu do wcześniejszych szacunków (60 000 diagnoz rocznie).¹

Badania epidemiologiczne wskazują na stały wzrost zachorowalności i częstości występowania choroby Parkinsona, co może być częściowo związane ze starzeniem się populacji.¹² Istnieją również dowody na różnice geograficzne w częstości występowania tej choroby, z wyższymi wskaźnikami w określonych regionach, co sugeruje potencjalny wpływ czynników środowiskowych.¹

W analizie postaci klinicznych choroby Parkinsona wykazano, że 66,7% pacjentów powyżej 61 roku życia otrzymało diagnozę postaci mieszanej, podczas gdy 71,4% pacjentów poniżej 61 roku życia zdiagnozowano z postacią akinetyczno-sztywną (AR). Postać akinetyczno-sztywna choroby Parkinsona ma tendencję do występowania u młodszych osób, z objawami niestabilności postawy i zamrożenia chodu rozwijającymi się wcześniej. Z kolei postaci mieszana i drżączka choroby Parkinsona mają większe prawdopodobieństwo późnego początku.¹²

Czynnościowe zaburzenia ruchowe

Czynnościowe zaburzenia ruchowe (FMD) stanowią podtyp czynnościowych zaburzeń neurologicznych, w których główną manifestacją jest drżenie, dystonia, zaburzenia chodu lub inne nieprawidłowe ruchy. Szacuje się, że FMD stanowi 2-10% wszystkich pacjentów w klinikach zaburzeń ruchowych, przy czym częstość występowania FMD wśród pacjentów z dystonią i przykurczami stawów może być jeszcze wyższa.¹²

Metaanaliza obejmująca blisko 5000 przypadków FMD wykazała następujące częstości występowania poszczególnych fenotypów:¹

FMD mieszane (23%)
Drżenie (22%)
Osłabienie (18%)
Dystonia (12%)
Zaburzenia chodu (8%)
Mioklonie/szarpnięcia (5%)
Parkinsonizm (2%)

W największym międzynarodowym badaniu obejmującym 70 autorów i 4905 pacjentów z FMD, które stanowi największy zbiór danych dotyczący jakiegokolwiek czynnościowego zaburzenia neurologicznego, potwierdzono, że FMD występuje najczęściej w średnim wieku, ale pacjenci z dystonią i osłabieniem byli młodsi, a ci z zaburzeniami chodu starsi.¹²

Niedawne badanie przekrojowe wykazało zwiększoną częstość występowania FMD zarówno u dzieci, jak i dorosłych podczas pandemii COVID-19, podkreślając rolę stresorów psychologicznych i środowiskowych w rozwoju tego zaburzenia.¹ Częstość występowania FMD wśród pacjentów ocenianych w klinikach zaburzeń ruchowych wynosi około 5%, ale podejrzewa się, że wzrosła w okresie po pandemii COVID-19.¹²

Zaburzenia ruchowe związane ze snem

Zaburzenia ruchowe związane ze snem (SRMD – Sleep-Related Movement Disorders) są powszechnymi, często uciążliwymi schorzeniami, szczególnie u osób starszych. Międzynarodowa Klasyfikacja Zaburzeń Snu (ICSD) definiuje SRMD jako „stosunkowo proste, zwykle stereotypowe ruchy, które zakłócają sen i jego początek”.¹

Zespół niespokojnych nóg (RLS – Restless Legs Syndrome) to jedno z najczęstszych zaburzeń ruchowych związanych ze snem, z częstością występowania w populacji ogólnej od 1% do 20%, z wyższą częstością u kobiet. Badania sugerują, że niedobór żelaza w mózgu, charakteryzujący się niskim poziomem ferrytyny i wysokim poziomem transferyny w płynie mózgowo-rdzeniowym, jest związany z patogenezą RLS.¹

Ekbom oszacował częstość występowania RLS na 5% w populacji ogólnej. Późniejsze badania ankietowe oszacowały częstość występowania tego zaburzenia w populacji na 1-9%. Badanie RLS Epidemiology, Symptoms, and Treatment (REST) jest największym badaniem ankietowym dotyczącym częstości występowania RLS. Kwestionariusze wypełniło 23 052 pacjentów zgłaszających się do praktyk podstawowej opieki zdrowotnej w USA i czterech krajach Europy Zachodniej. Jakikolwiek stopień objawów RLS doświadczyło 11,9% respondentów, 9,6% miało objawy co najmniej raz w tygodniu, a 551 (2,4% wszystkich respondentów, 3,4% respondentów z kompletnymi danymi) miało objawy co najmniej dwa razy w tygodniu i zgłaszało negatywny wpływ na jakość życia.¹

Okresowe ruchy kończyn podczas snu (PLMS – Periodic Limb Movements of Sleep) charakteryzują się stereotypowymi ruchami występującymi w regularnych odstępach czasu, zazwyczaj obejmującymi kończyny dolne. Częstość występowania PLMS u osób powyżej 60 roku życia waha się między 29% a 85%.¹ Częstość występowania okresowych ruchów kończyn podczas snu (PLMS) szacuje się na 4-11% u dorosłych. PLMS są najczęściej objawem zespołu niespokojnych nóg (RLS), ale często występują również w narkolepsji, zespole bezdechu sennego i zaburzeniach zachowania w fazie snu REM (RBD).¹

Inne zaburzenia ruchowe

Mózgowe porażenie dziecięce (CP – Cerebral Palsy) jest najczęstszym zaburzeniem ruchowym u dzieci, występującym u około 2,1 na 1000 żywych urodzeń. W latach 70. i 90. XX wieku odnotowano „umiarkowany, ale znaczący” wzrost częstości występowania CP. Częstość występowania CP wzrasta u wcześniaków lub dzieci z bardzo niską masą urodzeniową, niezależnie od jakości opieki. Częstość występowania mózgowego porażenia dziecięcego najlepiej obliczać w wieku wejścia do szkoły, około sześciu lat; częstość występowania w USA szacuje się na 2,4 na 1000 dzieci.¹

Zaburzenia ruchowe wywołane lekami, w tym późne dyskinezy, stanowią istotny problem kliniczny. W badaniu post-marketingowym wykorzystującym światową bazę danych o farmakovigilance wykazano, że chociaż zaburzenia ruchowe wywołane antydepresantami są rzadkimi działaniami niepożądanymi, stanowiąc tylko 2,8% raportów zawierających co najmniej jeden lek przeciwdepresyjny, znaleziono potencjalnie szkodliwy związek między zaburzeniami ruchowymi a stosowaniem ogólnie inhibitorów wychwytu zwrotnego serotoniny (SRI), a w szczególności mirtazapiny, wortioksetyny, amoksapiny, fenelzyny, tryptofanu, fluwoksaminy, citalopramu, paroksetyny, duloksetyny, bupropionu, klomipraminy, escitalopramu, fluoksetyny, mianseryny, sertraliny, wenlafaksyny i wilazodonu.¹²

Najczęściej zgłaszanym zaburzeniem ruchowym po ekspozycji na leki przeciwdepresyjne było drżenie, a najsilniejszy związek stwierdzono z bruksizmem.¹²

Nadzór epidemiologiczny i badania naukowe

Wyzwania w badaniach epidemiologicznych

Badania epidemiologiczne dotyczące zaburzeń ruchowych napotykają na liczne wyzwania metodologiczne i praktyczne:¹²

Trudności w ustaleniu jednolitych kryteriów diagnostycznych dla różnych zaburzeń ruchowych
Zróżnicowanie obrazu klinicznego i nakładanie się objawów różnych zaburzeń
Ograniczona liczba dużych, populacyjnych badań epidemiologicznych
Trudności w przeprowadzaniu długoterminowych badań follow-up
Brak systematycznych badań epidemiologicznych w wielu regionach świata, zwłaszcza w krajach o niskim i średnim dochodzie

¹²

Z częstością występowania 1%, większość zaburzeń ruchowych, w tym choroba Parkinsona, jest stosunkowo rzadka. Utrudnia to pozyskiwanie zbiorów danych o odpowiedniej wielkości. W konsekwencji, poszczególne badania epidemiologiczne często mają zbyt małą moc statystyczną, aby odpowiedzieć na interesujące pytania badawcze.¹

Inicjatywy badawcze i rejestry

W celu poprawy nadzoru epidemiologicznego i badań nad zaburzeniami ruchowymi powstały różne inicjatywy i rejestry:¹²

Movement Disorders Society utworzyło Grupę Badawczą ds. Epidemiologii, której celem jest podtrzymywanie międzynarodowej sieci ekspertów epidemiologów w celu prowadzenia i łączenia badań nad czynnikami modyfikującymi chorobę
Grupa Badawcza ds. Zaburzeń Ruchowych Związanych z Infekcjami (IRMD) ma na celu ułatwienie i promowanie edukacji, lepsze zrozumienie i badania zaburzeń ruchowych związanych z infekcjami oraz stworzenie międzynarodowego rejestru IRMD
Narodowy System Nadzoru Chorób Neurologicznych (NNCSS) to zintegrowany system wykorzystujący najnowocześniejsze źródła danych, narzędzia i metody analityczne do śledzenia epidemiologii chorób neurologicznych
Rejestr Zaburzeń Ruchowych gromadzi dane osób zainteresowanych udziałem w przyszłych badaniach naukowych, obejmujący pacjentów z chorobą Parkinsona, drżeniem, dystonią/kręczem szyi, chorobą Huntingtona, zespołem Tourette’a, zaburzeniami tikowymi, zespołem niespokojnych nóg, późnymi dyskinezami i innymi chorobami

¹²

Te inicjatywy mają kluczowe znaczenie dla szerokiego zakresu zastosowań badawczych i klinicznych. Na przykład, dążą one do określenia wskaźników zapadalności i częstości występowania w określonych populacjach, identyfikacji genetycznych i środowiskowych czynników ryzyka oraz zdefiniowania naturalnej historii choroby.¹

Nowoczesne technologie w monitorowaniu epidemiologicznym

Postęp technologiczny, w tym rozwój cyfrowych narzędzi zdrowotnych, stwarza nowe możliwości w monitorowaniu i badaniu zaburzeń ruchowych:¹²

Technologie ubieralne (np. akcelerometry, żyroskopy i magnetometry) umożliwiają obiektywne monitorowanie objawów ruchowych w warunkach codziennego życia
Aplikacje mobilne pozwalają na gromadzenie danych zgłaszanych przez pacjentów (PRO – Patient-Reported Outcomes) oraz obiektywnych pomiarów stanu pacjenta
Platformy zdalnego monitorowania umożliwiają ciągłą ocenę stanu pacjenta i efektywności leczenia
Algorytmy analizy danych i sztuczna inteligencja pomagają w interpretacji złożonych danych i identyfikacji biomarkerów

¹²

Ciągłe dane z rzeczywistych warunków są niezbędne do optymalizacji terapii neuromodulacyjnej; postęp technologiczny w neuromodulacji zależał do tej pory od ulepszeń opartych na sprzęcie, takich jak miniaturyzacja urządzeń implantowalnych i poprawiona geometria elektrod. Obecnie, postępy w czujnikach ubieralnych, rozwoju algorytmów i platformie Internetu Rzeczy (IoT) umożliwiły opracowanie systemów zdalnego monitorowania zaburzeń ruchowych.¹

Wpływ na zdrowie publiczne i opiekę zdrowotną

Obciążenie systemów opieki zdrowotnej

Zaburzenia ruchowe stanowią znaczące obciążenie dla systemów opieki zdrowotnej na całym świecie ze względu na ich przewlekły charakter, złożoność diagnostyki i leczenia oraz wpływ na jakość życia pacjentów.¹ W przypadku choroby Parkinsona, prognozowany wzrost liczby przypadków w najbliższych latach będzie stanowił dodatkowe wyzwanie dla systemów opieki zdrowotnej.¹

Światowa Organizacja Zdrowia prognozuje znaczący wzrost liczby przypadków choroby Parkinsona i innych zaburzeń związanych ze starzeniem się w Indiach i innych krajach rozwijających się w najbliższych dekadach.¹ Podobne trendy obserwuje się w innych regionach świata, co podkreśla potrzebę rozwoju odpowiednich strategii diagnostycznych, terapeutycznych i opieki długoterminowej.¹

Niedodiagnozowanie i opóźniona diagnoza

Mimo stosunkowo wysokiej częstości występowania, wiele zaburzeń ruchowych jest niedodiagnozowanych lub diagnoza jest opóźniona. W przypadku czynnościowych zaburzeń ruchowych (FMD), które są powszechne w środowiskach klinicznych, diagnoza jest często opóźniona lub przeoczona, a rokowanie dla całkowitej remisji jest ogólnie złe.¹

W badaniu REST, 65% respondentów z klinicznie istotnym zespołem niespokojnych nóg (RLS) zgłosiło szukanie pomocy medycznej z powodu swoich objawów w ciągu poprzednich 12 miesięcy. Z tej grupy tylko 25% otrzymało diagnozę RLS. W nowszym irlandzkim badaniu podstawowej opieki zdrowotnej tylko 32,4% pacjentów z umiarkowanym do ciężkiego RLS zgłosiło wcześniejsze szukanie pomocy medycznej z powodu objawów, a tylko czterech z 24 pacjentów (16,7%), którzy szukali pomocy medycznej, otrzymało diagnozę RLS, mimo że większość tych pacjentów zgłaszała zakłócenia snu i pogorszenie jakości życia.¹

Zaburzenie ruchowe	Szacowana częstość występowania	Rozkład płci	Główne grupy wiekowe	Trendy epidemiologiczne
Choroba Parkinsona	1% populacji, 4-5% >85 lat	M:K = 1,5:1	Głównie >60 lat, 4% przed 50 r.ż.	Wzrost zachorowalności, szczególnie w określonych regionach geograficznych
Drżenie samoistne	Do 10% populacji >60 lat	Równomierny rozkład	Wzrost z wiekiem	Najczęstszy hiperkinetyczny zaburzenie ruchowe
Dystonia	16,4 na 100 000 (ogniskowa)	Zależny od typu	Wzrost z wiekiem	Najczęstsza postać to dystonia szyjna
Czynnościowe zaburzenia ruchowe	2-10% wizyt w klinikach zaburzeń ruchowych	K:M = 2-3:1	Średnia wieku 40-53 lat	Wzrost częstości podczas pandemii COVID-19
Zespół niespokojnych nóg	1-20% populacji ogólnej	K:M = 1-3:1	Wzrost z wiekiem	2-3% populacji z objawami wymagającymi leczenia
Okresowe ruchy kończyn we śnie	4-11% dorosłych, 29-85% >60 lat	Brak wyraźnej przewagi	Wzrost z wiekiem	Często współwystępuje z RLS
Choroba Huntingtona	5-10 na 100 000 w USA, 0,4-5,7 na 100 000 na świecie	Równomierny rozkład	Zazwyczaj 30-50 lat	Najczęstsza przyczyna pląsawicy
Mózgowe porażenie dziecięce	2,1 na 1000 żywych urodzeń	Równomierny rozkład	Rozpoznanie w dzieciństwie	Najczęstsze zaburzenie ruchowe u dzieci

Wpływ na jakość życia i koszty socjoekonomiczne

Zaburzenia ruchowe mają znaczący wpływ na jakość życia pacjentów i wiążą się z istotnymi kosztami socjoekonomicznymi. W badaniu przeprowadzonym w 2021 roku, mającym na celu lepsze zrozumienie, ile lat życia osoby są skłonne poświęcić, aby żyć w pełnym zdrowiu zamiast żyć z chorobą Huntingtona lub późnymi dyskinezami, respondenci byli skłonni zrezygnować ze średnio 4,1 lat z 10-letniego okresu życia, aby uniknąć życia z późnymi dyskinezami. Gdy przedstawiono scenariusz życia z ciężką pląsawicą w chorobie Huntingtona, respondenci byli skłonni zrezygnować ze średnio 9,3 lat z 10-letniego okresu życia.¹

Niedostateczne rozpoznanie, błędna diagnoza i niedostateczne leczenie zaburzeń ruchowych, w tym pląsawicy w chorobie Huntingtona i późnych dyskinez, mają głęboki wpływ na życie pacjentów. Te mniej znane zaburzenia ruchowe są niedostatecznie rozpoznawane i często błędnie diagnozowane, mimo że łącznie dotykają około 600 000 osób w USA. Mimo dostępności leków zatwierdzonych przez FDA do leczenia objawów pląsawicy w chorobie Huntingtona i późnych dyskinez, niepowodzenie w dokładnym zdiagnozowaniu tych schorzeń opóźnia otrzymanie przez pacjentów odpowiedniego leczenia.¹

Strategie poprawy diagnostyki i leczenia

W celu poprawy diagnostyki i leczenia zaburzeń ruchowych wdrażane są różne strategie:¹²

Zwiększenie świadomości pacjentów i lekarzy na temat objawów i dostępnych opcji leczenia
Opracowanie i wdrażanie ujednoliconych kryteriów diagnostycznych
Tworzenie i rozwijanie specjalistycznych ośrodków zajmujących się zaburzeniami ruchowymi
Wdrażanie nowoczesnych technologii diagnostycznych i terapeutycznych, takich jak głęboka stymulacja mózgu (DBS) czy telemedycyna
Rozwój i dostęp do zintegrowanej, multidyscyplinarnej opieki uwzględniającej nie tylko aspekty neurologiczne, ale również psychologiczne, rehabilitacyjne i socjalne

¹²

W przypadku choroby Parkinsona i innych zaburzeń ruchowych, rozwój tzw. Centrów Doskonałości, takich jak ośrodki uznane przez Fundację Parkinsona, pozwala na zapewnienie wysokiej jakości opieki specjalistycznej, zwłaszcza w przypadkach skomplikowanych, a także prowadzenie badań klinicznych w celu oceny nowych leków i wprowadzania ich na rynek.¹

Postęp w zrozumieniu mechanizmów układu bazalnego i ewolucja technik neurochirurgicznych znacząco przyczyniły się do rozwoju podejść terapeutycznych stosowanych zarówno w wyspecjalizowanych ośrodkach, jak i w placówkach opieki na całym świecie.¹

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 SciELO Brasil – Descriptive epidemiological study on patients with movement disorders, with emphasis on Parkinsonâs disease Descriptive epidemiological study on patients with movement disorders, with emphasis on Parkinsonâs disease
https://www.scielo.br/j/spmj/a/hLM3qdBRx5rDHPvRWXvHcRm/?lang=en
BACKGROUND: Knowing the epidemiological profile is relevant for improving healthcare practices. Movement disorders are neurological disorders characterized by the presence of involuntary movements. They have a negative impact on patients quality of life. […] Epidemiological studies are widely reported in the literature, and are extremely valuable for improving healthcare practices. Epidemiological information is an instrument for healthcare planning that informs guidelines and improvements. […] Some studies on neurological diseases have revealed that one of the most recurrent diagnoses consists of movement disorders. These are neurological disorders resulting from lesions in the basal nuclei, which result in involuntary movements. […] Parkinsons disease is considered to be the second most common degenerative disorder after Alzheimers disease. The prevalence of Parkinsons disease in the general population has been estimated to be 0.3%, such that it affects approximately 1% of individuals over 60 years of age and 4% to 5% of those over 85 years of age.
#1 Functional movement disorder gender, age and phenotype study: a systematic review and individual patient meta-analysis of 4905 cases | Journal of Neurology, Neurosurgery & Psychiatry
https://jnnp.bmj.com/content/93/6/609
Functional movement disorder (FMD) is a common manifestation of functional neurological disorder presenting with diverse phenotypes such as tremor, weakness and gait disorder. Our current understanding of the basic epidemiological features of this condition is unclear. […] Despite its prevalence, the basic epidemiology of FMD is unclear. […] We hypothesised that women would have an earlier age at onset than men, perhaps related to higher frequency of childhood adversity and there would be gender differences among FMD phenotypes, which may be partly explained by differing age at onset. […] This international study involving 70 authors and 4905 patients is the largest data set of any functional neurological disorder to date. FMD peaks in midlife for all phenotypes, but dystonia and weakness patients were younger, and those with gait disorder older.
#1 Statistics | Parkinson’s Foundation
https://www.parkinson.org/understanding-parkinsons/statistics
An estimated 1.1 million people in the U.S. are living with Parkinson’s disease (PD). This number is expected to rise to 1.2 million by 2030. Parkinson’s is the second-most common neurodegenerative disease after Alzheimer’s disease. […] Nearly an estimated 90,000 people in the U.S. are diagnosed with PD each year. […] More than 10 million people worldwide are estimated to be living with PD. […] The incidence of Parkinsons disease increases with age, but an estimated 4% of people with PD are diagnosed before age 50. […] Men are 1.5 times more likely to have Parkinson’s disease than women. […] A 2022 Parkinsons Foundation-backed study revealed that nearly 90,000 people are diagnosed with Parkinsons disease in the U.S. each year. This represents a steep 50% increase from the previously estimated rate of 60,000 diagnoses annually.
#1 Hyperkinetic Movement Disorders | PM&R KnowledgeNow
https://now.aapmr.org/hyperkinetic-movement-disorders-including-dystonias-choreas/
Tremor, especially essential tremor (ET), is the most frequent type of HMD seen in clinical practice. The prevalence increases with age, with estimates that up to 10% of individuals over the age of 60 experience ET […] Huntingtons Disease is the most frequent cause of chorea with an estimated worldwide prevalence of 10/100,000 people. Dystonia is rare in childhood and becomes more prevalent with increasing age. Isolated focal dystonia has been estimated as occurring in 16.4 per 100,000 individuals, whereas generalized dystonia is less common. The most common type of focal dystonia is cervical dystonia. […] Psychiatric illnesses and associated neuroleptic medications have been associated with HMD. Therefore, close monitoring of patients on psychiatric medications is warranted for early detection and prevention.
#1 Chorea in Adults: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/1149854-overview
Epidemiology […] Although no data are available regarding the incidence of chorea, the incidences of several disorders in which chorea is the main clinical feature are well known. […] Huntington disease (HD) is an autosomal dominant, neurodegenerative disorder in which the defective gene is located on the short arm of chromosome 4. The estimated prevalence of HD in the United States is 510 cases per 100,000 people, while the worldwide prevalence is between 0.4 and 5.7 per 100,000. […] Wilson disease is an autosomal recessive, multisystem disease caused by a mutation in the ATP7B gene, which resides on the long arm (q) of chromosome 13 (13q14.3). This gene codes for an ATPase, which is involved with the transport of copper. Although the gene prevalence (heterozygous carriers who inherited only 1 abnormal gene) has been estimated to be as high as 1%, the disease prevalence is only 30 cases per 1 million people. […] Benign hereditary chorea, a fairly rare disorder in which most of the pedigrees have clearly demonstrated dominant inheritance, has a prevalence of approximately 1 case per 500,000 people. […]
#1 Statistics | Parkinson’s Foundation
https://www.parkinson.org/understanding-parkinsons/statistics
The primary risk factor for PD is age. […] PD incidence estimates are higher in men compared to women at all ages. […] The increase in the incidence of PD aligns with the growth of an aging population. […] PD incidence rates are higher in certain geographic regions: the Rust Belt (parts of the northwestern and midwestern U.S. previously regulated by industrial manufacturing), Southern California, Southeastern Texas, Central Pennsylvania and Florida. […] According to the Parkinsons Foundation Parkinsons Prevalence Project study published in 2018, 1.2 million people in the U.S. will be living with Parkinsons by 2030. […] The study confirms that men are more likely to have PD than women and that the number of those diagnosed with PD increases with age, regardless of sex. […] The study found that the prevalence of people diagnosed with PD varies by region.
#1 Journal of Movement Disorders
https://www.e-jmd.org/articles/search_result.php?term_type=keywords&term=epidemiology
A low prevalence of Parkinsons disease (PD) has been reported in the Sub-Saharan Africa (SSA) region. […] Very few reports have examined the availability and access to evidence-based quality care for people living with PD in this region. […] Large-scale genetic and epidemiological studies are therefore needed in SSA to provide further insights into the roles of genetics and other etiological factors in the pathogenesis of PD. […] The epidemiological features of dystonia in East China we collected were similar to the report in Japan which contrasts partly with that reported in Europe.
#1 Infection Related Movement Disorder Study Group
https://www.movementdisorders.org/Study-Groups/Infection-Related-Movement-Disorder-Study-Group.htm
Several infections including prion diseases, viral (retrovirus, arbovirus, measles, etc.), bacterial (streptococcal, mycobacterium tuberculosis, treponema pallidum, etc.) and parasitic (cysticercosis, toxoplasma) have been implicated to produce a variety of movement disorders with different phenomenology and temporal profile, and the prevalence of these have wide geographic variations. […] Some neurodegenerative disorders, including Parkinsons disease are thought to have causal relation with past infection as well as alteration of gut microbiota. […] Finally, the recent Corona virus pandemic has led to concern of delayed neurological sequelae including movement disorders.
#1 Clinical epidemiology of movement disorders in Douala General Hospital, Cameroon: A two years retrospective study – MDS Abstracts
https://www.mdsabstracts.org/abstract/clinical-epidemiology-of-movement-disorders-in-douala-general-hospital-cameroon-a-two-years-retrospective-study/
Clinical epidemiology of movement disorders in Douala General Hospital, Cameroon: A two years retrospective study […] Objective: The aim of this study was to determine the frequency of movement disorders and their characteristics in the outpatient department of neurology at the Douala general hospital in Cameroon. […] Background: Movement disorders are of increasing interest in the world of neuroscience. However, in Cameroon very few studies are devoted to this group of neurological conditions of varying severity and very often difficult to diagnose and manage. […] Results: Of the 1,126 medical records reviewed, 35 (prevalence = 3.1%) had a formal diagnosis of movement disorders. The mean age was 49.6 20 years and 57.1% of the patients were female. The most common comorbidities were alcohol consumption and high blood pressure. 11.4% of patients had a family history of movement disorders. Parkinsonism (22.9%), dystonia (20%), and cerebellar (17.1%) and essential (14.3%) tremors were the dominant clinical forms. Aetiologies were mainly Parkinsons disease (25.7%) and stroke (8.6%). Huntingtons disease accounted for 5.7% of cases. In 37.1% of cases, the aetiology remained unknown.
#1 PREVALENCE OF MOVEMENT DISORDERS AT A TERTIARY HEALTH CARE CENTRE IN ABUJA, NIGERIA – MDS Abstracts
https://www.mdsabstracts.org/abstract/prevalence-of-movement-disorders-at-a-tertiary-health-care-centre-in-abuja-nigeria/
PREVALENCE OF MOVEMENT DISORDERS AT A TERTIARY HEALTH CARE CENTRE IN ABUJA, NIGERIA […] Objective: This study aims to describe the prevalence and sociodemographic characteristics of movement disorders seen at our Specialised Movement Disorder (MD) clinic at Abuja, Nigeria. […] Background: There are few studies on the spectrum of movement disorders and demographics in sub-Saharan Africa. International and local studies have been done on Parkinsons disease and few others but there is little local data on the demographics of other movement disorders like dystonia, essential tremor and functional movement disorders. This study will help to better characterize disease patterns and generate local data for Nigeria and sub-Saharan Africa. […] Results: A total of 90 patients were included in the study. Mean age was 53.3 (14.28) and 71.1% were males. The most common MD was parkinsonism(62.2%) followed by dystonia (16.7%) and essential tremor (7.8%). PD accounted for 91% of parkinsonism presentations.
#1 Functional Movement Disorders: Updates and Clinical Overview
https://www.e-jmd.org/journal/view.php?doi=10.14802/jmd.24126
Functional movement disorder (FMD) is a type of functional neurological disorder that is common but often difficult to diagnose or manage. […] Studies have reported that FMD accounts for approximately 3% to 8% of movement disorder clinic visits. […] A recent cross-sectional study found an increased incidence of FMD in both children and adults during the relatively recent COVID-19 pandemic, highlighting the role of psychological and environmental stressors in the development of this disorder. […] The mean age at onset of FMD has been reported to range from 46 years to 53 years, with a female preponderance. […] A retrospective analysis of 199 patients seen from movement disorders centers at academic referral sites revealed that the prevalence of FMD was 2 to 3 times higher in women than in men.
#1 Functional Movement Disorders: Updates and Clinical Overview
https://www.e-jmd.org/journal/view.php?doi=10.14802/jmd.24126
A recent meta-analysis of 4,905 patients revealed that FMD peaks in midlife for all phenotypes, but those with functional dystonia and weakness are younger, whereas those with gait disorders are older. […] Several risk factors for FMD have been reported, including childhood trauma or psychiatric symptoms/illnesses such as anxiety, depression, and somatization. […] While most of the literature on FMD pertains to the adult population, there are some data on FMD in the pediatric population. […] The prevalence of childhood FMD has been reported to be lower than that of adult FMD, ranging from 2.8% to 23.1%, with a female preponderance in most studies. […] Neuroimaging research on FND has grown in the past 20 years, and studies have included or exclusively looked at patients with FMD. […] Recent fMRI studies have shown that there is decreased functional connectivity between the right temporoparietal junction (TPJ) and bilateral sensorimotor regions and impaired hemodynamic responsiveness of the dorsolateral prefrontal cortex and presupplementary cortex to changes in the loss of movement control in patients with FMD. […] Studies conducted on FMD thus far support the relationship between emotional processing and this disorder on the basis of altered activation of brain regions relevant to emotional processing and increased functional connectivity between these areas and movement-related brain regions.
#1 Descriptive epidemiological study on patients with movement disorders, with emphasis on Parkinsonâs disease
https://pmc.ncbi.nlm.nih.gov/articles/PMC9632504/
The Parkinsons disease analysis showed that 66.7% of the patients above 61 years of age were diagnosed with the mixed form, and 71.4% of the patients below 61 years were diagnosed with the AR form. […] The results from this analysis were compared with studies in the literature. This demonstrated that similar methodologies had been used to study Parkinsons disease in different parts of the world. The frequencies of occurrence described in previously published reports suggested that Parkinsons disease was the most common cause of movement disorders in the entire population studied, which was consistent with the results from our analysis. […] The most frequent diagnoses were Parkinsons disease (40.7%), essential tremor (15.4%) and dystonia (13.1%). […] The presence of dystonia has also been reported in the literature, at rates ranging from 2-50 cases per million (early onset dystonia) to 30-7,320 cases per million (late onset dystonia).
#1 Thieme E-Journals – Seminars in Neurology / Abstract
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1764140
In this manuscript, we review the epidemiology of movement disorders including Parkinson’s disease (PD), atypical parkinsonism, essential tremor, dystonia, functional movement disorders, tic disorders, chorea, and ataxias. […] We emphasize age-, sex-, and geography-based incidence and prevalence, as well as notable trends including the rising incidence and prevalence of PD. […] Given the growing global interest in refining clinical diagnostic skills in recognizing movement disorders, we highlight some key epidemiological findings that may be of interest to clinicians and health systems tasked with diagnosing and managing the health of patients with movement disorders.
#1 Functional movement disorders – UpToDate
https://www.uptodate.com/contents/functional-movement-disorders
Functional movement disorder (FMD) is a subtype of functional neurological symptom disorder (conversion disorder) in which the primary manifestation is tremor, dystonia, gait disorder, or other abnormal movement. Patients with FMD have neurologic symptoms that are incongruent with known neurologic disease but are nevertheless genuine and cause distress and/or psychosocial impairment. […] FMD is common in clinical settings, but the diagnosis is often delayed or missed, and prognosis for complete remission is generally poor. Over time, more emphasis has been placed on physical examination signs to guide diagnosis and use of evidence-based treatments, including physiotherapy and multidisciplinary rehabilitation. […] This topic reviews the epidemiology, etiology and pathogenesis, clinical features, diagnosis, treatment, and prognosis of FMD.
#1 Functional movement disorders – UpToDate
https://www.uptodate.com/contents/functional-movement-disorders
Phenotype frequency â Functional tremor is the most frequent FMD phenotype, followed by functional dystonia. Approximately one-quarter of patients have a mixed phenotype. A meta-analysis that included nearly 5000 cases of FMD reported the following phenotype frequencies: mixed FMD (23 percent), tremor (22 percent), weakness (18 percent), dystonia (12 percent), gait disorder (8 percent), myoclonus/jerks (5 percent), and parkinsonism (2 percent). […] FMD accounts for 2 to 10 percent of all movement disorders. Functional tremor is the most frequent phenotype of FMD, followed by functional dystonia. Mixed FMD with more than one phenotype is common.
#1 Impact of COVID-19 on the epidemiology of functional movement disorders – VJNeurology
https://www.vjneurology.com/video/xm1m4onyegi-impact-of-covid-19-on-the-epidemiology-of-functional-movement-disorders/
Alberto Espay discusses the current epidemiological understanding of functional movement disorders. While functional movement disorders are common, they are likely underrecognized. The frequency among patients evaluated in movement disorder clinics is around 5% but is suspected of having increased in the setting of the post-COVID-19 pandemic. The reasons behind the increase in functional movement disorders prevalence worldwide are unknown but could be a result of COVID-19 infection or vaccination. A number of reports indicate that functional symptoms may follow COVID-19 vaccination. Still, it is important to note that vaccination did not cause functional movement disorders but could trigger the development of symptoms. Given the presence of significant vaccine hesitancy, a clear understanding of the relationship between functional movement disorders and COVID-19 vaccines is critical to the success of the global vaccination effort.
#1 Frontiers | Sleep related movement disorders in the elderly: a review of recent literature
https://www.frontiersin.org/journals/sleep/articles/10.3389/frsle.2024.1356644/full
Sleep-related movement disorders (SRMD) are common, often troublesome, conditions in the elderly. Although these disorders can impact people of all ages, there are different considerations when diagnosing and managing SRMD in the elderly. […] Sleep-related movement disorders (SRMD) are one category of sleep disorders that can occur in the geriatric population which we will focus on in this review. The International Classification of Sleep Disorders (ICSD) defines SMRD as being ârelatively simple, usually stereotyped movements that disturb sleep and its onsetâ (American Academy of Sleep Medicine, 2014). […] The prevalence of RLS in the general population ranges from 1 to 20%, with a higher prevalence in women. […] Several studies suggest that brain iron deficiency, characterized by low ferritin and high transferrin levels in the cerebrospinal fluid, is implicated in the pathogenesis of RLS.
#1 Epidemiology and Pathophysiology of Restless Legs Syndrome – touchNEUROLOGY
https://touchneurology.com/movement-disorders/journal-articles/epidemiology-and-pathophysiology-of-restless-legs-syndrome-2/
Ekbom estimated the prevalence of RLS to be 5% in the general population. Subsequent survey studies have estimated the population prevalence of the disorder to be 12-9%. The RLS Epidemiology, Symptoms, and Treatment (REST) trial is the largest survey study to date of RLS prevalence. Questionnaires were completed by 23,052 patients presenting to primary care practices in the US and four Western European countries during a two-week period. Any degree of RLS symptoms was experienced by 11.9% of respondents, 9.6% had at least weekly symptoms, and 551 (2.4% of total respondents, 3.4% of respondents with complete data) had at least twice-weekly symptoms and endorsed a negative impact on QOL. Recently, similar figures have been reported in the Irish and Spanish primary care populations. […] In summary, symptoms of RLS are quite common, and the population prevalence of RLS severe enough to cause impairment in QOL and warrant medical treatment is probably about 2-3%. This makes clinically significant RLS two to six times as prevalent as epilepsy in developed countries (estimated prevalence of 0.51%).
#1 Frontiers | Sleep related movement disorders in the elderly: a review of recent literature
https://www.frontiersin.org/journals/sleep/articles/10.3389/frsle.2024.1356644/full
Another consideration for elderly patients with RLS is the potential association with cognitive decline. […] Conversely, the influence of cognitive decline on the diagnosis and management of RLS should also be addressed. […] Periodic limb movements of sleep (PLMS) are characterized as stereotyped movements that occur at regular intervals, typically involving the lower extremities of the leg and often presenting with extension of the great toe, the dorsiflexion of the ankle and occasionally flexion at the knee and hip as well. […] The prevalence of PLMS in people over the age of 60 has been noted to range between 29 and 85%. […] Effective treatment of PLMS associated with RLS parallels the treatment of RLS itself, with lifestyle modifications and pharmacological interventions with alpha-2delta ligands and dopaminergics being the mainstay of treatment.
#1 Periodic Limb Movement Disorder: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/1188558-overview
The prevalence of periodic leg movements in sleep (PLMS) is estimated to be 411% in adults. PLMS are most frequently a symptom of restless legs syndrome (RLS). They also often occur in narcolepsy, sleep apnea syndrome, and rapid eye movement (REM) sleep behavior disorder (RBD). Some patients with otherwise unexplained insomnia or excessive daytime sleepiness exhibit an elevated number of PLMS, a condition defined as periodic limb movement disorder (PLMD). […] The idiopathic form of periodic limb movement disorder (PLMD) may be chronic. Relapses and remissions may occur, but treatment does not appear to modify the disease. […] The secondary form of this syndrome may cease with treatment of the underlying cause.
#1 Cerebral palsy – Wikipedia
https://en.wikipedia.org/wiki/Cerebral_palsy
Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. […] Cerebral palsy is the most common movement disorder in children, occurring in about 2.1 per 1,000 live births. […] There was a „moderate, but significant” rise in the prevalence of CP between the 1970s and 1990s. […] As of 2005, advances in the care of pregnant mothers and their babies did not result in a noticeable decrease in CP. […] The incidence of CP increases with premature or very low-weight babies regardless of the quality of care. […] As of 2016, there is a suggestion that both incidence and severity are slightly decreasing; more research is needed to find out if this is significant, and if so, which interventions are effective. […] It has been found that high-income countries have lower rates of children born with cerebral palsy than low or middle-income countries. […] Prevalence of cerebral palsy is best calculated around the school entry age of about six years; the prevalence in the U.S. is estimated to be 2.4 out of 1000 children.
#1 Antidepressants and movement disorders: a postmarketing study in the world pharmacovigilance database | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02711-z
A potential harmful association was found between movement disorders and use of the antidepressants mirtazapine, vortioxetine, amoxapine, phenelzine, tryptophan, fluvoxamine, citalopram, paroxetine, duloxetine, bupropion, clomipramine, escitalopram, fluoxetine, mianserin, sertraline, venlafaxine and vilazodone. […] The aim of this study was to identify antidepressants classes and antidepressants suspected of inducing different subtypes of movement disorders as adverse drug reactions using a case/non-case approach in a worldwide pharmacovigilance database. […] The quantitative association of drug-related adverse drug reaction was detected by estimating a measure of disproportionality, expressed as the reporting odds ratio (ROR). […] The most frequently notified movement disorder after antidepressant exposure was tremor and the least frequently notified was tics. When comparing antidepressants taken as a whole with all other drugs in VigiBase, we found a significant increased ROR for all subtypes of movement disorders, with the highest association with bruxism and the lowest with tics.
#1 General Overview of Psychogenic Movement Disorders: Epidemiology, Diagnosis, and Prognosis | Neupsy Key
https://neupsykey.com/general-overview-of-psychogenic-movement-disorders-epidemiology-diagnosis-and-prognosis/
General Overview of Psychogenic Movement Disorders: Epidemiology, Diagnosis, and Prognosis Anthony E. Lang ABSTRACT Epidemiologic studies of medically unexplained symptoms are fraught with problems. Despite numerous confounding issues, it is clear that conversion disorders are probably as common as other disabling conditions such as multiple sclerosis and schizophrenia. […] Epidemiologic studies of psychogenic movement disorders are lacking. All available reports originate from tertiary academic movement disorder clinics, and therefore it is impossible to say how common these disorders are in the community at large or even how common they are with respect to neurological conversion disorders in general. […] Despite these confounding issues, it is clear that somatoform disorders or medically unexplained symptoms are probably as common as other disabling conditions such as multiple sclerosis and schizophrenia.
#1 Epidemiology Study Group
https://www.movementdisorders.org/MDS/About/Committees–Other-Groups/Study-Groups/Epidemiology-Study-Group.htm
The MDS Epidemiology Study group sustains an international network of expert epidemiologists with the aim to conduct and combine studies on disease-modifying factors. The goal is to strengthen the validity of epidemiological studies and derive new biomarkers for movement disorders. […] With a prevalence of 1%, most movement disorders including Parkinsons disease are comparatively rare. This makes the acquisition of sufficiently sized datasets difficult. As a consequence, individual epidemiologic studies are often underpowered to address the research questions of interest. However, these types of studies are crucial for a broad range of research and clinical care applications. For instance, they aim to derive population-specific incidence rates and prevalences, identify genetic and environmental risk factors, and define the natural history of disease. The MDS Epidemiology Study group was founded to alleviate the current lack of effort invested on conducting and combining appropriately powered epidemiological research. This will be achieved by utilizing the resources available to the international MDS Epidemiology Study Group.
#1
https://pittplusme.org/studyarms/publicdetails?guid=ecd24fbc-bf43-4e44-84e1-185e686d58ad
Do you have a movement disorder? If so, you may be able to participate in the Movement Disorders Registry. This registry is a list of individuals who are interested in being contacted about future research studies. […] This research registry is dedicated to studying movement disorders. Eligible participants include those with Parkinsons disease, tremors, dystonia/torticollis, Huntingtons disease, Tourettes syndrome, tic disorders, restless legs syndrome, tardive dyskinesia, Lewy body dementia, corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), multisystem atrophy (MSA), normal pressure hydrocephalus (NPH), ataxia, myoclonus, and other mobility problems. […] Dr. Chahines research interests include epidemiology and clinical/biomarker characterization of Parkinsons disease.
#1 Development of a remote therapeutic monitoring platform: applications for movement disorders | Scientific Reports
https://www.nature.com/articles/s41598-024-80567-z
Digital health tools are emerging as a promising solution for optimizing Deep Brain Stimulation (DBS) therapy for neurodegenerative diseases such as Parkinsons Disease (PD), addressing challenges of therapy maintenance, care access, and discrete assessments. […] Digital health is a rapidly evolving field that is transforming healthcare delivery. Access to ongoing care from DBS specialists can be cumbersome as it may require patients to take time off from work, commute long distances, arrange for travel, or work around a caregivers schedule. […] Integration of digital health solutions with neuromodulation care has the potential to significantly improve patient outcomes and experience. Tools, such as wearable technology and mobile health platforms, may offer personalized and efficient solutions for accessing patient care, improving clinical assessments, and enhancing neuromodulation therapy while limiting patient travel, time, and cost.
#1 Development of a remote therapeutic monitoring platform: applications for movement disorders | Scientific Reports
https://www.nature.com/articles/s41598-024-80567-z
Continuous, real-world data are essential for optimizing neuromodulation therapy; technological progress in neuromodulation has thus far depended on hardware-based improvements such as implantable device miniaturization and improved geometry of electrodes. […] Advancements in wearable sensors, algorithm development and the Internet of Things (IoT) platform have enabled development of remote monitoring systems for movement disorders. […] We built the RM app to combine passive monitoring through consumer-grade wearables and disease-specific patient reported outcomes (PROs) to leverage ubiquitous platforms such as Apple Watch, Fitbit, and Oura ring. […] The frequency of PROs can provide important insights into the effectiveness of therapy for movement disorders. […] A systematic review focused on PD highlighted the importance of selecting appropriate PROs for different measures and the need for consistent and frequent monitoring of patients to ensure optimal outcomes.
#1 World Movement Disorders Day | Parkinsons Disease and Movement Disorders Clinic
https://www.movementdisordersclinic.com/world-movement-disorders-day/
Movement Disorders are a group of brain disorders, which leads to either abnormally excess or slowness of body movements and not related to any other body system involvement. […] The Field of Movement disorders has been growing in India since the 2000s and India has now its own movement disorders specialists society called as Movement Disorders Society of India, started in 2014. […] The number of movement disorders cases are on steady increase in India and the World Health Organization, has predicted a tremendous increase in Parkinsons disease and other ageing disorders across India over the next decades. […] There is clear lack of systematic epidemiological studies to understand the prevalence of various movement disorders in India. […] In these specialized private movement disorders clinics, it has been noted that Parkinsonism disorders contributed to almost 2/3rd of the various diseases seen, which is followed by dystonic disorders (15%), and tremors (8%).
#1 Epidemiology and Pathophysiology of Restless Legs Syndrome – touchNEUROLOGY
https://touchneurology.com/movement-disorders/journal-articles/epidemiology-and-pathophysiology-of-restless-legs-syndrome-2/
RLS is encountered with greater than expected frequency in several general medical conditions, and the RLS occurring in these conditions is often referred to as secondary RLS. The most well-established secondary causes of RLS are renal failure, iron deficiency, and pregnancy. RLS is common, with 20% prevalence, in the hemodialysis population, tends to be more severe than primary RLS, and is a predictor of mortality in this population. Iron deficiency has long been thought to be associated with RLS. […] In the REST population, 65% of respondents with clinically significant RLS (at least twice-weekly symptoms) reported seeking medical attention for their symptoms within the preceding 12 months. Of this 65%, only 25% received a diagnosis of RLS. In the more recent Irish primary care study, only 32.4% of patients with moderate to severe RLS reported previously seeking medical attention for the symptoms, and only four of 24 patients (16.7%) who sought medical attention had received a diagnosis of RLS despite the majority of these patients reporting disruption of sleep and impairment in QOL. Clearly, improved patient and physician awareness of RLS would increase the rates of diagnosis.
#1 Interactive tools to assess movement disorders | CnsBytes
https://www.cnsbytes.us/tardive-dyskinesia/interactive-tools-to-uncover-more-about-the-impact-and-epidemiology-of-movement-disorders/
To gain a better understanding of how many years of life individuals are willing to sacrifice to live in full health rather than living with HD or TD, two further surveys were conducted in 2021. The aim of the surveys was to understand peoples perceptions of living with HD or TD, and to bring attention to the reality of living with these conditions. After being shown a scenario depicting life with this condition, respondents were willing to give up an average of 4.1 years of a 10 year lifespan to avoid living with TD. When shown a scenario of life with severe HD chorea, respondents were willing to give up an average of 9.3 years out of a 10 year lifespan.
#1 Interactive tools to assess movement disorders | CnsBytes
https://www.cnsbytes.us/tardive-dyskinesia/interactive-tools-to-uncover-more-about-the-impact-and-epidemiology-of-movement-disorders/
Under-recognition, misdiagnosis, and undertreatment of movement disorders including Huntingtons disease chorea and tardive dyskinesia have a profound effect on patients lives. The lesser-known movement disorders Huntingtons disease (HD) and tardive dyskinesia (TD) are under-recognized and frequently misdiagnosed, despite collectively affecting around 600,000 people in the USA. While FDA-approved medications are available to treat symptoms of HD chorea and TD, failure to accurately diagnose these conditions delays patients from receiving appropriate treatment. […] Even after diagnosis, HD is often undertreated. A 2016 survey, conducted by the Huntingtons Disease Society of America, reported that 40% of respondents were unaware of, or not utilizing, any medication to treat their chorea. Similarly, only 53% of 200 neurologists in the USA reported treating patients with severe chorea (2018 online survey). This undertreatment may be due to a lack of awareness of the burden surrounding HD chorea and TD.
#1 Comprehensive Movement Disorders Center
https://montefioreeinstein.org/neuroscience/programs/movement-disorder-division
The Montefiore Einstein Comprehensive Movement Disorders Center is at the forefront of delivering the most advanced and innovative care for patients with all types of movement disorders. […] Our multidisciplinary team of movement disorder experts is at the forefront of movement disorder care and the development of therapies through seeking a better understanding of the interrelationships between movement and neuromuscular disorders, as well as the interrelationships between movement disorders and psychological conditions. […] Montefiore Einstein has developed several effective neurosurgical treatments for movement disorders. By improving our understanding of basal ganglia circuitry and evolving neurosurgical techniques, we have contributed greatly to treatment approaches used in our center and at care facilities worldwide.
#1 Moving Day Tampa Bay raises money for Parkinson’s Disease
https://baynews9.com/fl/tampa/news/2025/05/01/moving-day-tampa-bay-raises-money-for-parkinson-s-disease
Cutting-edge Parkinson’s research is happening right here in Tampa. […] The Parkinsons Foundation designated the facility as one of about 50 Centers of Excellence around the world. […] A Center of Excellence designation allows people to know that we have the expertise in Parkinsons disease to see complicated cases, said Hauser. […] And also that we do clinical trials to evaluate new medications and bring new medications to market. […] While doctors work on improving care and expanding research, the Dunahue family finds other ways to raise awareness. […] When you bring the medical community, the research community together and those living with the disease and their caregivers, thats such a critical piece when you get to see the power come together, said Shawn, who also advocates through work with the Parkinsons Foundation.
#2 Descriptive epidemiological study on patients with movement disorders, with emphasis on Parkinsonâs disease
https://pmc.ncbi.nlm.nih.gov/articles/PMC9632504/
Knowing the epidemiological profile is relevant for improving healthcare practices. Movement disorders are neurological disorders characterized by the presence of involuntary movements. They have a negative impact on patients quality of life. […] The objective of this study was to outline the frequencies of the different diagnoses seen among patients, along with their demographic characteristics, at the movement disorders outpatient clinic of a state public hospital, in So Paulo (SP), Brazil, and to highlight the clinical aspects of those with Parkinsons disease. […] The analysis on the medical records was previously authorized and scheduled as a maximum number of 20 medical records per day. The records were analyzed individually in the medical file sector of the state public hospital, by one of the doctors responsible for this research. The study exclusively included patients who had been diagnosed with movement disorders.
#2 Thieme E-Journals – Seminars in Neurology / Abstract
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1764140
In this manuscript, we review the epidemiology of movement disorders including Parkinson’s disease (PD), atypical parkinsonism, essential tremor, dystonia, functional movement disorders, tic disorders, chorea, and ataxias. […] We emphasize age-, sex-, and geography-based incidence and prevalence, as well as notable trends including the rising incidence and prevalence of PD. […] Given the growing global interest in refining clinical diagnostic skills in recognizing movement disorders, we highlight some key epidemiological findings that may be of interest to clinicians and health systems tasked with diagnosing and managing the health of patients with movement disorders.
#2 Epidemiology of dystonia, chorea, and athetosis in Al Quseir City (Red Sea Governorate), Egypt | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text
https://ejnpn.springeropen.com/articles/10.1186/s41983-019-0109-4
Movement disorders are common neurological problems, but epidemiological studies are lacking in our locality. […] The aim of this study is to estimate the prevalence of dystonia, chorea, and athetosis in Al Quseir City, Red Sea Governorate (Egypt) as a part of a big project studying the epidemiology of many neurological disorders through door-to-door survey. […] This study examined the prevalence of three extrapyramidal diseases (dystonia, chorea, and athetosis) among the whole population (33,285 persons) in Al Qusier City, Red Sea Governorate, Egypt. […] The prevalence of dystonia in this study is 39/100,000 while the result reported by El-Tallawy and his colleagues in Al Kharga District, Egypt, was (30.36/100,000). […] In our study, seven patients of chorea were identified with total prevalence of 21/100,000. […] In this study, the prevalence of Athetosis was 15/100,000.
#2 Hyperkinetic Movement Disorders | PM&R KnowledgeNow
https://now.aapmr.org/hyperkinetic-movement-disorders-including-dystonias-choreas/
Tremor, especially essential tremor (ET), is the most frequent type of HMD seen in clinical practice. The prevalence increases with age, with estimates that up to 10% of individuals over the age of 60 experience ET […] Huntingtons Disease is the most frequent cause of chorea with an estimated worldwide prevalence of 10/100,000 people. Dystonia is rare in childhood and becomes more prevalent with increasing age. Isolated focal dystonia has been estimated as occurring in 16.4 per 100,000 individuals, whereas generalized dystonia is less common. The most common type of focal dystonia is cervical dystonia. […] Psychiatric illnesses and associated neuroleptic medications have been associated with HMD. Therefore, close monitoring of patients on psychiatric medications is warranted for early detection and prevention.
#2 Functional movement disorder gender, age and phenotype study: a systematic review and individual patient meta-analysis of 4905 cases | Journal of Neurology, Neurosurgery & Psychiatry
https://jnnp.bmj.com/content/93/6/609
Our data provides unprecedented resolution for the basic epidemiology of FMD, highlighting similarities and differences in phenotypes, and shedding light on lumping vs splitting questions in this disorder. […] This large individual patient data meta-analysis primarily provides detail on age of onset and gender for FMD and its phenotypes with unprecedented resolution compared with previous studies. […] These results confirm previous much smaller studies demonstrating that FMD is more common in women (73%75%) and symptom onset occurs most commonly in midlife. […] The onset of FMD occurs in midlife, ranging from 35 to 45 years, although this probably underestimates paediatric and elderly cases. […] Our analysis found no association between phenotype and age at onset or gender. This may reflect stability of FMD across the lifespan, supporting the view of a unitary diagnosis rather than a phenotype-based diagnosis. […] In summary, our data gives unprecedented resolution on the basic epidemiology of FMD which occurs across the lifespan but peaks in midlife with varying effects of gender on age at onset and phenotype.
#2 Descriptive epidemiological study on patients with movement disorders, with emphasis on Parkinsonâs disease
https://pmc.ncbi.nlm.nih.gov/articles/PMC9632504/
This study showed higher frequencies of diagnoses of Parkinsons disease, essential tremor and dystonia, and the patients were predominantly white, female, aged between 71 and 80 years, teachers and married. The mixed clinical form of Parkinsons disease with an initial symptom of resting tremor was found in higher numbers of patients. The akinetic-rigid (AR) clinical form of Parkinsons disease tended to occur in younger individuals, with symptoms of postural instability and freezing of gait that developed earlier. On the other hand, the mixed and tremulous forms of Parkinsons disease had greater likelihood of late onset.
#2 Statistics | Parkinson’s Foundation
https://www.parkinson.org/understanding-parkinsons/statistics
The primary risk factor for PD is age. […] PD incidence estimates are higher in men compared to women at all ages. […] The increase in the incidence of PD aligns with the growth of an aging population. […] PD incidence rates are higher in certain geographic regions: the Rust Belt (parts of the northwestern and midwestern U.S. previously regulated by industrial manufacturing), Southern California, Southeastern Texas, Central Pennsylvania and Florida. […] According to the Parkinsons Foundation Parkinsons Prevalence Project study published in 2018, 1.2 million people in the U.S. will be living with Parkinsons by 2030. […] The study confirms that men are more likely to have PD than women and that the number of those diagnosed with PD increases with age, regardless of sex. […] The study found that the prevalence of people diagnosed with PD varies by region.
#2 Functional movement disorders – UpToDate
https://www.uptodate.com/contents/functional-movement-disorders
Population rates of FMD are not known, and most studies are small and drawn from clinical settings focusing on specific phenotypes. The incidence of functional neurological symptom disorder more broadly is reviewed separately. […] Prevalence in clinical settings â FMD accounts for 2 to 10 percent of patients in movement disorder clinics. The prevalence of FMD among patients who present with dystonia and fixed, contracted joints may be even higher. As an example, one prospective study of 41 such patients reported that criteria for functional dystonia were fulfilled in 15 (37 percent). […] Age of onset â FMD usually begins in middle adulthood but can affect children as young as six years and older adults. The mean age at presentation is 40 years. […] Sex ratio â Females are affected more often than males in both children and adults. In large cohort studies, the percentage of females ranges from 60 to 90 percent. However, the sex preponderance may vary by phenotype; as an example, functional myoclonus and functional parkinsonism appear to have similar frequency in males and females.
#2 Impact of COVID-19 on the epidemiology of functional movement disorders – VJNeurology
https://www.vjneurology.com/video/xm1m4onyegi-impact-of-covid-19-on-the-epidemiology-of-functional-movement-disorders/
The frequency among patients evaluated in movement disorder clinics is around 5% but is suspected of having increased in the setting of the post-COVID-19 pandemic. […] The reasons behind the increase in functional movement disorders prevalence worldwide are unknown but could be a result of COVID-19 infection or vaccination.
#2 Antidepressants and movement disorders: a postmarketing study in the world pharmacovigilance database | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02711-z
Although this type of pharmacovigilance study cannot lead to a precise evaluation of adverse drug reactions frequencies, our results tend to confirm the fact that antidepressant-induced movements disorders are rare adverse drug reactions (only 2.8% of reports containing at least one antidepressant). […] The present study used the case/non-case approach, a validated method in drug safety research, to precise a relatively rare and little-known adverse effect of antidepressants. The most notified movement disorder after antidepressant exposure was tremor and the highest association was found with bruxism. A potential harmful association was found between movement disorders and use of SRIs in general, and of mirtazapine, vortioxetine, amoxapine, phenelzine, tryptophan, fluvoxamine, citalopram, paroxetine, duloxetine, bupropion, clomipramine, escitalopram, fluoxetine, mianserin, sertraline, venlafaxine and vilazodone in particular.
#2 Epidemiology Study Group
https://www.movementdisorders.org/MDS/About/Committees–Other-Groups/Study-Groups/Epidemiology-Study-Group.htm
The MDS Epidemiology Study group sustains an international network of expert epidemiologists with the aim to conduct and combine studies on disease-modifying factors. The goal is to strengthen the validity of epidemiological studies and derive new biomarkers for movement disorders. […] With a prevalence of 1%, most movement disorders including Parkinsons disease are comparatively rare. This makes the acquisition of sufficiently sized datasets difficult. As a consequence, individual epidemiologic studies are often underpowered to address the research questions of interest. However, these types of studies are crucial for a broad range of research and clinical care applications. For instance, they aim to derive population-specific incidence rates and prevalences, identify genetic and environmental risk factors, and define the natural history of disease. The MDS Epidemiology Study group was founded to alleviate the current lack of effort invested on conducting and combining appropriately powered epidemiological research. This will be achieved by utilizing the resources available to the international MDS Epidemiology Study Group.
#2 World Movement Disorders Day | Parkinsons Disease and Movement Disorders Clinic
https://www.movementdisordersclinic.com/world-movement-disorders-day/
Movement Disorders are a group of brain disorders, which leads to either abnormally excess or slowness of body movements and not related to any other body system involvement. […] The Field of Movement disorders has been growing in India since the 2000s and India has now its own movement disorders specialists society called as Movement Disorders Society of India, started in 2014. […] The number of movement disorders cases are on steady increase in India and the World Health Organization, has predicted a tremendous increase in Parkinsons disease and other ageing disorders across India over the next decades. […] There is clear lack of systematic epidemiological studies to understand the prevalence of various movement disorders in India. […] In these specialized private movement disorders clinics, it has been noted that Parkinsonism disorders contributed to almost 2/3rd of the various diseases seen, which is followed by dystonic disorders (15%), and tremors (8%).
#2 Infection Related Movement Disorder Study Group
https://www.movementdisorders.org/Study-Groups/Infection-Related-Movement-Disorder-Study-Group.htm
The main missions of the IRMD will be to: […] To facilitate and promote education, better understanding and research in infection related movement disorders. […] To launch an international registry of IRMD with emphasis on types of infection, phenomenology/syndrome of movement disorders, levels of diagnostic certainty, natural history and long-term outcome. […] Determine the global prevalence of movement disorders associated with infection/neuroinfection. […] To identify research goals in IRMDs with regards to epidemiology, risk factors, pathophysiology, and therapeutics. […] To study the epidemiology of IRMDs based on geographical regions. […] Infections are one of the major causes of morbidity and mortality globally and a variety of movement disorders occur during or after an infectious illness with or without apparent involvement of the nervous system.
#2 National Neurological Conditions Surveillance System | NNCSS | CDC
https://www.cdc.gov/nncss/php/index.html
NNCSS is an integrated system that uses state-of-the-art data sources, tools, and analytic methods to track the epidemiology of neurological conditions.
#2 Development of a remote therapeutic monitoring platform: applications for movement disorders | Scientific Reports
https://www.nature.com/articles/s41598-024-80567-z
A digital health platform that can extend these initial capabilities with integrated remote monitoring is critical for optimizing DBS therapy. Remote monitoring enables healthcare providers to remotely monitor patients health status including vital signs, using digital tools such as wearable devices, sensors, and mobile apps. […] Digital biomarkers for cardinal motor symptoms of PD (ex: tremor and bradykinesia) have been quantified in recent studies using non-invasive sensors that include inertial measuring unit (IMU) sensors, such as, accelerometers, gyroscopes, and magnetometers. […] Through our investigational remote monitoring application (RM App) integrating patient-reported outcomes (PROs) and objective data using wearables, we aimed to develop an accessible, data-driven digital tool to remotely monitor patient symptoms and deliver low-burden and easy-to-access individualized DBS therapy.
#2 Development of a remote therapeutic monitoring platform: applications for movement disorders | Scientific Reports
https://www.nature.com/articles/s41598-024-80567-z
In addition to PROs and wearables, remote monitoring systems for movement disorders should also include video and voice analytics, and other sensor-based technologies. […] The remote monitoring of patients with chronic illness is efficient and cost-effective for healthcare utilization especially in patients with implanted devices. […] The remote monitoring platform, currently available on iOS, was developed to integrate passive and objective data to support patient-feedback and clinical decision-making. […] The option of a low-cost, efficient method of research leads to high quality data leading to results with adequately powered studies. […] In conclusion, the RM app is a remote monitoring platform that can help address the growing need for passive and objective data to support patient feedback and clinical decision-making for movement disorders.
#2 Functional movement disorders – UpToDate
https://www.uptodate.com/contents/functional-movement-disorders
Functional movement disorder (FMD) is a subtype of functional neurological symptom disorder (conversion disorder) in which the primary manifestation is tremor, dystonia, gait disorder, or other abnormal movement. Patients with FMD have neurologic symptoms that are incongruent with known neurologic disease but are nevertheless genuine and cause distress and/or psychosocial impairment. […] FMD is common in clinical settings, but the diagnosis is often delayed or missed, and prognosis for complete remission is generally poor. Over time, more emphasis has been placed on physical examination signs to guide diagnosis and use of evidence-based treatments, including physiotherapy and multidisciplinary rehabilitation. […] This topic reviews the epidemiology, etiology and pathogenesis, clinical features, diagnosis, treatment, and prognosis of FMD.
#2 Movement Disorders | USF Health
https://health.usf.edu/care/neurology/services-specialties/movement-disorders
When essential parts of the nervous system fail to work properly, patients can develop a broad range of movement disorder symptoms. […] We diagnose and care for patients with these movement disorders and diseases: […] The USF Health Parkinsons Disease and Movement Disorders Center is recognized as a National Parkinson Foundation Center of Excellence. […] We also work extensively with patients with other movement disorders, including essential tremor, ataxia and dystonia. […] The center also collaborates closely with neurosurgery in treating patients who require deep brain stimulation for Parkinson’s disease and tremor. […] We are an international leader in the advancing of Parkinsons disease management, and we utilize this new knowledge to improve both diagnosis and patient care.