Journal of Movement Disorders

Original Article

Optimal Stimulation Sites and Long-Term Efficacy of Pallidal Deep-Brain Stimulation for Patients With Tardive Dystonia: Taku Nonaka, Shiro Horisawa, Kilsoo Kim, Masato Murakami, Masahiko Nishitani, Takakazu Kawamata, Takaomi Taira; J Mov Disord. 2026;19(1):49-57. Published online October 28, 2025; DOI: https://doi.org/10.14802/jmd.25164

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Abstract PDF: Objective
Globus pallidus internus deep brain stimulation (GPi-DBS) is an established treatment for dystonia, but its specific efficacy for tardive dystonia (TD) remains insufficiently documented. To evaluate the long-term clinical outcomes of GPi-DBS and to identify optimal stimulation sites in patients with medically refractory TD.
Methods
We retrospectively analyzed data from 26 patients with TD who underwent bilateral GPi-DBS. Clinical outcomes were assessed using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS). Optimal stimulation sites were identified using voxelwise sweet spot analysis.
Results
At an average follow-up time of 42 months (range 12–4 months), the mean BFMDRS score improvement was 81.5%. The optimal stimulation sites were located in the posteroventral region of the GPi. Two patients experienced sustained symptom remission after DBS cessation. Complications included device-related infection (n=2), dysarthria (n=4), and gait imbalance (n= 1); no severe permanent complications occurred.
Conclusion
GPi-DBS is effective and safe for patients with medically refractory TD, providing significant long-term symptom relief. The optimal stimulation sites were located in the posteroventral GPi, which is consistent with those reported for patients with other dystonia types.

Brief communications

Efficacy and Safety of Zolpidem for Musician’s Dystonia: Shiro Horisawa, Kilsoo Kim, Masato Murakami, Masahiko Nishitani, Takakazu Kawamata, Takaomi Taira; J Mov Disord. 2024;17(4):425-429. Published online July 1, 2024; DOI: https://doi.org/10.14802/jmd.24121

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Objective
The efficacy and safety of zolpidem for treating musician’s dystonia are not well understood. We aimed to retrospectively investigate the efficacy and safety of zolpidem for treating musician’s dystonia.
Methods
We retrospectively reviewed medical records between January 2021 and December 2023 to identify patients with musician’s dystonia who had been prescribed zolpidem. Tubiana’s Musician’s Dystonia Rating Scale (range, 1–5; lower scores indicating greater severity) was used to evaluate musician’s dystonia.
Results
Fifteen patients were included in this study. The mean effective dose of zolpidem was 5.3 ± 2.0 mg. The mean effective duration of zolpidem was 4.3 ± 1.2 h. With zolpidem administration, Tubiana’s musician’s dystonia rating scale score significantly improved from 2.2 ± 1.0 to 4.3 ± 0.8 (48.9% improvement, p < 0.001). Two patients (13.3%) discontinued the drug owing to unsatisfactory results or sleepiness.
Conclusion
The results of this study suggest that zolpidem may be an alternative treatment option for musician’s dystonia.

Citations

Citations to this article as recorded by

Deep Phenotyping of Musicians’ Upper Limb Dystonia
Steven J. Frucht
Tremor and Other Hyperkinetic Movements.2025; 15: 31. CrossRef
The Treatment of Runner’s Dystonia With Zolpidem and a Device Inducing Hanger Reflex
Takashi Asahi, Shiro Horisawa, Takuto Nakamura, Hiroyuki Kajimoto, Ichiro Takumi
Cureus.2025;[Epub] CrossRef
Sleep-Related Eating Disorder and Sexsomnia; Two Rare Parasomnias? A Mini-Review with Illustrative Case-Reports
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Dance Intervention Using the Feldenkrais Method Improves Motor, and Non-Motor Symptoms and Gait in Parkinson’s Disease: A 12-Month Study: Sung Hoon Kang, Jinhee Kim, Ilsoo Kim, Young Ae Moon, Sojung Park, Seong-Beom Koh; J Mov Disord. 2022;15(1):53-57. Published online November 3, 2021; DOI: https://doi.org/10.14802/jmd.21086

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5 Web of Science
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Abstract PDF Supplementary Material

Objective
The aim of this study was to assess the effects of dancing (using the Feldenkrais method) on motor and non-motor symptoms, quality of life (QoL), and objective parameters of gait at the time of intervention and at the end of the 1-year study period.
Methods
This was a single-arm study in which 12 subjects with Parkinson’s disease (PD) received dance intervention during a 6-month period. Objective motor scales, gait analysis, and questionnaires on non-motor symptoms were evaluated at baseline and at 3, 6, and 12 months.
Results
Dance intervention decreased motor scale (Unified Parkinson’s Disease Rating Scale and Tinetti scale) scores and improved gait disturbance (gait velocity and step length) without increasing levodopa equivalent dose. Furthermore, dancing decreased non-motor scale (Non-Motor Symptoms Scale and Montgomery-Asberg Depression Rating Scale) scores and improved QoL.
Conclusion
Our findings suggest that dance intervention can be a complementary management method for PD patients.

Citations

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Effects of deep brain stimulation on non-motor symptoms in Parkinson’s disease: insights from longitudinal studies using consistent evaluation scales
Hongyu Xu, Zhiqiang Yan, Qiong Ye, Jia Lu, Kexin Chen, Juan Fang, Zijin Li, Jingyao Jiang
Journal of Neurology.2026;[Epub] CrossRef
ParkiSoDance: Feasibility Assessment of a Forró -Based Dance Program for Persons With Parkinson’s Disease
Beatriz Menezes DeJesus, Annanda Oliveira Santos, Lavinia Teixeira-Machado, Josimari Melo DeSantana
Journal of Dance Medicine & Science.2026;[Epub] CrossRef
Somatic movement intervention among older adults to improve body awareness and spine mobility: A pilot study
Diana K. Lara, Kate A. Hamel, David I. Anderson
Journal of Bodywork and Movement Therapies.2025; 42: 319. CrossRef
Feldenkrais method and clinical psychology: A systematic literature review exploring the potential of Feldenkrais Method in psychiatric care
Sylvia Martin, Clara La Monica, Laura Soto, Vladimir Latocha
Complementary Therapies in Medicine.2024; 85: 103073. CrossRef
Mild cognitive impairment is associated with poor gait performance in patients with Parkinson’s disease
Sung Hoon Kang, Jinhee Kim, Jungyeun Lee, Seong-Beom Koh
Frontiers in Aging Neuroscience.2022;[Epub] CrossRef

Original Article

The Four Square Step Test for Assessing Cognitively Demanding Dynamic Balance in Parkinson’s Disease Patients: Jinhee Kim, Ilsoo Kim, Ye Eun Kim, Seong-Beom Koh; J Mov Disord. 2021;14(3):208-213. Published online May 26, 2021; DOI: https://doi.org/10.14802/jmd.20146

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Abstract PDF Supplementary Material

Objective
The Four Square Step Test (FSST) is a tool that assesses dynamic balance during obstacle step-over. To date, few studies have used the FSST to measure balance in patients with Parkinson’s disease (PD). This study aimed to verify that patients with PD, even at the de novo early stage, take more time to perform the FSST and identify which factors, cognitive status or cardinal motor symptoms, are related most to FSST scores.
Methods
Thirty-five newly diagnosed drug-naïve patients with PD and 17 controls completed the FSST. The Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) stage, spatiotemporal gait parameters, and neuropsychological test battery were also assessed in the PD group.
Results
Mean FSST performance time was 8.20 ± 1.61 seconds in patients with PD, which was significantly more than the control group (7.13 ± 1.10 seconds, p = 0.018). UPDRS part III total score and H&Y stage were not significantly associated with FSST, but among the UPDRS subscores, only the postural instability/gait disturbance subscore showed a significant association. Regarding the association between FSST and cognition, the Trail Making Test-B and the Color Word Stroop Test showed strongly inverse correlations with FSST (rho = -0.598 and -0.590, respectively). With respect to gait parameters, double support time was significantly associated with FSST score (rho = 0.342, p = 0.044); however, other parameters, including velocity and step length, were not associated with the FSST.
Conclusion
The FSST can be used in the clinic to assess dynamic balance with cognitive demands even in the early stages of PD.

Citations

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Physiotherapy Research International.2026;[Epub] CrossRef
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Patrick Tait, Lisa Graham, Rodrigo Vitorio, Tamlyn Watermeyer, Emily C. Timm, Joan O’Keefe, Samuel Stuart, Rosie Morris
Journal of NeuroEngineering and Rehabilitation.2025;[Epub] CrossRef
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Irish Journal of Medical Science (1971 -).2025; 194(5): 1915. CrossRef
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2023 Carol B. Lewis Distinguished Lecture Address to the APTA Geriatrics Membership Combined Sections Meeting, February 23, 2023 Key Words & Challenges: Defining Our Role in Caring for Older Adults
Michelle M. Lusardi
Journal of Geriatric Physical Therapy.2023; 46(2): 93. CrossRef
The relationship between visual function and physical performance in the Study of Muscle, Mobility and Aging (SOMMA)
Atalie C. Thompson, Eileen Johnson, Michael E. Miller, Jeff D. Williamson, Anne B. Newman, Steve Cummings, Peggy Cawthon, Stephen B. Kritchevsky, Eric R. Anson
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