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Milestones in clinical neurophysiology
1Human Motor Control Section, NINDS, NIH, Bethesda, Maryland 20892-1428, USA. hallettm@ninds.nih.gov
Summary
Clinical neurophysiology has advanced movement disorder understanding and diagnosis over 25 years, with transcranial magnetic stimulation being a key technical development. Pathophysiology insights improve diagnosis for Parkinson's disease, dystonia, and psychogenic movement disorders, though therapy effects are modest.
Area of Science:
- Clinical neurophysiology
- Movement disorders
- Neuroscience
Background:
- Clinical neurophysiology has seen significant advancements in understanding, diagnosing, and treating movement disorders over the past 25 years.
- Transcranial magnetic stimulation (TMS) represents a major technical breakthrough in the field.
- Progress in understanding the underlying pathophysiology of various movement disorders has been substantial.
Observation:
- Improved knowledge of bradykinesia in Parkinson's disease.
- Understanding of reduced inhibition and increased plasticity in dystonia.
- Identification of abnormal startle reflexes in hyperekplexia.
- Characterization of psychogenic movement disorders aiding in diagnosis.
Findings:
- Key technical advances include transcranial magnetic stimulation.
- Significant progress in the pathophysiology of Parkinson's disease, dystonia, and hyperekplexia.
- Diagnostic capabilities for movement disorders have been enhanced through better pathophysiological understanding.
Implications:
- Enhanced diagnostic accuracy for complex movement disorders.
- Potential for targeted therapeutic strategies based on improved pathophysiological insights.
- Noninvasive brain stimulation shows promise for therapy, although current effects are generally small.
