The goal of this project is to translate basic science advances into therapies for patients with movement disorders. Advances often come from work in our own laboratory, but we also seek to take advantage of other research.
Specific aims i nclude: Develop therapies for dystonia including brain stimulation and new rehabilitation techniques. Develop therapies for Parkinson disease using brain stimulation. Develop octanol for the treatment of essential tremor. Develop therapies for patients with psychogenic movement disorders. Summary In the area of dystonia treatment, we continue to provide botulinum toxin injections to our patients while training physicians to perform these injections. We are also conducting a therapeutic trial of transcranial direct current stimulation (tDCS) of the brain in patients with focal hand dystonia. For patients with blepharospasm, we are evaluating the efficacy of various types of non-invasive brain stimulation. Low frequency repetitive TMS, theta burst stimulation and tDCS are being compared. Past studies from our group have shown that certain rehabilitation techniques, such as motor training and sensory training can be therapeutic. We are trying to develop other methods of rehabilitation that might be more efficacious. We are trying to develop non-invasive brain stimulation methods for improvement in Parkinson disease (PD). A past study showed that this could be done with 25 Hz repetitive transcranial magnetic stimulation (rTMS). We have now completed a second trial of tDCS to see if this will improve gait in patients with PD. Other trials will be with intermittent theta burst stimulation (iTBS) and rTMS at 5-0 Hz. In other studies, we are evaluating a new device to see if it can provide objective evidence of motor deterioration in early PD. New treatments are needed for essential tremor. One promising agent is 1-octanol which we continue to develop. We are currently working to characterize this drugs pharmacokinetics and comparing the efficacy of different formulations in a dose escalation and cross-over study in patients with ET. In addition to characterizing the pharmacokinetics of 1-octanol, we have tested its efficacy in a double-blind placebo-controlled trial in patients with essential tremor. We are currently conducting a trial with 1-octanoic acid, a metabolite of 1-octanol. Other similar agents might also be examined in the future.
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