Category: Education, History, Disparities (Other)
Objective: Objective. To investigate the phenomenology and lesion locations in poststroke movement disorders (PSMDs).
Background: Background. PSMDs are among the most common acquired movement disorders, although all evidence comes from case reports or case series. Moreover, there are no established clinical guidelines, and clinical practices are highly variable across countries, thus highlighting the need for a systematic approach to study these disorders.
Method: Methods. In this international multicentre study conducted by the Movement Disorder Society (MDS) PSMD study group, we collected PSMD cases from 13 institutions from 9 countries across 5 continents. PSMD diagnoses were required to be established by a movement disorder specialist or equivalent in countries with no formal movement disorder subspeciality. Demographic, clinical, and neuroimaging data were systematically collected in each centre, and analyses of this combined data were conducted at the primary study site.
Results: Results. A total of 219 PSMD cases (94 females, 42.9%) were identified. The mean (SD) age at the time movement disorder onset was 61.6 (16.3) years. Tremor was the most common and dominant movement disorder (24.7% of all cases), followed by dystonia (18.7%), chorea (13.7%), and parkinsonism (13.2%). Notably, 63 (28.8%) patients had mixed movement disorders. The association between lesion locations and phenomenology exhibited considerable heterogeneity. There were also clear differences in latencies between phenotypes, as tremor (48.1% within 7 days), chorea (50.0%), ballismus (80.0%) and myoclonus (60.0%) most commonly appeared early, while dystonia (43.9% appearing more than 3 months from stroke) and parkinsonism (65.5%) were the most common delayed movement disorders. The clinical outcomes were mixed: 16.9% were reported to be progressive, 41.6% stable, 17.4% improved, and 10.1% resolved.
Conclusion: Conclusions. We describe the world’s largest original cohort of PSMD cases with a comprehensive overview of the spectrum of clinical presentations free from publication bias. The results highlight substantial heterogeneity and overlap in terms of clinical phenomenology and lesion locations, challenging established clinico-radiological correlations within PSMDs. Further recruitment and analyses will disclose additional findings for a better understanding of PSMD pathophysiology and adequate management.
To cite this abstract in AMA style:
R. Mehanna, E. Ellis, K. Gulati, A. Mukherjee, A. Shalash, J. Jankovic, C. Falup-Pecurariu, A. Espay, L. Wang, J. Abanto, E. Dietrichs, S. Bjerknes, H. Holm, C. Armas, C. Cosentino, A. Wagle Shukla, J. Kungshamn, E. Myller, E. Ottela, H. Sarva, H. Ooi, G. Mostile, G. Lanza, M. Tripodi, R. Bella, F. Rodriguez-Porcel, S. Pandey, J. Joutsa. Poststroke Movement Disorders: An International Multicentre Study by the MDS Poststroke Movement Disorders Study Group [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/poststroke-movement-disorders-an-international-multicentre-study-by-the-mds-poststroke-movement-disorders-study-group/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/poststroke-movement-disorders-an-international-multicentre-study-by-the-mds-poststroke-movement-disorders-study-group/