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Abstract Details

Motivation States for Bodily Movement in Hyperkinetic Movement Disorders: A Scoping Review
Movement Disorders
P10 - Poster Session 10 (11:45 AM-12:45 PM)
3-016

A subset of hyperkinetic movement disorders are characterized by excessive movements which are suppressible and associated with a premonitory urge to move. The present review focuses specifically in exploration of the “urge” or subjective motivation to move. Investigating such sensations may help elucidate the pathophysiology, endogenous and exogenous stimuli, subjective experiences, correlates, and other factors related to these conditions, which remain poorly understood.

The objective of this scoping review is to quantify the literature on motivation states (e.g., urges, impulses) surrounding bodily movement as applied to movement disorders.

Iterative searches of scholarly databases took place to determine the optimal search strategy. Two investigators independently reviewed the literature and selected studies based on predetermined inclusion/exclusion criteria. A data extraction form was developed based on JBI's System for the Unified Management, Assessment and Review of Information (SUMARI). Guidelines for reporting evidence were followed as outlined by the PRISMA-ScR Checklist.

116 studies involving movement disorders were selected. Conditions included restless leg syndrome (RLS) and variants (78.4%), akathisia/tardive dyskinesia (10.3%), tic disorders (8.6%), and epilepsy of right posterior precuneus origin (0.9%). 45.7% of studies used a validated scale to assess the sensations. Articles revealed complex and multifactorial pathophysiology, however the former three disorders shared common associations: 1) dysfunction of the cortico-striato-thalamocortical loop, insula, and SMA; 2) neurotransmitter abnormalities including dopamine dysfunction, decreased GABA activity, and increased glutamate activity; and 3) co-morbid psychiatric disorders. 5% of RLS articles discussed an association with brain iron deficiency.

This review is the first to unify the literature on motivation states for movement. A refined understanding of such states may lead to improved treatments for applicable movement disorders. Further, common themes suggest movement motivation may represent a motor urge dysfunction spectrum that includes normal sensations, and if so, future research elucidating its mechanism may have extensive public health applications.
Authors/Disclosures
Danielle A. Reynolds, MD (Yale New Haven Hospital)
PRESENTER
Dr. Reynolds has nothing to disclose.
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Brian Koo, MD Dr. Koo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for American Regent. Dr. Koo has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Speckhals Law. The institution of Dr. Koo has received research support from Department of Defense.
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