Movement Disorders

The Movement Disorders section focuses on diagnosing and treating patients with involuntary movement disorders. These disorders can be classified as hypokinetic, when movements are too slow compared to normal, or hyperkinetic, when there is too much movement present. A common example of a hypokinetic disorder is Parkinson disease, a neurodegenerative disorder affecting 1% of the general population over the age of 60. Hyperkinetic movement disorders, including the most common essential tremor, are also prevalent in the population. Diagnosing movement disorders requires thorough evaluation, which is available in the Movement Disorders section. 

Clinical 

Established in 1994 as the Clinical Center for Movement Disorders under the leadership of Richard B. Dewey,Jr., M.D., the section has grown to include nine full-time faculty members and four advanced practice providers and sees several thousand unique patients per year. In addition to our primarily outpatient practice, we also staff the resident Ron Anderson clinic, Parkland Hospital, and William P. Clements Jr. University Hospital in rotation with other UTSW neurologists.

The clinical activities of the Movement Disorders section include:

  • Evaluation and management of various movement disorder conditions
  • Botulinum toxin injections for dystonia, spasticity, and other disorders of muscle spasm
  • Evaluation of patients for interventional therapies, such as Deep brain stimulation (DBS) surgery, HiFU or MRI-guided focused ultrasound (MRgFUS) lesioning procedures for disorders such as Parkinson disease and essential tremor

Research 

 

With recruitments of world-class basic researchers, the Movement Section now has a dynamic program of research into basic mechanisms of ataxic disorders, dystonia, and tremor. Our faculty have received funding from organizations including the National Institute of Neurologic Disorders and Stroke. Current clinical research in the section involves study of a novel agent as a possible disease modifying treatment for Parkinson disease, several projects assessing patient satisfaction from our various treatment programs, and a high-impact study using sophisticated brain mapping in a rare form of dystonia.

Research Overview Videos

Collaborative Research

We are developing, in cooperation with Radiology, a new surgical approach that targets specific brain regions with highly focused ultrasound beams to treat tremor non-invasively. We work in close conjunction with colleagues from Neurosurgery, Palliative Care, Physical Medicine and Rehabilitation (physical, occupational, and speech therapy) and Psychiatry for interdisciplinary care of our patients.

Education 

The Movement Disorders section is committed to the educational mission of the UT Southwestern. We present lectures on movement disorders to UTSW medical students rotating on the neurology clerkship, and a series of lectures given annually to UTSW neurology residents. We also have a highly competitive clinical fellowship in movement disorders to train the next generation of movement disorders experts.

Conditions Treated

The Movement Disorders section is committed to providing comprehensive, compassionate, efficient, high-quality care to all of our patients and their families. The most common conditions seen in our section include: 

Hypokinetic disorders: 

  • Parkinson's disease
  • Progressive supranuclear palsy
  • Multiple systems atrophy
  • Lewy body dementia
  • Normal pressure hydrocephalus
  • Vascular parkinsonism

Hyperkinetic disorders:

  • Essential tremor
  • Blepharospasm
  • Cervical dystonia
  • Hemifacial spasm
  • Huntington's Chorea
  • Tic disorders (including Tourette syndrome)
  • Myoclonus
  • Spasticity

Primary Services

Our section offers a variety of diagnostic and therapeutic services, including

  • Advanced MRI
  • SPECT scan
  • Neuropsychological assessments
  • Gait assessments
  • Blood work
  • Neurological exams
  • Botulinum toxin injections
  • Deep brain stimulation evaluation
  • Surgery
  • Programming jejunal levodopa infusion therapy
  • High-intensity frequency ultrasound (HiFU) treatment for tremor

Specialty Programs 

  • Deep brain stimulation program
  • HiFU program
  • Jejunal levodopa infusion program
  • Ataxia program
  • Multiple systems atrophy program
  • Essential tremor centralized brain repository
  • Functional movement disorders program (under development) 

Section Head 

Faculty

Advanced Practice Providers

Research Labs

Chitnis Lab

The Chitnis lab focuses on developing creative DBS programming techniques to help patients unlock the full potential of this remarkable therapy. We also develop processes to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson's disease (PD), essential tremor (ET), and dystonia. The Chitnis lab is also involved in identifying unmet needs for care of patients with functional neurological disorders (FND) and devising strategies to create unique multi-disciplinary programs for their care. 

Dauer Lab

The Dauer lab studies the molecular and cellular pathogenesis of dystonia and Parkinson disease in cell and animal models. Major interests include DYT1 dystonia and inherited forms of Parkinson's disease.

Louis Lab

The Louis lab focuses on the epidemiology, genetics, clinical features, and pathophysiology of tremor disorders, with a primary focus on essential tremor – the most common of these disorders. Many of these studies involve deep phenotyping of carefully assembled patient cohorts followed by tissue-based studies to address research questions.

Napierala Lab

The mission of the Napierala lab is to contribute to the development of therapies and a cure for Friedreich’s ataxia (FRDA) by elucidating molecular mechanisms causing the disease, developing novel cellular and animal models of FRDA, identifying disease biomarkers and testing novel therapeutic approaches.

O’Suilleabhain Lab

Current work is on two main threads: analyzing the neurophysiologic basis or motor control via magnetoencephalography, with particular interest into the way this breaks down in dystonia; and understanding and alleviating the burden of social stigma felt by many people with essential tremor.

Shakkottai Lab

The Shakkottai lab studies the basis for motor dysfunction and neuronal degeneration in cerebellar ataxia. The lab uses both animal models of disease and performs human clinical studies in participants with ataxia in order to develop novel therapies for this group of disorders. Major interests are the inherited forms of spinocerebellar ataxia, including SCA1, SCA2, SCA3, SCA6 and SCA7.

Vibhash Sharma

Dr. Sharma focuses on understanding how various factors impact the clinical outcomes of patients who have undergone DBS surgery, with a goal to optimize and expand the use of DBS for the treatment of movement disorders. Dr. Sharma aims to understand the utility of newly developed modalities in DBS on long-term clinical care and to explore the barriers which prevent the utilization of interventional therapies. Dr. Sharma is also interested in studying the phenomenology of various movement disorders.

Clinical Trials