Gaps, Controversies, and Proposed Roadmap for Research in Poststroke Movement Disorders

Poststroke movement disorders (PSMDs) are a common cause of secondary movement disorders. Although prior studies have highlighted the clinical spectrum and phenomenology of PSMDs, there are many knowledge gaps worth addressing. Some of the most important include lack of clinical definitions, variable stroke symptom latencies, and lack of biomarkers for vulnerability for or resilience against developing PSMDs. Collectively, the association between stroke localization and phenomenology is less than 30%, and the long-term clinical prognosis and treatment responses are highly variable. After summarizing the accumulated evidence regarding the phenomenology, pathophysiology, neuroimaging, and treatment of PSMDs, highlighting the many gaps and controversies including diagnostic challenges, we propose a roadmap for future research to fill these gaps and resolve the related controversies. More research is warranted concerning the phenomenology, classification, diagnostic criteria, and pathophysiology of PSMDs. Further, there is an urgent need for treatment guidelines for the management of PSMDs. (c) 2022 International Parkinson and Movement Disorder Society.

Automated summary

Poststroke movement disorders (PSMDs) are a common cause of secondary movement disorders. However, there are many knowledge gaps in terms of clinical definitions, stroke symptom latencies, and biomarkers for vulnerability for or resilience against developing PSMDs. After summarizing the existing evidence, a roadmap for future research is proposed to fill these gaps and resolve the related controversies. Further research is needed in the phenomenology, classification, diagnostic criteria, and pathophysiology of PSMDs, as well as the development of treatment guidelines.