Espen Dietrichs

• Staubo, Sara Cecilie; Størset, Elisabet; Toft, Mathias; Lie, Ingeborg Haugesag; Alvik, Kirsti Margrete Johansen & Pål, Jostad, [Show all 11 contributors for this article] (2026). Evaluating impulse control disorders in people with Parkinson’s disease: agreement and added value of patient and caregiver reports. Frontiers in Neurology. 17. doi: 10.3389/fneur.2026.1791205. Full text in Research Archive Show summary

  Background: People with Parkinson’s Disease (PD) treated with dopamine agonists are at increased risk for developing impaired impulse control behavior. It has been suggested that patients tend to underreport problems with impaired impulse control, indicating that caregiver evaluations may be a helpful supplement to clinical assessment.Objective: To examine the agreement between evaluations of impaired impulse control provided by people with PD treated with dopamine agonists and by their caregivers.Methods: People with PD and their caregivers independently completed the validated Questionnaire for Impulse-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS) and the Impulse Control Disorders and Related Conditions (ICDRC) questionnaire. Patient and caregiver assessment were compared statistically for total scores and subscores on both questionnaires.Results: Overall, patient and caregiver assessment on both the QUIP-RS and ICDRC showed no consistent systematic differences. Patients reported a slightly higher total ICDRC score and higher combined subscores for punding and dopamine dysregulation syndrome compared to their caregivers. Further, patient evaluations showed a wider range of responses for hypersexuality (QUIP-RS and ICDRC) and for gambling (ICDRC).Conclusion: The assessment of impaired impulse control remains difficult, and our findings indicate that the role of caregiver evaluations is still uncertain.

• Alves, Guido Werner; Sørenes, Yvonne; Frantzen, Veslømøy Hamre; Gjerstad, Michaela-Alexandra Dreetz; Bjørnestad, Anders & Grødem, Jodi Maple [Show all 25 contributors for this article] (2025). Validation of the Norwegian version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale. Clinical Parkinsonism & Related Disorders. 14. doi: 10.1016/j.prdoa.2025.100420. Full text in Research Archive
• Holm, Hedda; Dietrichs, Espen; Juho, Joutsa,; Connelly, James Patrick; Lund, Christian & Skjelland, Mona [Show all 8 contributors for this article] (2025). Delayed-onset parkinsonism is common after isolated striatal infarcts. Frontiers in Neurology. doi: 10.3389/fneur.2025.1653832. Full text in Research Archive Show summary

  BackgroundWhile case studies have suggested that only a minority of patients with putaminal lesions develop parkinsonism, existing data are limited by involv...

• Staubo, Sara Cecilie; Fuskevåg, Ole Martin; Toft, Mathias; Lie, Ingeborg Haugesag; Alvik, Kirsti Margrete Johansen & Jostad, Pål [Show all 13 contributors for this article] (2025). Impulse control and correlation to dopamine agonist serum concentrations in people with Parkinson's disease. Journal of Neurology. ISSN 0340-5354. 272(2). doi: 10.1007/s00415-024-12870-8. Full text in Research Archive
• Finger, Stanley; Stien, Ragnar & Dietrichs, Espen (2025). Jean-Martin Charcot and Scandinavian literature: On the 200th anniversary of his birth. History of Psychiatry. ISSN 0957-154X. doi: 10.1177/0957154X251316115. Full text in Research Archive
• Dietrichs, Espen (2024). Reflekser, vin på fat, sauebønder – og nevrologer som slåss. Michael. ISSN 1893-9651. 21(Supplement 33), p. 174–174. doi: 10.5617/michael.11721. Full text in Research Archive Show summary

  Er det sant at reflekshammeren opprinnelig ikke ble lagd til nevrologisk og medisinsk bruk? En historisk gjennomgang viser at moderne reflekshammere sannsynligvis er utviklet fra perkusjonshammere som sveitsiske bønder brukte i Alpene. Bøndene banket sauene på skallen når de lette etter hjernecyster forårsaket av parasitter. Hammerne ble utviklet videre, både til reflekstesting og andre typer medisinske undersøkelser hos mennesker. Men det var først etter et heftig slagsmål på en nevrologikongress at dagens mest populære reflekshammer ble konstruert.

• Dietrichs, Espen (2024). Kan man gjøre nevrofysiologi på månen? Michael. ISSN 1893-9651. 21(Supplement 33), p. 144–144. doi: 10.5617/michael.11715. Full text in Research Archive Show summary

  Da astronautene i Apollo-programmet landet på månen, ble de kontinuerlig overvåket med nevrofysiologiske registreringer. Overlege Carl Wilhelm Sem- Jacobsen på Gaustad hadde fått økonomisk støtte fra blant annet NASA som han brukte til å utvikle portabelt registreringsutstyr for EEG og EKG, inkludert verdens minste EEG-apparat «Vesla». Neil Armstrong hadde på seg slikt utstyr da han som første menneske satte sin fot på månen.

• Dietrichs, Espen (2024). Drev CIA hemmelige eksperimenter med hjernekontroll i Oslo? Michael. ISSN 1893-9651. 21(Supplement 33), p. 141–141. doi: 10.5617/michael.11714. Full text in Research Archive Show summary

  På 1950- og 60-tallet begynte ryktene å gå om at overlege Carl Wilhelm Sem- Jacobsen (1912–1991) på Gaustad sykehus eksperimenterte på pasienter for å styre hjernen og adferden – forsøk på såkalt «mind control». Det ble i fullt alvor hevdet at uvitende og vergeløse pasienter ble hjerneoperert og utsatt for barbariske eksperimenter, eller gitt overdoser LSD. De døde ble dumpet i en umerket grav på Ris kirkegård. Oppdragsgivere skulle være CIA og det amerikanske forsvaret, godt støttet av regjeringen Gerhardsen. Beskyldningene ble hengende ved Sem- Jacobsen helt til han døde i 1991. I lang tid etterpå ble familien hans fortsatt plaget av gravejournalister som ville bekrefte teoriene. Senere har det vist seg at beskyldningene hadde svært tynt grunnlag, ikke kunne dokumenteres, og etter all sannsynlighet var falske og bevisst fabrikkerte. Sem-Jacobsen var egentlig en foregangsmann som utviklet avansert medisinsk-teknisk utstyr til undersøkelse og behandling av hjernesykdommer – lenge før den norske samtiden var moden for slike nyvinninger. Menneskene bak de alvorlige konspirasjonsteoriene kan ha forsinket utviklingen av visse typer medisinske behandling med flere tiår fordi de skremte andre leger fra å videreføre og videreutvikle Sem-Jacobsens nye metoder, for eksempel dyp hjernestimulering ved Parkinsons sykdom..

• Sandmo, Stian Bahr; Dietrichs, Espen & Bahr, Roald (2024). When You Hear Hoofbeats, Don't Forget the ZEBRA: Paroxysmal DYSKINESIAS as A Cause of Atypical Movements in Athletes. Current sports medicine reports. ISSN 1537-890X. 23(2), p. 38–40. doi: 10.1249/JSR.0000000000001137. Full text in Research Archive
• Solbakken, Gro; Løseth, Sissel; Frich, Jan; Dietrichs, Espen & Ørstavik, Kristin (2024). Small and large fiber neuropathy in adults with myotonic dystrophy type 1. Frontiers in Neurology. 15. doi: 10.3389/fneur.2024.1375218. Full text in Research Archive Show summary

  Introduction: Myotonic dystrophy type 1 (DM1) is an inherited neuromuscular disorder that affects multiple organs. In this study, we investigated symptoms of pain and presence of small and large fiber neuropathy in the juvenile and adult form of DM1.<p> <p>Method: Twenty genetically verified DM1 patients were included. Pain was assessed, and neurological examination and investigations of the peripheral nervous system by quantification of small nerve fibers in skin biopsy, quantitative sensory testing and nerve conduction studies were performed. Results from skin biopsies were compared to healthy controls. <p>Result: Seventeen patients reported chronic pain. Large and/or small fiber abnormalities were present in 50% of the patients. The intraepidermal nerve fiber density was significantly lower in the whole group of patients compared to healthy controls. <p>Conclusion: Small-fiber neuropathy might be an important cause of pain in DM1.

• Staubo, Sara Cecilie; Fuskevåg, Ole Martin; Toft, Mathias; Lie, Ingeborg Haugesag; Alvik, Kirsti Margrete Johansen & Jostad, Pål [Show all 13 contributors for this article] (2023). Dopamine agonist serum concentrations and impulse control disorders in Parkinson's disease. European Journal of Neurology. ISSN 1351-5101. 31(2). doi: 10.1111/ene.16144. Full text in Research Archive Show summary

  Background and purpose: Impulse control disorders (ICDs) are common among Parkinson's disease patients using dopamine agonists. We wanted to determine whether ICD patients have higher dopamine agonist serum concentrations than those without any sign of ICD.<p> <p>Methods: Patients who used either pramipexole or ropinirole depot once daily were screened for ICDs using the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease–Rating Scale. Those who scored above the cut-off for one or more of the four defined ICDs (gambling, compulsive sexual behavior, compulsive shopping, and binge-eating) were compared in a case–control study to patients who scored zero points (no evidence of ICD) on the same items. They were examined clinically and evaluated using relevant scales. Three blood samples were taken on the same day: before daily dose, and then 6 and 12 h later. <p>Results: Forty-six patients were included: 19 ICD-positive and 27 controls. Ropinirole serum concentrations 6 h after daily intake (C_max) were higher in the case group compared to the control group, as was the daily ropinirole dosage. No differences were observed in serum concentrations, dosage or total drug exposure for pramipexole. Disease duration and length of dopamine agonist treatment was significantly longer among ICD patients for ropinirole, but not for pramipexole. <p>Conclusions: The use of pramipexole may in itself confer high ICD risk, whereas ICDs among ropinirole users depend more on serum concentration and drug exposure. The pharmacokinetic properties of ropinirole make it challenging to predict its effects on patients, which supports the need for therapeutic drug monitoring to reduce risk of ICD.

• kvernmo, nadja; Konglund, Ane; Reich, Martin M.; Roothans, Jonas; Pripp, Are Hugo & Dietrichs, Espen [Show all 8 contributors for this article] (2022). Deep Brain Stimulation for Arm Tremor: A Randomized Trial Comparing Two Targets. Annals of Neurology. ISSN 0364-5134. 91(5), p. 585–601. doi: 10.1002/ana.26317. Full text in Research Archive Show summary

  Objective Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM) effectively suppresses arm tremor. Uncontrolled studies suggest the posterior subthalamic area (PSA) may be superior. We compared the intra-individual efficacy of VIM- versus PSA-DBS on tremor suppression and arm function. Methods We performed a randomized, double-blind, crossover trial at Oslo University Hospital in patients (18–80 years) with isolated or combined action tremor affecting at least one arm. Four-contact DBS leads were implanted (bi- or unilaterally) with a trajectory to cover the VIM (upper two contacts) and PSA (lower two contacts). Patients were randomized (1:1 ratio) post-surgery to: Group 1, VIM-stimulation months 0–3 (period 1), then PSA-stimulation months 4–6 (period 2); Group 2, PSA-stimulation first, then VIM-stimulation. Primary endpoint was the difference in improvement from baseline to the end of the VIM- versus PSA-period in the sum of the dominant arm tremor scores of the Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS), items 5/6 + 10−14. Results Forty-five patients were randomized to Group 1 (n = 23) or 2 (n = 22). In the primary endpoint per-protocol analysis (mixed model, n = 40), mean difference in the sum FTMTRS score improvement for the dominant arm was −2.65 points (95% CI −4.33 to −0.97; p = 0.002). The difference in favour of PSA stimulation was highly significant in period 2, but not period 1. Interpretation Our randomized trial demonstrated that PSA stimulation provided superior tremor suppression compared with VIM stimulation. A period effect reducing tremor for up to three months in both groups was most likely attributed to a post-surgery stun effect. ANN NEUROL 2022;91:585–601

• Herrman, Helle; Osnes, Kåre; Egge, Arild; Konglund, Ane; Ramm-Pettersen, Jon-Terje & Dietrichs, Espen [Show all 7 contributors for this article] (2022). ANT-DBS in epilepsy shows no effect on selected neuropsychiatric tests. Acta Neurologica Scandinavica. ISSN 0001-6314. 146(3), p. 258–264. doi: 10.1111/ane.13658. Full text in Research Archive Show summary

  Objectives Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) is an established option in treatment-resistant epilepsy and obtained FDA approval in 2018. Increased psychiatric comorbidity is well known in epilepsy. The main objective of this study was to investigate possible neuropsychiatric treatment-related changes in patients receiving ANT-DBS. Materials and Methods Bilateral ANT electrodes were implanted in 18 adult patients with refractory epilepsy in a randomized, double-blinded study. Immediately after implantation, patients were randomized to stimulation ON (n = 8) or OFF (n = 10) for the first 6 months (blinded phase). During the next six months (open phase), both groups received active stimulation. Neuropsychiatric assessment was conducted before implantation (T1), at the end of the blinded period (T2), and 1 year after implantation (T3). Results Comparing preoperative status (T1) and 12 months (T3), postoperative outcome in all patients did not show significant differences between the two groups for any of the applied tests. Groupwise comparisons across the two first time points (the blinded period, representing the randomized controlled trial) showed no significant differences between the two groups in any of the neuropsychiatric parameters studied. Comparing test results after 6 months of stimulation in both groups (sum of ON group T1 to T2 and OFF group T2 to T3) did not show significant changes for any of the psychiatric assessments. Conclusions Our results indicate that ANT-DBS has limited effect concerning psychiatric issues. Subjective side effects were, however, reported in individual patients.

• Solbakken, Gro; Løseth, Sissel; Johanessen, Anne Froholdt; Eikeland, Torunn; Nærland, Terje & Frich, Jan C [Show all 8 contributors for this article] (2021). Pain in adult myotonic dystrophy type 1: relation to function and gender. BMC Neurology. 21(1), p. 1–11. doi: 10.1186/s12883-021-02124-9. Full text in Research Archive Show summary

  <i>Background</i> - Pain is prevalent in myotonic dystrophy 1 (DM1). This study investigated whether CTG repeat size, disease duration, BMI and motor and psychological function were related to pain in adult patients with DM1, and if there were gender differences regarding intensity and location of pain.<br><br> <i>Method</i> - Cross-sectional design. Pain was investigated in 50 genetically confirmed DM1 patients by combining clinical assessment and self-reports of pain intensity and locations. Pain scoring results were related to CTG size, disease duration, muscle strength, walking capacity measured by 6-min walk test, activity of daily life by Katz ADL Index, respiratory function by Forced Vital Capacity and BMI. In addition, the degree of reported pain was related to Quality of life measured by WHOQOL-BREF; fatigue was measured by Fatigue severity scale; psychological functions were measured by Beck Depression Inventory, Beck Anxiety Inventory, IQ and Autism spectrum Quotient.<br><br> <i>Results</i> - Pain was reported in 84% of the patients and was significantly correlated with CTG size (<i>r </i>= 0.28 <i>p</i> = 0.050), disease duration (<i>r</i> = 0.38 <i>p</i> = 0.007), quality of life (<i>r</i> = − 0.37 <i>p</i> = 0.009), fatigue (<i>r</i> = 0.33 <i>p</i> = 0.02) and forced vital capacity (<i>r</i> = − 0.51, <i>p</i> = 0.005). Significant gender differences, with higher scores for females, were documented. In male subjects the number of pain locations was significantly correlated with quality of life and the autism quotient. In females, pain intensity was significantly correlated with activity, respiratory function and BMI.<br><br> <i>Conclusions</i> - Pain in DM1 was prevalent, with a strong association to lung function and other aspects of the disease. Significant gender differences were present for pain intensity and number of pain locations. How pain was related to other symptoms differed between male and female subjects. Our findings highlight the importance of assessments of pain in DM1 patients.

• Heminghyt, Einar; Herrman, Helle; Skogan, Annette Holth; Konglund, Ane; Egge, Arild & Lossius, Morten Ingvar [Show all 8 contributors for this article] (2021). Cognitive change after DBS in refractory epilepsy: A randomized-controlled trial. Acta Neurologica Scandinavica. ISSN 0001-6314. p. 1–8. doi: 10.1111/ane.13539. Full text in Research Archive Show summary

  Objectives Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) reduces seizure frequency in patients with refractory epilepsy. There are, however, few studies on treatment-related changes in cognitive functions. The main objective of this study was to investigate cognitive changes in patients receiving ANT-DBS. We also explored whether possible effects were related to stimulation duration and whether change in seizure frequency was associated with cognitive changes. Materials and methods Bilateral ANT electrodes were implanted in 18 patients with refractory epilepsy, aged 18–52 years. Immediately after implantation, patients were randomized to stimulation ON (n = 8) or OFF (n = 10) for the first 6 months (blinded phase). During the following 6-month open phase, both groups received stimulation. Neuropsychological assessments were conducted before implantation (T1), at the end of the blinded period (T2), and 1 year after implantation (T3). Results Groupwise comparisons across the three time points revealed changes in performance in two of 22 cognitive test scores: motor speed and sustained attention. We found no significant group differences in cognitive change from T1 to T2. Patients reported fewer symptoms of executive dysfunction after 12 months of stimulation. Patients showing significant improvement in seizure frequency had better performance in a measure of verbal learning. Conclusion Our results indicate that ANT-DBS has very limited effects on cognitive functioning, as measured by formal tests after 6- or 12-month stimulation. ANT-DBS may have a positive influence on executive function. Our findings provide limited support for an association between change in seizure frequency and cognitive functioning.

• Bjerknes, Silje Kristin; Toft, Mathias; Brandt, Reidun; Rygvold, Trine Waage; Konglund, Ane & Dietrichs, Espen [Show all 8 contributors for this article] (2021). Subthalamic Nucleus Stimulation in Parkinson's Disease: 5-Year Extension Study of a Randomized Trial. Movement Disorders Clinical Practice. 9(1), p. 48–59. doi: 10.1002/mdc3.13348. Full text in Research Archive Show summary

  Background In Parkinson's disease (PD) long-term motor outcomes of subthalamic nucleus deep brain stimulation (STN-DBS) are well documented, while comprehensive reports on non-motor outcomes are fewer and less consistent. Objective To report motor and non-motor symptoms after 5-years of STN-DBS. Methods We performed an open 5-year extension study of a randomized trial that compared intraoperative verification versus mapping of STN using microelectrode recordings. Changes from preoperative to 5-years of STN-DBS were evaluated for motor and non-motor symptoms (MDS-UPDRS I-IV), sleep disturbances (PDSS), autonomic symptoms (Scopa-Aut), quality of life (PDQ-39) and cognition through a neuropsychological test battery. We evaluated whether any differences between the two randomization groups were still present, and assessed preoperative predictors of physical dependence after 5 years of treatment using logistic regression. Results We found lasting improvement of off-medication motor symptoms (total MDS-UPDRS III, bradykinetic-rigid symptoms and tremor), on-medication tremor, motor fluctuations, and sleep disturbances, but reduced performance across all cognitive domains, except verbal memory. Reduction of verbal fluency and executive function was most pronounced the first year and may thus be more directly related to the surgery than worsening in other domains. The group mapped with multiple microelectrode recordings had more improvement of bradykinetic-rigid symptoms and of PDQ-39 bodily discomfort sub-score, but also more reduction in word fluency. Older age was the most important factor associated with physical dependence after 5 years. Conclusion STN-DBS offers good long-term effects, including improved sleep, despite disease progression. STN-DBS surgery may negatively impact verbal fluency and executive function.

• Bjerknes, Silje Kristin; Skogseid, Inger Marie; Hauge, Tuva Jin; Dietrichs, Espen & Toft, Mathias (2020). Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease. NPJ Parkinson's Disease. 6:29, p. 1–7. doi: 10.1038/s41531-020-00131-0. Full text in Research Archive Show summary

  Abstract Parkinson’s disease (PD) is a complex multisystem disorder with motor and non-motor symptoms (NMS). NMS may have an even greater impact on quality of life than motor symptoms. Subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to improve motor fluctuations and quality of life, whereas the effects on different NMS have been less examined. Sleep disturbances and autonomic dysfunction are among the most prevalent NMS. We here report the efficacy of STN-DBS on sleep disturbances and autonomic dysfunction. In the parent trial, 60 patients were included in a single-center randomized prospective study, with MDS-UPDRS III and PDQ-39 as primary endpoints at 12 months of STN-DBS. Preplanned assessments at baseline and postoperatively at 3 and 12 months also included Parkinson’s Disease Sleep Scale (PDSS); Scopa-Aut; and MDS-UPDRS I, II, and IV. We found that STN-DBS had a significant and lasting positive effect on overall sleep quality, nocturnal motor symptoms and restlessness, and daytime dozing. Several aspects of autonomic dysfunction were also improved at 3 months postoperatively, although at 12 months only thermoregulation (sudomotor symptoms) remained significantly improved. We could not identify preoperative factors that predicted improvement in PDSS or Scopa-Aut. There was a close relationship between improved autonomic symptoms and improved quality of life after 1 year. NMS and especially sleep and autonomic dysfunction deserve more focus to improve patient outcomes further.

• Nome, Terje; Herrman, Helle; Lehtimäki, Kai; Egge, Arild; Konglund, Ane & Ramm-Pettersen, Jon-Terje [Show all 8 contributors for this article] (2020). Direct visual targeting versus preset coordinates for ANT-DBS in epilepsy. Acta Neurologica Scandinavica. ISSN 0001-6314. 142(1), p. 23–29. doi: 10.1111/ane.13233. Full text in Research Archive Show summary

  Objectives Deep brain stimulation (DBS) of the anterior thalamic nucleus (ANT) may be used against refractory focal epilepsy, but only two randomized double‐blinded trials have been performed. The Oslo study was discontinued prematurely since reduction in seizure frequency was less than expected. The aim of the present study was to review the targeting used in the Oslo study and to identify the actual positions of the contacts used for stimulation. Material and methods BrainLab MRI data were available from 12 Oslo study patients. Based on MRI the coordinates of the center of the ANT were identified. The coordinates were considered as the visually identified preferred target and were compared with the target originally used for ANT electrode implantation and with the actual electrode positions estimated from post‐operative CT scans. Results We found considerable differences between the visually identified preferred target, the originally planned target, and the actual electrode position. The total distance between the active electrode position and the visually identified preferred target was on average 3.3 mm on the right and 2.9 mm on the left side. Conclusion Indirect targeting based on preset coordinates may contribute to explain the modest effect of ANT‐DBS on seizure frequency seen in the Oslo study. Observed differences between the center of the ANT and the actual electrode position may at least in part be explained by variations in position and size of the ANT. Direct identification of the target using better MRI imaging protocols is recommended for future ANT‐DBS surgery.

• Tamás, Gertrúd; Fabbri, Margherita; Falup-Pecurariu, Cristian; Teodoro, Tiago; Kurtis, Mónica M. & Aliyev, Rahim [Show all 35 contributors for this article] (2020). Lack of Accredited Clinical Training in Movement Disorders in Europe, Egypt, and Tunisia. Journal of Parkinson's Disease. ISSN 1877-7171. 10(4), p. 1833–1843. doi: 10.3233/JPD-202000. Full text in Research Archive
• Rennie, Linda; Opheim, Arve Isak; Dietrichs, Espen; Löfgren, Niklas & Franzèn, Erika (2020). Highly challenging balance and gait training for individuals with Parkinson’s disease improves pace, rhythm and variability domains of gait – A secondary analysis from a randomized controlled trial. Clinical Rehabilitation. ISSN 0269-2155. 35(2), p. 200–212. doi: 10.1177/0269215520956503. Full text in Research Archive
• Flengsrud, Karoline; Toft, Mathias & Dietrichs, Espen (2019). Essensiell tremor. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(8), p. 1–5. doi: 10.4045/tidsskr.18.0904. Full text in Research Archive Show summary

  Essensiell tremor rammer nesten 1 % av befolkningen og kan være svært hemmende. Fortsatt er mye uklart rundt patofysiologi, miljøfaktorer og genetiske årsaker. Sannsynligvis rommer diagnosen flere forskjellige tilstander. Vi gir her en oppdatert oversikt over essensiell tremor, medikamentell og nevrokirurgisk behandling samt gjennomgang av forslag til nye definisjoner for tremor generelt og essensiell tremor spesielt. Essensiell tremor er en av de vanligste nevrologiske sykdommene, med en anslått prevalens på nesten 1 % og økende med alder (1). Tradisjonelt ble essensiell tremor oppfattet som en monosymptomatisk sykdom med aksjonstremor, men uten andre nevrologiske symptomer. Vi vet nå at tilstanden kan være mer kompleks, med flere motoriske og ikke-motoriske symptomer (2). En oversikt over essensiell tremor ble publisert i Tidsskriftet i 2008 (3). Siden den gang er det blitt introdusert en ny sykdomsklassifikasjon, og vi har fått flere og bedre alternativer til nevrokirurgisk behandling. Vi gir her en oppdatert klinisk oversikt over tilstanden. Artikkelen bygger dels på forfatternes egne erfaringer, dels på litteratursøk i PubMed, der et skjønnsmessig utvalg av relevante artikler om diagnostikk, etiologi, patofysiologi, definisjon og behandling etter 2007 er inkludert.

• Juvodden, Hilde Therese; Alnæs, Dag; Lund, Martina Jonette; Dietrichs, Espen; Thorsby, Per Medbøe & Westlye, Lars Tjelta [Show all 7 contributors for this article] (2019). Hypocretin-deficient narcolepsy patients have abnormal brain activation during humor processing. Sleep. ISSN 0161-8105. 42:zsz082(7), p. 1–12. doi: 10.1093/sleep/zsz082. Full text in Research Archive Show summary

  Study Objectives To assess brain activation patterns in response to fun-rated and neutral-rated movies we performed functional magnetic resonance imaging (fMRI) during a humor-paradigm in narcolepsy type 1 (NT1) patients with cataplexy (muscle atonia triggered by emotions) and controls. The fMRI-humor-paradigm consisted of short movies (25/30 with a humorous punchline; 5/30 without a humorous punchline [but with similar build-up/anticipation]) rated by participants based on their humor experience. We included 41 NT1 patients and 44 controls. Group-level inferences were made using permutation testing. Permutation testing revealed no group differences in average movie ratings. fMRI analysis found no group differences in brain activations to fun-rated movies. Patients showed significantly higher activations compared to controls during neutral-rated movies; including bilaterally in the thalamus, pallidum, putamen, amygdala, hippocampus, middle temporal gyrus, cerebellum, brainstem and in the left precuneus, supramarginal gyrus, and caudate. We found no brain overactivation for patients during movies without a humorous punchline (89.0% neutral-rated). Group analyses revealed significantly stronger differentiation between fun-rated and neutral-rated movies in controls compared with patients (patients showed no significant differentiation), including bilaterally in the inferior frontal gyrus, thalamus, putamen, precentral gyrus, lingual gyrus, supramarginal gyrus, occipital areas, temporal areas, cerebellum and in the right hippocampus, postcentral gyrus, pallidum, and insula. Patients showed significantly higher activations in several cortical and subcortical regions during neutral-rated movies, with no differentiation from activations during fun-rated movies. This lower threshold for activating the humor response (even during neutral-rated movies), might represent insight into the mechanisms associated with cataplexy.

• Herrman, Helle; Egge, Arild; Konglund, Ane; Ramm-Pettersen, Jon-Terje; Dietrichs, Espen & Taubøll, Erik (2018). Anterior thalamic deep brain stimulation in refractory epilepsy: A randomized, double-blinded study. Acta Neurologica Scandinavica. ISSN 0001-6314. 139(3), p. 294–304. doi: 10.1111/ane.13047. Full text in Research Archive Show summary

  Objectives The safety and effect on seizure frequency of anterior thalamic nucleus deep brain stimulation were studied in this prospective, randomized, double‐blinded study. Patients were followed for 12 months. The first 6 months were blinded with regard to active stimulation or not. After 6 months, all patients received active stimulation. Material and methods Bilateral ANT electrodes were implanted into 18 patients suffering from focal, pharmacoresistant epilepsy. Antiepileptic treatment was kept unchanged from three months prior to operation. The Liverpool seizure severity scale (LSSS) was used to measure the burden of epilepsy. Results There was no significant difference between the 2 groups at the end of the blinded period at 6 months. However, when considering all patients and comparing 6 months of stimulation with baseline, there was a significant, 22% reduction in the frequency of all seizures (P = 0.009). Four patients had ≥50% reduction in total seizure frequency and 5 patients ≥50% reduction in focal seizures after 6 months of stimulation. No increased effect over time was shown. LSSS at 6 months compared to baseline showed no significant difference between the 2 groups, but a small, significant reduction in LSSS was found when all patients had received stimulation for 6 months. Conclusions Our study supports results from earlier studies concerning DBS as a safe treatment option, with effects even in patients with severe, refractory epilepsy. However, our results are not as encouraging as those reported from many other, mainly unblinded, and open studies.

• Odin, Per; chaudhury, kr; Volkmann, Jens; Antonini, Angelo; storch, a & Dietrichs, Espen [Show all 11 contributors for this article] (2018). Viewpoint and practical recommendations from a movement disorder specialist panel on objective measurements in the clinical management of Parkinson's disease. NPJ Parkinson's Disease. 4(14). doi: 10.1038/s41531-018-0051-7. Full text in Research Archive Show summary

  Motor aspects of Parkinson’s disease, such as fluctuations and dyskinesia, can be reliably evaluated using a variety of “wearable” technologies, but practical guidance on objective measurement (OM) and the optimum use of these devices is lacking. Therefore, as a first step, a panel of movement disorder specialists met to provide guidance on how OM could be assessed and incorporated into clinical guidelines. A key aspect of the incorporation of OM into the management of Parkinson’s disease (PD) is defining cutoff values that separate “controlled” from “uncontrolled” symptoms that can be modified by therapy and that relate to an outcome that is relevant to the person with PD (such as quality of life). Defining cutoffs by consensus, which can be subsequently tested and refined, is the first step to optimizing OM in the management of PD. OM should be used by all clinicians that treat people with PD but the least experienced may find the most value, but this requires guidance from experts to allow non-experts to apply guidelines. While evidence is gained for devices that produce OM, expert opinion is needed to supplement the evidence base.

• Bjørnaraa, Kari Anne; Pihlstrøm, Lasse; Dietrichs, Espen & Toft, Mathias (2018). Risk variants of the α-synuclein locus and REM sleep behavior disorder in Parkinson's disease: A genetic association study. BMC Neurology. 18(20), p. 1–5. doi: 10.1186/s12883-018-1023-6. Full text in Research Archive Show summary

  Background Parkinson’s disease is a heterogeneous disorder where genetic factors may underlie clinical variability. Rapid eye movement sleep behavior disorder (RBD) is a parasomnia strongly linked to synucleinopathies, including Parkinson’s disease. We hypothesized that SNCA variants conferring risk of Parkinson’s disease would also predispose to an RBD phenotype. Methods We assessed possible RBD (pRBD) status using the RBD screening questionnaire and investigated known susceptibility variants for Parkinson’s disease located in the α-synuclein (SNCA) and tau (MAPT) gene loci in 325 Parkinson’s disease patients. Associations between genetic risk variants and RBD were investigated by logistic regression, and an independent dataset of 382 patients from the Parkinson’s Progression Marker Initiative (PPMI) study was used for replication. Results pRBD was associated with rs3756063 located in the 5’ region of SNCA (two-sided p = 0.018, odds ratio 1.44). We replicated this finding in the PPMI dataset (one-sided p = 0.036, odds ratio 1.35) and meta-analyzed the results (two-sided p = 0.0032, odds ratio 1.40). The Parkinson’s disease risk variant in the 3′ region of SNCA and the MAPT variant showed no association with pRBD. Conclusions Our findings provide proof of principle that a largely stable, dichotomous clinical feature of Parkinson’s disease can be linked to a specific genetic susceptibility profile. Indirectly, it also supports the hypothesis of RBD as relevant marker for a distinct subtype of the disorder.

• Bjerknes, Silje Kristin; Toft, Mathias; Konglund, Ane; Pham, Uyen Ha Gia; Waage, Trine Rygvold & Pedersen, Lena [Show all 11 contributors for this article] (2018). Multiple microelectrode recordings in STN-DBS surgery for Parkinson's disease: a randomized study. Movement Disorders Clinical Practice. 5(3), p. 296–305. doi: 10.1002/mdc3.12621. Full text in Research Archive Show summary

  Background: Subthalamic nucleus deep brain stimulation improves motor symptoms and fluctuations in advanced Parkinson's disease, but the degree of clinical improvement depends on accurate anatomical electrode placement. Methods used to localize the sensory‐motor part of the nucleus vary substantially. Using microelectrode recordings, at least three inserted microelectrodes are needed to obtain a three‐dimensional map. Therefore, multiple simultaneously inserted microelectrodes should provide better guidance than single sequential microelectrodes. We aimed to compare the use of multiple simultaneous versus single sequential microelectrode recordings on efficacy and safety of subthalamic nucleus stimulation. Methods: Sixty patients were included in this double‐blind, randomized study, 30 in each group. Primary outcome measures were the difference from baseline to 12 months in the MDS‐UPDRS motor score (part III) in the off‐medication state and quality of life using the Parkinson's Disease Questionnaire‐39 (PDQ‐39) scores. Results: The mean reduction of the MDS‐UPDRS III off score was 35 (SD 12) in the group investigated with multiple simultaneous microelectrodes compared to 26 (SD 10) in the single sequential microelectrode group (p = 0.004). The PDQ‐39 Summary Index did not differ between the groups, but the domain scores activities of daily living and bodily discomfort improved significantly more in the multiple microelectrodes group. The frequency of serious adverse events did not differ significantly. Conclusions: After 12 months of subthalamic nucleus stimulation, the multiple microelectrodes group had a significantly greater improvement both in MDS‐UPDRS III off score and in two PDQ‐39 domains. Our results may support the use of multiple simultaneous microelectrode recordings.

• Zak, Nathalia; Moberget, Torgeir; Bøen, Erlend; Boye, Birgitte; Waage, Trine Rygvold & Dietrichs, Espen [Show all 12 contributors for this article] (2018). Longitudinal and cross-sectional investigations of long-term potentiation-like cortical plasticity in bipolar disorder type II and healthy individuals. Translational Psychiatry. 8(103). doi: 10.1038/s41398-018-0151-5. Full text in Research Archive Show summary

  Visual evoked potential (VEP) plasticity is a promising assay for noninvasive examination of long-term potentiation (LTP)-like synaptic processes in the cerebral cortex. We conducted longitudinal and cross-sectional investigations of VEP plasticity in controls and individuals with bipolar disorder (BD) type II. VEP plasticity was assessed at baseline, as described previously (Elvsåshagen et al. Biol Psychiatry 2012), and 2.2 years later, at follow-up. The longitudinal sample with VEP data from both time points comprised 29 controls and 16 patients. VEP data were available from 13 additional patients at follow-up (total n = 58). VEPs were evoked by checkerboard reversals in two premodulation blocks before and six blocks after a plasticity-inducing block of prolonged (10 min) visual stimulation. VEP plasticity was computed by subtracting premodulation VEP amplitudes from postmodulation amplitudes. Saliva samples for cortisol analysis were collected immediately after awakening in the morning, 30 min later, and at 12:30 PM, at follow-up. We found reduced VEP plasticity in BD type II, that impaired plasticity was present in the euthymic phases of the illness, and that VEP plasticity correlated negatively with depression severity. There was a positive association between VEP plasticity and saliva cortisol in controls, possibly reflecting an inverted U-shaped relationship between cortisol and synaptic plasticity. VEP plasticity exhibited moderate temporal stability over a period of 2.2 years. The present study provides additional evidence for impaired LTP-like cortical plasticity in BD type II. VEP plasticity is an accessible method, which may help elucidate the pathophysiological and clinical significance of synaptic dysfunction in psychiatric disorders.

• RENNIE, LINDA; Löfgren, Niklas; Moe-Nilssen, Rolf; Opheim, Arve Isak; Dietrichs, Espen & Franzèn, Erika (2018). The reliability of gait variability measures for individuals with Parkinson's disease and healthy older adults ? The effect of gait speed. Gait & Posture. ISSN 0966-6362. 62, p. 505–509. doi: 10.1016/j.gaitpost.2018.04.011. Full text in Research Archive
• Juvodden, Hilde Therese; Alnæs, Dag; Lund, Martina Jonette; Agartz, Ingrid; Andreassen, Ole Andreas & Dietrichs, Espen [Show all 9 contributors for this article] (2018). Widespread white matter changes in post-H1N1 patients with narcolepsy type 1 and first-degree relatives. Sleep. ISSN 0161-8105. 41(10). doi: 10.1093/sleep/zsy145. Full text in Research Archive Show summary

  Study Objectives To assess white matter involvement in H1N1-vaccinated hypocretin deficient patients with narcolepsy type 1 (NT1) compared with first-degree relatives (a potential risk group) and healthy controls. Methods We compared four diffusion tensor imaging–based microstructural indices (fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) in 57 patients with NT1 (39 females, mean age 21.8 years, 51/57 H1N1-vaccinated, 57/57 HLA-DQB1*06:02-positive, 54/54 hypocretin-deficient), 54 first-degree relatives (29 females, mean age 19.1 years, 37/54 H1N1-vaccinated, 32/54 HLA-DQB1*06:02-positive), and 55 healthy controls (38 females, mean age 22.3 years). We tested for differences between these groups, for parametric effects (controls > first-degree relatives > patients) and associations in patients (cerebrospinal fluid [CSF] hypocretin-1 and disease duration) and first-degree relatives (HLA-DQB1*06:02 and H1N1-vaccination). We employed tract-based spatial statistics and used permutation testing and threshold-free cluster enhancement for inference. Results Patients with NT1 had a widespread, bilateral pattern of significantly lower FA compared with first-degree relatives and healthy controls. Additionally, patients with NT1 also exhibited significantly higher RD and lower AD in several focal white matter clusters. The parametric model showed that first-degree relatives had intermediate values. Full sample of patients with NT1 showed no significant associations with disease duration or CSF hypocretin-1. Conclusions Our study suggests widespread abnormal white matter involvement far beyond the already known focal hypothalamic pathology in NT1, possibly reflecting the combined effects of the loss of the widely projecting hypothalamic hypocretin neurons, and/or secondary effects of wake/sleep dysregulation. These findings demonstrate the importance of white matter pathology in NT1.

• Dietrichs, Espen (2018). Albert Einsteins forsvunne hjerne. Michael. ISSN 1893-9651. 15, p. 80–86. Full text in Research Archive Show summary

  Da Albert Einstein døde i 1955, ble han obdusert på lokalsykehuset i Princeton, New Jersey. Hjernen ble #ernet under obduksjonen. Patologen $omas Stoltz Harvey tok med seg hjernen hjem, og han hadde den med seg da han flyttet fra Princeton. Det var lenge usikkert hva som egentlig skjedde med hjernen etter dette, men gjennom undersøkelsene til to amerikanske journalister har vi nå fått kjennskap til hvordan $omas Stoltz Harvey holdt hjernen skjult for omverdenen og flyttet den rundt i USA. Harvey oppfattet trolig Einsteins hjerne som et viktig forskningsobjekt, men han oppbevarte den hjemme og initierte aldri vitenskapelige undersøkelser. I senere år har enkelte forskere fått undersøke deler av hjernen, men det er ikke blitt gjort funn som kan knyttes opp mot Albert Einsteins spesielle kognitive evner.

• Dietrichs, Espen (2018). Først i verden med dyp hjernestimulering ved Parkinson. Michael. ISSN 1893-9651. 15, p. 133–135. doi: 10.4045/tidsskr.14.0376. Full text in Research Archive Show summary

  Overlege Carl Wilhelm Sem-Jacobsen presenterte i 1962 resultatene fra elektrisk hjernestimulering gjennom innopererte elektroder utført på Gaustad sykehus hos 10 parkinsonpasienter. Sannsynligvis var Sem-Jacobsen den første i verden som foretok dyp hjernestimulering hos denne pasientgruppen.

• Dietrichs, Espen (2018). Jan Birger Jansen - en grå eminense som har satt spor. Michael. ISSN 1893-9651. 15, p. 34–42. Full text in Research Archive Show summary

  Professor Jan Birger Jansen (1898–1984) startet den nevrovitenskapelige aktiviteten ved Anatomisk institutt, Universitetet i Oslo og la grunnlaget for den internasjonalt berømte «"e Oslo School of Neuroanatomy». Han publiserte en rekke viktige artikler og bøker innen komparativ nevroanatomi, ikke minst om hjernen hos hvalene. To artikler han skrev sammen med Alf Brodal har blitt epokegjørende for vår forståelse av lillehjernen. I 21 år var han instituttbestyrer ved Anatomisk institutt og bidro sterkt til å gi instituttet dets sentrale posisjon. Mer ukjent, men minst like viktig, var Jansens innsats under annen verdenskrig. Han arbeidet meget aktivt i den sivile motstandsbevegelsen, hadde i en lang periode nærmest eneansvaret for produksjonen og distribusjonen av motstandsbevegelsens kanskje aller viktigste illegale avis, Bulletinen, og han spilte en viktig rolle i den indre «Kretsen», i Koordinasjonskomiteen, i Informasjonskomiteen og etter hvert i Hjemmefrontens ledelse.

• Dietrichs, Espen & Odin, Per (2017). Algorithms for the treatment of motor problems in Parkinson's disease. Acta Neurologica Scandinavica. ISSN 0001-6314. 136(5), p. 378–385. doi: 10.1111/ane.12733. Full text in Research Archive Show summary

  Several different strategies are effective for medical treatment of motor problems in Parkinson's disease (PD). Many guidelines and evidence‐based reviews are available, but there is no documentation or consensus in favor of just one treatment strategy. This review presents two algorithms that may be helpful when deciding how to treat a PD patient at various stages of the disease. The first algorithm suggests one way to treat PD from the first onset of motor symptoms. It is largely based on treatment recommendations from the Scandinavian countries and Germany. The other algorithm is meant as assistance for choosing among the different device‐aided treatments for advanced PD. There is not sufficient comparative data to recommend one particular line of treatment, neither in early PD nor in advanced disease with motor complications. Individualized treatment is needed for each patient. The current algorithms only represent an alternative for aiding treatment decisions.

• RENNIE, LINDA; Dietrichs, Espen; Moe-Nilssen, Rolf; Opheim, Arve Isak & Franzèn, Erika (2017). The validity of the Gait Variability Index for individuals with mild to moderate Parkinson's disease. Gait & Posture. ISSN 0966-6362. 54, p. 311–317. doi: 10.1016/j.gaitpost.2017.03.023. Full text in Research Archive Show summary

  Increased step-to-step variability is a feature of gait in individuals with Parkinson’s disease (PD) and is associated with increased disease severity and reductions in balance and mobility. The Gait Variability Index (GVI) quantifies gait variability in spatiotemporal variables where a score ≥100 indicates a similar level of gait variability as the control group, and lower scores denote increased gait variability. The study aim was to explore mean GVI score and investigate construct validity of the index for individuals with mild to moderate PD. 100 (57 males) subjects with idiopathic PD, Hoehn & Yahr 2 (n = 44) and 3, and ≥60 years were included. Data on disease severity, dynamic balance, mobility and spatiotemporal gait parameters at self-selected speed (GAITRite) was collected. The results showed a mean overall GVI: 97.5 (SD 11.7) and mean GVI for the most affected side: 94.5 (SD 10.6). The associations between the GVI and Mini- BESTest and TUG were low (r = 0.33 and 0.42) and the GVI could not distinguish between Hoehn & Yahr 2 and 3 (AUC = 0.529, SE = 0.058, p = 0.622). The mean GVI was similar to previously reported values for older adults, contrary to consistent reports of increased gait variability in PD compared to healthy peers. Therefore, the validity of the GVI could not be confirmed for individuals with mild to moderate PD in its current form due to low associations with validated tests for functional balance and mobility and poor discriminatory ability. Future work should aim to establish which spatiotemporal variables are most informative regarding gait variability in individuals with PD.

• Ezat, Beriwan; Pihlstrøm, Lasse; Aasly, Jan; Tysnes, Ole-Bjørn; Egge, Arild & Dietrichs, Espen (2017). Bruk av avansert behandling ved Parkinsons sykdom i Norge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(9), p. 619–623. doi: 10.4045/tidsskr.16.0711. Full text in Research Archive
• Solbakken, Gro; Ørstavik, Kristin; Hagen, Tormod; Dietrichs, Espen & Nærland, Terje (2016). Major involvement of trunk muscles in myotonic dystrophy type 1. Acta Neurologica Scandinavica. ISSN 0001-6314. 134, p. 463–473. doi: 10.1111/ane.12565. Full text in Research Archive
• Dietrichs, Erik Sveberg & Dietrichs, Espen (2015). Nevroprotektiv effekt av hypotermi. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(18), p. 1646–1651. doi: 10.4045/tidsskr.14.1250. Full text in Research Archive
• Odin, Per; Chaudhuri, Kallol Ray; Slevin, John T.; Volkmann, Jens; Dietrichs, Espen & Martinez-Martin, Pablo [Show all 12 contributors for this article] (2015). Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease: Consensus from an international survey and discussion program. Parkinsonism & Related Disorders. ISSN 1353-8020. 21(10), p. 1133–1144. doi: 10.1016/j.parkreldis.2015.07.020. Full text in Research Archive
• Pihlstrøm, Lasse; Rengmark, Aina Sylvia Haugen; Bjørnarå, Kari Anne; Dizdar, Nil; Fardell, Camilla & Forsgren, Lars [Show all 13 contributors for this article] (2015). Fine mapping and resequencing of the PARK16 locus in Parkinson's disease. Journal of Human Genetics. ISSN 1434-5161. 60(7), p. 357–362. doi: 10.1038/jhg.2015.34. Full text in Research Archive
• Pham, Uyen Ha Gia; Solbakk, Anne-Kristin; Skogseid, Inger Marie; Toft, Mathias; Pripp, Are Hugo & Konglund, Ane [Show all 11 contributors for this article] (2015). Personality changes after deep brain stimulation in Parkinson's Disease. Parkinson's Disease. ISSN 2090-8083. 2015:490507. doi: 10.1155/2015/490507. Full text in Research Archive
• Pham, Uyen Ha Gia; Andersson, Stein; Toft, Mathias; Pripp, Are Hugo; Konglund, Ane & Dietrichs, Espen [Show all 10 contributors for this article] (2015). Self-Reported Executive Functioning in Everyday Life in Parkinson's Disease after Three Months of Subthalamic Deep Brain Stimulation. Parkinson's Disease. ISSN 2090-8083. 2015:461453. doi: 10.1155/2015/461453. Full text in Research Archive Show summary

  Objective . Studies on the effect of subthalamic deep brain stimulation (STN-DBS) on executive functioning in Parkinson’s disease (PD) are still controversial. In this study we compared self-reported daily executive functioning in PD patients before and after three months of STN-DBS. We also examined whether executive functioning in everyday life was associated with motor symptoms, apathy, and psychiatric symptoms. Method . 40 PD patients were examined with the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), the Symptom Checklist 90-Revised (SCL-90-R), and the Apathy Evaluation Scale (AES-S). Results . PD patients reported significant improvement in daily life executive functioning after 3 months of STN-DBS. Anxiety scores significantly declined, while other psychiatric symptoms remained unchanged. The improvement of self-reported executive functioning did not correlate with motor improvement after STN-DBS. Apathy scores remained unchanged after surgery. Only preoperative depressed mood had predictive value to the improvement of executive function and appears to prevent potentially favorable outcomes from STN-DBS on some aspects of executive function. Conclusion . PD patients being screened for STN-DBS surgery should be evaluated with regard to self-reported executive functioning. Depressive symptoms in presurgical PD patients should be treated. Complementary information about daily life executive functioning in PD patients might enhance further treatment planning of STN-DBS.

• Bjørnarå, Kari Anne; Dietrichs, Espen & Toft, Mathias (2015). Longitudinal assessment of probable rapid eye movement sleep behaviour disorder in Parkinson's disease. European Journal of Neurology. ISSN 1351-5101. 22(8), p. 1242–1244. doi: 10.1111/ene.12723. Full text in Research Archive
• Larsen, Jan Petter; Dietrichs, Espen; Beiske, Antonie Giæver; Tysnes, Ole-Bjørn; Aasly, Jan & Bekkelund, Svein Ivar (2014). Terapianbefaling Parkinsons sykdom. Nyhetsbulletin. ISSN 1892-9699. 19(2), p. 5–29. Full text in Research Archive
• Bjerknes, Silje Kristin; Skogseid, Inger Marie; Sæhle, Terje; Dietrichs, Espen & Toft, Mathias (2014). Surgical site infections after deep brain stimulation surgery: Frequency, characteristics and management in a 10-year period. PLOS ONE. 9(8). doi: 10.1371/journal.pone.0105288. Full text in Research Archive
• Rizos, A.; Martinez-Martin, P.; Odin, P.; Antonini, A.; Kessel, B. & Kozul, T.Klemencic [Show all 12 contributors for this article] (2014). Characterizing motor and non-motor aspects of early-morning off periods in Parkinson's disease: An international multicenter study. Parkinsonism & Related Disorders. ISSN 1353-8020. 20(11), p. 1231–1235. doi: 10.1016/j.parkreldis.2014.09.013. Full text in Research Archive
• Børretzen, Mari Naumann; Bjerknes, Silje Kristin; Sæhle, Terje; Skjelland, Mona; Skogseid, Inger Marie & Toft, Mathias [Show all 7 contributors for this article] (2014). Long-term follow-up of thalamic deep brain stimulation for essential tremor - patient satisfaction and mortality. BMC Neurology. 14(120). doi: 10.1186/1471-2377-14-120. Full text in Research Archive
• Bjørnarå, Kari Anne; Dietrichs, Espen & Toft, Mathias (2014). Clinical features associated with sleep disturbances in Parkinson's disease. Clinical neurology and neurosurgery (Dutch-Flemish ed. Print). ISSN 0303-8467. 124, p. 37–43. doi: 10.1016/j.clineuro.2014.06.027. Full text in Research Archive
• Jusufovic, Mirza; Konglund, Ane; Beyer, Mona K.; Dietrichs, Espen & Skjelland, Mona (2014). Deep brain stimulation in essential tremor. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 134, p. 1757–1757. Full text in Research Archive
• Lilleeng, Bård Flattun; Brønnick, Kolbjørn S; Toft, Mathias; Dietrichs, Espen & Larsen, Jan Petter (2014). Progression and survival in Parkinson's disease with subthalamic nucleus stimulation. Acta Neurologica Scandinavica. ISSN 0001-6314. 130(5), p. 292–298. doi: 10.1111/ane.12224. Full text in Research Archive
• Bjørnarå, Kari Anne; Dietrichs, Espen & Toft, Mathias (2013). REM sleep behavior disorder in Parkinson's disease - Is there a gender difference? Parkinsonism & Related Disorders. ISSN 1353-8020. 19(1), p. 120–122. doi: 10.1016/j.parkreldis.2012.05.027. Full text in Research Archive
• Pihlstrøm, Lasse; Axelsson, Gunnar; Bjørnarå, Kari Anne; Dizdar, Nil; Fardell, Camilla & Forsgren, Lars [Show all 14 contributors for this article] (2013). Supportive evidence for 11 loci from genome-wide association studies in Parkinson's disease. Neurobiology of Aging. ISSN 0197-4580. 34(6). doi: 10.1016/j.neurobiolaging.2012.10.019. Full text in Research Archive
• Ferreira, JJ; Katzenschlager, R.; Bloem, BR; Bonuccelli, U.; Burn, D. & Deuschl, G [Show all 22 contributors for this article] (2013). Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson's disease. European Journal of Neurology. ISSN 1351-5101. 20(1), p. 5–15. doi: 10.1111/j.1468-1331.2012.03866.x. Full text in Research Archive
• Wedding, Iselin Marie; Koht, Jeanette; Dietrichs, Espen; Landrø, Nils Inge & Tallaksen, Chantal (2013). Cognition is only minimally impaired in Spinocerebellar ataxia type 14 (SCA14): a neuropsychological study of ten Norwegian subjects compared to intrafamilial controls and population norm. BMC Neurology. 13:186. doi: 10.1186/1471-2377-13-186. Full text in Research Archive Show summary

  Background: There is an increasing awareness of the role of the cerebellum not only in motor, but also in cognitive and emotional functions. Spinocerebellar ataxia type 14 (SCA14) is an autosomal dominant hereditary ataxia characterized by a relatively pure cerebellar phenotype. Cognitive impairment has been reported in studies with phenotype descriptions of SCA14, but previous studies have been small without control groups, and no homogeneous and systematic test panel has been used. The objective of this study was to thoroughly characterize the neuropsychological profile in ten Norwegian SCA14 subjects compared to unaffected family members and population norm data. Methods: Ten SCA14 subjects and ten intrafamilial unaffected age- and education-matched controls from two Norwegian families were included. The unaffected intrafamilial controls included six first degree relatives, two second degree relatives, and two spouses. General intellectual ability, memory, visuoperceptive skills, psychomotor speed, executive functions, depression and anxiety were examined using internationally standardized tests, with minimal need for manual response to avoid motor bias. Results: No significant cognitive deficit was found in SCA14 subjects compared to intrafamilial controls. Verbal IQ, verbal executive function and psychomotor speed tended to be reduced in affected subjects, but previously reported non-verbal executive dysfunction was not confirmed in this study. Conclusion: Only subtle cognitive impairment was found in SCA14 affected subjects. The current findings do not confirm earlier reports of cognitive dysfunction in SCA14, but does shows a mild impairment in specific verbal executive functions. Genotypic differences may partly account for this discrepancy, and further studies on larger materials are needed to verify the findings.

• Jørum, Ellen; Torbergsen, Torberg & Dietrichs, Espen (2013). Combined testing of autonomic and sensory dysfunction in patients with unilateral facial flushing and sweating during exercise. Neurophysiologie clinique. ISSN 0987-7053. 43(1), p. 1–10. doi: 10.1016/j.neucli.2012.09.090. Full text in Research Archive
• Elvsåshagen, Torbjørn; Moberget, Torgeir; Bøen, Erlend; Boye, Turid Birgitte; Englin, Nils Olof Andreas & Pedersen, Per Øystein Heiberg [Show all 10 contributors for this article] (2012). Evidence for Impaired Neocortical Synaptic Plasticity in Bipolar II Disorder. Biological Psychiatry. ISSN 0006-3223. 71(1), p. 68–74. doi: 10.1016/j.biopsych.2011.09.026. Full text in Research Archive
• Haines, Duane E. & Dietrichs, Espen (2012). The cerebellum - structure and connections. Handbook of Clinical Neurology. ISSN 0072-9752. 103, p. 3–36. doi: 10.1016/b978-0-444-51892-7.00001-2. Full text in Research Archive
• Skogseid, Inger Marie; Ramm-Pettersen, Jon-Terje; Volkmann, Jens; Kerty, Emilia; Dietrichs, Espen & Røste, Geir Ketil (2012). Good long-term efficacy of pallidal stimulation in cervical dystonia: a prospective, observer-blinded study. European Journal of Neurology. ISSN 1351-5101. 19(4), p. 610–615. doi: 10.1111/j.1468-1331.2011.03591.x. Full text in Research Archive
• Toft, Mathias & Dietrichs, Espen (2011). Aggravated stuttering following subthalamic deep brain stimulation in Parkinson's disease - two cases. BMC Neurology. 11. doi: 10.1186/1471-2377-11-44. Full text in Research Archive Show summary

  Stuttering is a speech disorder with disruption of verbal fluency which is occasionally present in patients with Parkinson's disease (PD). Long-term medical management of PD is frequently complicated by fluctuating motor functions and dyskinesias. High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment of motor fluctuations and is the most common surgical procedure in PD. Here we report the re-occurrence and aggravation of stuttering following STN-DBS in two male patients treated for advanced PD. In both patients the speech fluency improved considerably when the neurostimulator was turned off, indicating that stuttering aggravation was related to neurostimulation of the STN itself, its afferent or efferent projections and/or to structures localized in the immediate proximity. This report supports previous studies demonstrating that lesions of the basal ganglia-thalamocortical motor circuit, including the STN, is involved in the development of stuttering. In advanced PD STN-DBS is generally an effective and safe treatment. However, patients with PD and stuttering should be informed about the risk of aggravated symptoms following surgical therapy.

• Toft, Mathias; Lilleeng, Bård; Ramm-Pettersen, Jon-Terje; Skogseid, Inger Marie; Gundersen, Vidar & Gerdts, Reno [Show all 10 contributors for this article] (2011). Long-Term Efficacy and Mortality in Parkinson's Disease Patients Treated with Subthalamic Stimulation. Movement Disorders. ISSN 0885-3185. 26(10), p. 1931–1934. doi: 10.1002/mds.23817. Full text in Research Archive
• Bø, Siri M. Hylleraas; Davidsen, Eva Male; Saltyte-Benth, Jurate; Gulbrandsen, Pål & Dietrichs, Espen (2010). Cerebrospinal fluid opening pressure measurements in acute headache patients and in patients with either chronic or no pain. Acta Neurologica Scandinavica. ISSN 0001-6314. 122, p. 6–11. doi: 10.1111/j.1600-0404.2010.01368.x. Full text in Research Archive
• Bø, Siri M. Hylleraas; Davidsen, Eva Male; Saltyte-Benth, Jurate; Gulbrandsen, Pål & Dietrichs, Espen (2010). The usefulness of testing head and neck muscle tenderness and neck mobility in acute headache patients. Functional Neurology. ISSN 0393-5264. 25(1), p. 27–31. Full text in Research Archive
• Lundin, Anders; Dietrichs, Espen; Haghighi, S; Goller, Marie-Louise; Heiberg, Arvid & Loutfi, Ghada [Show all 14 contributors for this article] (2010). Efficacy and Safety of the Dopaminergic Stabilizer Pridopidine (ACR16) in Patients With Huntington's Disease. Clinical neuropharmacology. ISSN 0362-5664. 33(5), p. 260–264. doi: 10.1097/WNF.0b013e3181ebb285. Full text in Research Archive
• Bo, SH; Bø, Siri Hyllerås; Davidsen, EM; Gulbrandsen, P; Dietrichs, Espen & Bovim, Gunnar [Show all 8 contributors for this article] (2009). Cerebrospinal fluid cytokine levels in migraine, tension-type headache and cervicogenic headache. Cephalalgia. ISSN 0333-1024. 29(3), p. 365–372. doi: 10.1111/j.1468-2982.2008.01727.x. Full text in Research Archive
• Bø, Siri M. Hylleraas; Davidsen, EM; Gulbrandsen, Pål & Dietrichs, Espen (2008). Acute headache: a prospective diagnostic work-up of patients admitted to a general hospital. European Journal of Neurology. ISSN 1351-5101. 15(12), p. 1293–1299. doi: 10.1111/j.1468-1331.2008.02279.x. Full text in Research Archive
• Bø, Siri M. Hylleraas; Davidsen, Eva Male; Gulbrandsen, Pål; Dietrichs, Espen; Bovim, Gunnar & Stovner, Lars Jacob [Show all 7 contributors for this article] (2008). Cerebrospinal fluid cytokine levels in migraine, tension-type headache, and cervicogenic headache. Cephalalgia. ISSN 0333-1024. 29, p. 365–372. doi: 10.1111/j.1468-2982.2008.01727.x. Full text in Research Archive
• Lilleeng, B & Dietrichs, Espen (2008). Unmasking psychiatric symptoms after STN deep brain stimulation in Parkinson's disease. Acta Neurologica Scandinavica. ISSN 0001-6314. 117. Full text in Research Archive
• Larsen, Jan Petter; Beiske, Antonie Giæver; bekkelund, svein ivar; Bekkelund, Svein Ivar; Dietrichs, Espen & Tysnes, Ole-Bjørn [Show all 8 contributors for this article] (2008). Motoriske symptomer ved Parkinsons sykdom. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(18), p. 2068–2071. Full text in Research Archive
• Dietrichs, Espen & Stien, Ragnar (2008). Art, history and the creativity of the brain. In Dietrichs, Espen & Stien, Ragnar (Ed.), The Brain and the Arts. Koloritt. ISSN 9788292395646. p. 13–36. Full text in Research Archive
• Dietrichs, Espen (2008). What is a baguette? In Dietrichs, Espen & Stien, Ragnar (Ed.), The Brain and the Arts. Koloritt. ISSN 9788292395646. p. 239–240. Full text in Research Archive
• Dietrichs, Espen (2008). Dr. Magelssen and the weather. In Dietrichs, Espen & Stien, Ragnar (Ed.), The Brain and the Arts. Koloritt. ISSN 9788292395646. p. 265–276. Full text in Research Archive

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• Frich, Jan C; Brean, Are & Dietrichs, Espen (2024). Hjernen og mytene. Michael. ISBN 9788292871713. 216 p. Full text in Research Archive
• Schiøtz, Aina; Nylander, Gro; Lie, Anne Kveim; Fors, Egil Andreas; Skårderud, Finn & Godøy, Bjørn [Show all 17 contributors for this article] (2019). Blod og Bein.Lidelse, lindring og behandling i norsk medisinhistorie. Nasjonalbiblioteket. ISBN 9788279653868. 223 p. Full text in Research Archive
• Frich, Jan C; Brean, Are & Dietrichs, Espen (2018). Hjernen og historien. Michael. ISBN 9788292871843. 144 p. Full text in Research Archive
• Brean, Are; Frich, Jan C. & Dietrichs, Espen (2018). Hjernen og historien. Det norske medicinske Selskab. ISBN 9788292871843. 144 p. Full text in Research Archive
• Dietrichs, Espen (2015). Hva er hjernen. Universitetsforlaget. ISBN 9788215024417. 150 p. Full text in Research Archive
• Aquilonius, S-M; mouradian, MM; Dietrichs, Espen; steiner, ja; nissen, th & katzenschlager, r [Show all 15 contributors for this article] (2012). Parkinson's disease. Role of continuous dopaminergic stimulation. ESP Bioscience. ISBN 9780957140608. 255 p. Full text in Research Archive
• Dietrichs, Espen & Stien, Ragnar (2008). The Brain and the Arts. Koloritt. ISBN 9788292395646. 308 p. Full text in Research Archive

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• Frich, Jan C; Brean, Are & Dietrichs, Espen (2024). Forord. In Frich, Jan C; Brean, Are & Dietrichs, Espen (Ed.), Hjernen og mytene. Michael. ISSN 9788292871713. p. 8–8. doi: 10.5617/michael.11728. Full text in Research Archive
• Frich, Jan C; Dietrichs, Espen & Brean, Are (2024). Innledning. In Frich, Jan C; Brean, Are & Dietrichs, Espen (Ed.), Hjernen og mytene. Michael. ISSN 9788292871713. p. 9–17. doi: 10.5617/michael.11698. Full text in Research Archive
• Holm, Hedda; Gundersen, Vidar & Dietrichs, Espen (2023). Vaskulær parkinsonisme. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(7). doi: 10.4045/tidsskr.22.0539. Full text in Research Archive Show summary

  Parkinsonisme kan ha mange årsaker, inkludert cerebrovaskulær sykdom. Vaskulær parkinsonisme skyldes infarkt eller blødning i den nigrostriatale banen med påfølgende hemiparkinsonisme eller utbredt småkarsykdom i hvit substans med gradvis utvikling av bilaterale symptomer i underekstremitetene. Sammenlignet med Parkinsons sykdom har pasientene tidligere debut av gangforstyrrelser, hyppigere urininkontinens og kognitiv svikt og dårligere behandlingsrespons og prognose, men sjeldnere tremor. Vaskulær parkinsonisme er imidlertid en lite kjent og til dels omstridt diagnose grunnet uklar patofysiologi, varierende klinisk bilde og overlapp med andre sykdommer.

• Dietrichs, Erik Sveberg & Dietrichs, Espen (2023). Kan tortilla­lefser og øl laget av kongle­palmer føre til demens, parkinsonisme og ALS? Forskning.no. ISSN 1891-635X. Full text in Research Archive
• Dietrichs, Espen; Alves, Guido Werner; Benjaminsen, Espen; Johansen, Krisztina Kunszt & Tysnes, Ole-Bjørn (2023). E. Dietrichs og medarbeidere svarer. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(12). doi: 10.4045/tidsskr.23.0533. Full text in Research Archive
• Hurlen, Petter & Dietrichs, Espen (2023). Hva skal vi gjøre med koleraepidemien i Norge? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(13). doi: 10.4045/tidsskr.23.0511. Full text in Research Archive
• Dietrichs, Espen; Alves, Guido Werner; Benjaminsen, Espen; Johansen, Krisztina Kunszt & Tysnes, Ole-Bjørn (2023). Behandling av motoriske symptomer ved Parkinsons sykdom. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(7), p. 620–623. doi: 10.4045/tidsskr.22.0804. Full text in Research Archive Show summary

  Gjennom de siste årene har nye terapimuligheter og økt kunnskap om gamle metoder ført til endringer i vår behandling av Parkinsons sykdom. Likevel åpner alle tilgjengelige norske og utenlandske terapianbefalinger for ulike og ofte sidestilte alternativer. Basert på de evidensbaserte terapianbefalingene og på våre egne personlige erfaringer og oppfatninger presenterer vi i denne kliniske oversikten et forslag til fremgangsmåte for medisinsk behandling av motoriske symptomer ved Parkinsons sykdom.

• Dietrichs, Espen (2022). Verdens minste EEG-apparat. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(18). doi: 10.4045/tidsskr.22.0389. Full text in Research Archive
• Dietrichs, Espen (2022). STN-DBS in the 1950s? Carl Wilhelm Sem-Jacobsen's Missing Films Recovered. Movement Disorders. ISSN 0885-3185. doi: 10.1002/mds.29217. Full text in Research Archive
• Dietrichs, Espen (2022). Dyp hjernestimulering på 1950-tallet. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(11). doi: 10.4045/tidsskr.22.0121. Full text in Research Archive
• Dietrichs, Erik Sveberg & Dietrichs, Espen (2022). Time to replace the term neuroleptic malignant syndrome with antidopaminergic syndrome? The Lancet Psychiatry. ISSN 2215-0374. doi: 10.1016/S2215-0366(22)00108-0. Full text in Research Archive
• Dietrichs, Erik Sveberg & Dietrichs, Espen (2022). Antidopaminergt syndrom – ikke malignt nevroleptikasyndrom. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(14). doi: 10.4045/tidsskr.22.0415. Full text in Research Archive
• Dietrichs, Espen (2022). Carl Wilhelm Sem-Jacobsen. Neurology. ISSN 0028-3878. 98(5), p. 199–203. doi: 10.1212/WNL.0000000000013149. Full text in Research Archive
• Wold-Olsen, Per Ola & Dietrichs, Espen (2022). Bøddelen som bommet. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(18), p. 1–7. doi: 10.4045/tidsskr.22.0388. Full text in Research Archive
• Dietrichs, Espen; Brean, Are & Frich, Jan C (2018). Introduksjon - hjernen og historien. In Frich, Jan C; Brean, Are & Dietrichs, Espen (Ed.), Hjernen og historien. Michael. ISSN 9788292871843. p. 7–14. Full text in Research Archive
• Toft, Mathias & Dietrichs, Espen (2014). Medication costs following subthalamic nucleus deep brain stimulation for Parkinson's disease. Movement Disorders. ISSN 0885-3185. 29(2), p. 275–276. doi: 10.1002/mds.25504. Full text in Research Archive
• Dietrichs, Espen (2013). Ufullstendig oppdatering av det autonome nervesystemets "bibel". Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 133, p. 2529–2529. Full text in Research Archive
• Dietrichs, Espen (2012). Hva er årsaken til palatal tremor? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 132, p. 930–930. Full text in Research Archive
• Pihlstrøm, Lasse; Bjornara, KA; Dizdar, N; Fardell, C; Forsgren, L & Holmberg, B [Show all 12 contributors for this article] (2012). A Scandinavian multi-centre study replicates 11 susceptibility loci from genome-wide association studies in Parkinson's disease. European Journal of Neurology. ISSN 1351-5101. 19, p. 40–40. Full text in Research Archive
• Toft, Mathias & Dietrichs, Espen (2011). Levodopa-Responsive Parkinsonism in Probable Extrapontine Myelinolysis of the Mesencephalon. Movement Disorders. ISSN 0885-3185. 26(12), p. 2180–2181. doi: 10.1002/mds.23876. Full text in Research Archive
• Bø, Siri Hyleraas; Davidsen, E M; Gulbrandsen, P; Dietrichs, Espen; Bovim, Gunnar & Stovner, Lars Jacob [Show all 7 contributors for this article] (2009). Cytokiner hos hovedpine- og migrænepatienter. MigræneNytt. 2, p. 15–15. Full text in Research Archive
• Dietrichs, Espen (2008). Bevegelsesforstyrrelser - et samfunnsproblem. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(17), p. 1936–1936. Full text in Research Archive
• Solbakken, Gro; Ørstavik, Kristin; Frich, Jan C & Dietrichs, Espen (2021). Trunk Muscle Impairment and Pain in Myotonic Dystrophy type 1: Association to CTG size and Function. Universitetet i Oslo. Full text in Research Archive Show summary

  Myotonic Dystrophy 1 (DM1) is a progressive, hereditary neuromuscular disorder with multi-organ involvement. The genetic cause is an unstable CTG trinucleotide expansion in the DMPK gene at chromosome 19. Muscle involvement is expected to be distal in the extremities, the face and neck. Pain has not been described as part of the symptom complex. We investigated trunk muscle impairments, myopathy and pain in adult forms of DM1, and explored associations to function, CTG size and disease duration. In a cross-sectional design, 50 subjects with DM1 and 20 healthy age and gender-matched controls were included. Motor and psychological function, muscles and peripheral nerves were investigated. Clinical testing documented early and severe impairment in trunk muscles. An MRI study confirmed high degree of muscle fat infiltration and atrophy of trunk muscles. The clinical and radiological findings were significantly correlated to CTG size, disease duration, mobility, balance and respiration. We found high frequency of chronic pain (84%), most frequent locations were the lower back, neck and palmar side of the hands. Significant higher pain intensity and more pain locations was documented in women compared to men. In a sub study neuropathic pain was the probable mechanism in 15 %. Overall, pain was related to CTG size, quality of life, fatigue and respiration. In adult subjects with DM1, clinical impairment of trunk muscle function and objective findings of myopathy were clearly documented in our studies. These findings were related to motor function and CTG size. Pain was frequently reported, and gender differences significant. These findings suggest that follow up programs should include regularly assessment of trunk muscle function and pain in DM1. Whether trunk muscle impairment can be prevented or limited by exercise could be an important topic for a clinical intervention study. Pain studies accounting for gender differences should be conducted.

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