{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T09:26:01Z","timestamp":1786785961443,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Orthostatic tremor (OT) and orthostatic myoclonus (OM) are rare hyperkinetic disorders characterized by unsteadiness during stance. Substantial clinical overlap limits the prognostic and therapeutic value of categorical diagnostic labels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess whether a multidomain disease burden framework provides more meaningful stratification than traditional OT\/OM diagnoses and to identify phenotypic subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional analysis of 58 patients with OT\/OM who underwent multidomain assessment. A composite Disease Burden Score (DBS) was derived from five domains: symptom severity, functional limitation, comorbidity burden, medication exposure, and fall risk. Patients were classified into high\u2010 and low\u2010burden groups. Predictors of high disease burden were evaluated using Firth logistic regression and random forest classifiers. Latent class analysis (LCA) identified subgroups, and concordance between DBS strata and latent classes was assessed. Exploratory k\u2010means and hierarchical clustering were performed for validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DBS stratification distinguished high\u2010 and low\u2010burden patients with strong accuracy (AUC\u2009=\u20090.96). All five domains contributed to burden classification, although individual regression coefficients were imprecise. LCA identified four subgroups: low\u2010burden, functionally impaired, comorbidity\u2010dominant, and globally burdened. These subgroups did not align with OT\/OM diagnostic categories. Concordance between LCA classes and DBS strata was weak (Cramer's\n                      <jats:italic>V<\/jats:italic>\n                      \u2009=\u20090.176). Demographic variables and SF\u201036 quality\u2010of\u2010life domains did not differ across latent classes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multidomain clinical data enable disease\u2010burden stratification and reveal phenotypic heterogeneity in orthostatic movement disorders. Limited correspondence with traditional diagnoses supports a spectrum\u2010based model. DBS and LCA offer complementary frameworks for individualized assessment, warranting validation in larger and longitudinal cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70563","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:29:40Z","timestamp":1771396180000},"page":"1876-1885","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Heterogeneity in Orthostatic Movement Disorders: Insights from Latent Class Analysis and Disease Burden Scoring"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-1835","authenticated-orcid":false,"given":"Anish","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Neurology, Ramaiah Medical College and Hospitals Ramaiah University of Applied Sciences  Bengaluru India"},{"name":"Department of Research Placeboes Research Foundation  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thyagarajan","family":"Shivashanmugam","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Placeboes Research Foundation  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6575-424X","authenticated-orcid":false,"given":"Michiko K.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Parkinson's and Movement Disorder Center, The Queen's Medical Center University of Hawai\u02bbi  Honolulu Hawaii USA"},{"name":"John A. Burns School of Medicine University of Hawaii  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis C.S.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramod Kumar","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Neurology National Institute of Mental Health and Neurosciences  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.05.006"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880161117"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5334\/tohm.325"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000260225.46732.af"},{"key":"e_1_2_10_6_1","article-title":"Slow orthostatic tremor: review of the current evidence","volume":"9","author":"Hassan A","year":"2019","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12917"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20132"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.03.013"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002328"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2018.06.014"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27121"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.1184"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.12.014"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007037"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2022.01.004"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx118"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2961"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.98725","article-title":"Connectome\u2010based attractor dynamics underlie brain activity in rest, task, and disease","volume":"13","author":"Englert R","year":"2024","journal-title":"elife"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.729677"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2024.0004"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70563","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70563","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T08:35:56Z","timestamp":1786782956000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/mdc3.70563"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70563","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"assertion":[{"value":"2025-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}