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Movement disorders: what lies beneath?
  1. Matthew C Kiernan
  1. Correspondence to Professor Matthew C Kiernan, Editor-in-Chief of JNNP, Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW 2031, Australia; m.kiernan{at}

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The term extrapyramidal has been ascribed to the founding editor of JNNP, Samuel A Kinnier Wilson (figure 1),1 to incorporate all efferent mechanisms involved in the control of movement, apart from the pyramidal tract. As an alternative lay approach, Wilson would group these regions together in what he referred to as the ‘dark basement of the brain’.

Figure 1

SA Kinnier Wilson, the Marco Polo of extrapyramidal exploration.

From this seemingly limited early concept of movement and the role of the brain, Wilson set about trying to understand how the various components of motor control came together. His knowledge of neuroanatomy, combined with neurophysiology doctrine acquired from Charles Sherrington, led his acolyte Macdonald Critchley to refer to Wilson as the Marco Polo of the extrapyramidal system.2 To draw parallels between the foremost neurologist of his time and the renowned Venetian explorer makes sense. According to Critchley, the undiscovered vagaries of neurological presentations sparked for Wilson ‘a multitude of questions. Why? Why? Always probing, questioning, speculating. [Wilson] was a seeker; an investigator of startling originality. To him, everything in neurology was a cornucopia of wonder and fascination.'

With this heritage of discovery, JNNP has borne witness to the tremendous progress in modern understanding of movement disorders over the past century. Indeed, the journal has been far more than a witness, rather a keen participant, having published many of the original and now landmark studies. Some of this treasured past is illustrated in the present issue, where Andrew Lees outlines the complexities involved in determining a pathological understanding of Parkinson's disease to aid differentiation from apparently related syndromes.3 These innovative clinico-pathological studies through the Queen Square Brain Bank led in turn to improved diagnostic accuracy in clinical practice. The strength of these groundbreaking studies has been further emphasised by citation counts, now well into the thousands, for the resultant publications.4 ,5 Reinforcement may also be derived from the fact that these studies continue to be heavily cited, as reflected by the citation half-life of JNNP, the highest of any journal across the clinical neurosciences.

The journal's history in the development of understanding movement disorders and clinical treatments is long and distinguished; from publishing landmark manuscripts, through to the sustained and ongoing presence of international authorities on our Editorial Advisory Boards. Furthermore, a former Editor of JNNP, David Marsden, was the first to declare Kinnier Wilson as the father of basal ganglia research.

Perhaps then, JNNP has been that most loyal conduit of dissemination, from the origins of a movement disorders entity, through metamorphosis to a known state and into current understanding.6–8 As such, it seems timely for JNNP to launch a special issue covering the widespread progress across all territories of movement disorders through the realms of clinical neuroscience: the combined approaches of neurology, neuropsychiatry and neurosurgery.


Supplementary materials

  • JNNP editors Matthew Kiernan, Nick Ward, and Alan Carson discuss the past, present and future of movement disorders in the JNNP podcast.

    Listen to the podcast


  • Provenance and peer review Commissioned; internally peer reviewed.