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Lee JY, Ma HI, Ferreira JJ, Rocha JF, Sung YH, Song IU, Ahn TB, Kwon DY, Cheon SM, Kim JM, Lee CS, Lee PH, Park JH, Lee JH, Park MY, Kim SJ, Baik JS, Choi SM, Shin HW, Lee HW, Kang SY, Jeon B. Opicapone to Treat Early Wearing-off in Parkinson's Disease Patients: The Korean ADOPTION Trial. Mov Disord Clin Pract 2024. [PMID: 38594812 DOI: 10.1002/mdc3.14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/06/2024] [Accepted: 03/17/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Increasing levodopa (L-dopa)/dopa decarboxylase inhibitor (DDCI) daily dose or adding a catechol-O-methyltransferase (COMT) inhibitor to levodopa/DDCI therapy are strategies used to manage wearing-off symptoms in Parkinson's disease (PD) patients. OBJECTIVES To evaluate the COMT inhibitor opicapone versus an additional dose of levodopa to treat early wearing-off in PD patients. METHODS ADOPTION was a randomized, parallel-group, open-label, Phase 4 study conducted in Korea. At baseline, eligible patients were randomized (1:1) to opicapone 50 mg (n = 87) or L-dopa 100 mg (n = 81) (added to current L-dopa/DDCI therapy) for 4 weeks. The main efficacy endpoint was change from baseline to end of study in absolute off time. Other endpoints included changes in on time, in Movement Disorder Society-Unified Parkinson's Disease Rating Scale and 8-item PD Questionnaire scores, and the Clinical and Patient Global Impression of Improvement/Change. RESULTS The adjusted mean in absolute off time was significantly greater for opicapone 50 mg than for L-dopa 100 mg (-62.1 vs. -16.7 minutes; P = 0.0015). Opicapone-treated patients also reported a greater reduction in the percentage of off time (P = 0.0015), a greater increase in absolute on time (P = 0.0338) and a greater increase in the percentage of on time (P = 0.0015). There were no significant differences in other secondary endpoints. The L-dopa equivalent daily dose was significantly higher in the opicapone group (750.9 vs. 690.0 mg; P = 0.0247), when a 0.5 conversion factor is applied. CONCLUSIONS Opicapone 50 mg was more effective than an additional 100 mg L-dopa dose at decreasing off time in patients with PD and early wearing-off.
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Affiliation(s)
- Jee-Young Lee
- Department of Neurology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Joaquim J Ferreira
- IMM - Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- CNS - Campus Neurológico, Torres Vedras, Portugal
| | | | | | - In-Uk Song
- The Catholic University of Korea Incheon St. Mary's Hospital, Incheon, Korea
| | - Tae-Beom Ahn
- Kyung Hee University Medical Center, Seoul, Korea
| | | | | | - Jong-Min Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
| | | | | | - Jeong-Ho Park
- Soon Chun Hyang University Hospital Bucheon, Bucheon, Korea
| | - Jae-Hyeok Lee
- Pusan National University Yangsan Hospital, Yangsan, Korea
| | | | - Sang Jin Kim
- Inje University Busan Paik Hospital, Busan, Korea
| | | | - Seong-Min Choi
- Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | | | - Ho-Won Lee
- Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Suk Yun Kang
- Dongtan Sacred Heart Hospital Hallym University College of Medicine, Hwaseong, Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
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Park J, Oh ES, Koh SB, Song IU, Ahn TB, Kim SJ, Cheon SM, Kim YJ, Cho JW, Ma HI, Park MY, Baik JS, Lee PH, Chung SJ, Kim JM, Kim HJ, Sung YH, Kwon DY, Lee JH, Lee JY, Kim JS, Yun JY, Kim HJ, Hong JY, Kim MJ, Youn J, Kim JS, Yang HJ, Yoon WT, You S, Kwon KY, Lee SY, Kim Y, Kim HT, Kim JS, Kim JY. Evaluating the validity and reliability of the Korean version of Scales for Outcomes in Parkinson's Disease-Cognition. J Mov Disord 2024:jmd.24061. [PMID: 38566308 DOI: 10.14802/jmd.24061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/02/2024] [Indexed: 04/04/2024] Open
Abstract
Objective The Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog) was developed to screen for cognition in PD. In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPA-cog. Methods We recruited 129 PD patients from 31 clinics with movement disorders in South Korea. The original version of the SCOPA-cognition was translated into Korean using the translation-retranslation method. The test-rest method with an intraclass correlation coefficient (ICC) and Cronbach's alpha coefficient were used to assess reliability. The Spearman's Rank correlation analysis with Montreal Cognitive Assessment-Korean version (MOCA-K) and Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity. Results The Cronbach's alpha coefficient was 0.797, and the ICC was 0.887. Spearman's rank correlation analysis showed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively). Conclusions Our results demonstrate that K-SCOPA-Cog exhibits good reliability and validity.
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Affiliation(s)
- Jinse Park
- Department of Neurology, Heundae Paik Hospital, Inje University
| | - Eung Seok Oh
- Depratment of Neurology, Chungnam National University, School of Medicine, Choungnam University Hospital
| | | | - In-Uk Song
- Department of Neurology, College of Medicine, The Catholic University of Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine
| | | | | | - Jin Whan Cho
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine
| | - Mee-Young Park
- Department of Neurology, Yeungnam University College of Medicine
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine
| | - Sun Ju Chung
- Department of Neurology, Parkinson/Alzheimer Center, Asan Medical Center, University of Ulsan College of Medicine
| | - Jong-Min Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine
| | - Young-Hee Sung
- Department of Neurology, College of Medicine, Gachon University
| | - Do Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine
| | - Jae-Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, College of Medicine, Seoul National University
| | | | - Ji Young Yun
- Department of Neurology, Ewha Womans University School of Medicine, Ewha Womans University Seoul Hospital
| | | | - Jin Young Hong
- Department of Neurology, Yonsei University Wonju College of Medicine
| | - Mi-Jung Kim
- Department of Neurology, Bobath Memorial Hospital
| | - Jinyoung Youn
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Ji Seon Kim
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine
| | - Hui-Jun Yang
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Sooyeoun You
- Department of Neurology, Keimyung University School of Medicine
| | - Kyum-Yil Kwon
- Department of Neurology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine
| | | | - Younsoo Kim
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Hee-Tae Kim
- Department of Neurology, Hanyang University College of Medicine
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea
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Thi Lai T, Kim YE, Nguyen LTN, Thi Nguyen T, Kwak IH, Richter F, Kim YJ, Ma HI. Microglial inhibition alleviates alpha-synuclein propagation and neurodegeneration in Parkinson's disease mouse model. NPJ Parkinsons Dis 2024; 10:32. [PMID: 38302446 PMCID: PMC10834509 DOI: 10.1038/s41531-024-00640-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
The accumulation of alpha-synuclein (αSyn) is widely recognized as the main pathological process in Parkinson's disease (PD). Additionally, neuroinflammation is considered to be one of the contributing mechanisms in the development of PD. In light of this, it is hypothesized that the reactive microglia exacerbate the propagation of αSyn and neurodegeneration, while the inhibition of microglial activity may mitigate these effects. To test this hypothesis, αSyn preformed fibrils (PFF)-injected PD mouse model was employed. Co-injection of lipopolysaccharide (LPS) and PFF was performed to investigate if microglial reactivity intensified αSyn propagation and neurodegeneration. Additionally, oral administration of PLX5622, a microglial inhibitor that targets the colony-stimulating factor 1 receptor, was given for two weeks before and after PFF injection each to explore if microglial inhibition could prevent or reduce αSyn pathology. Intrastriatal co-injection of LPS and PFF resulted in increased microglial reactivity, αSyn accumulation, and neurodegeneration compared to PFF injection alone. However, treatment with PLX5622 significantly suppressed microglial reactivity, reduced αSyn pathology, and alleviated dopaminergic neuron degeneration in the PD mouse model injected with PFF. Based on these findings, it is evident that microglial reactivity plays a crucial role in the progression of αSyn pathology and neurodegeneration in PD. Furthermore, the results suggest that microglial inhibition may hold promise as a therapeutic strategy to delay the progression of αSyn pathology in PD.
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Affiliation(s)
- Thuy Thi Lai
- Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, 30559, Hannover, Germany
- Center for Systems Neuroscience Hannover, Hannover, Germany
| | - Young Eun Kim
- Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea.
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea.
| | - Linh Thi Nhat Nguyen
- Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Tinh Thi Nguyen
- Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - In Hee Kwak
- Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Franziska Richter
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, 30559, Hannover, Germany
- Center for Systems Neuroscience Hannover, Hannover, Germany
| | - Yun Joong Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi, South Korea
| | - Hyeo-Il Ma
- Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
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Nguyen HD, Kim YE, Nhat Nguyen LT, Kwak IH, Lee YK, Kim YJ, Hai Nguyen TT, Pham HN, Ma HI. Upregulation of immunoproteasome PSMB8 is associated with Parkinson's disease. Parkinsonism Relat Disord 2023; 114:105797. [PMID: 37562243 DOI: 10.1016/j.parkreldis.2023.105797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Immunoproteasome, a part of ubiquitin-proteasome system, is involved in immune response as well as protein degradation. However, the relationship between immunoproteasome and Parkinson's disease (PD) was not evaluated clearly. We hypothesized that the shift of immunoproteasome attributes to PD pathogenesis due to its role in inflammation and protein homeostasis. OBJECTIVE To determine whether immunoproteasome in peripheral blood mononuclear cells (PBMC) and brain is expressed differently between patients with PD and healthy controls (HC). METHODS Blood samples were collected from 19 HC to 40 patients with PD of comparable ages. Peripheral blood mononuclear cells were isolated and followed by RT-qPCR to measure the mRNA levels of three catalytic subunits of immunoproteasome, namely, PSMB8, PSMB9, and PSMB10. Then, the protein levels of each subunit were measured by western blot. Finally, we confirmed the altered immunoproteasome subunit in the post-mortem human brain of PD. RESULTS In PBMCs, PSMB8 mRNA expression of PD group significantly increased compared to HC (p = 0.004), whereas PSMB9 and PSMB10 mRNA were not different between the PD and HC. The ratio of PSMB10 and PSMB8 mRNA (PSMB10/8 ratio) also reflected the significant difference between the PD and HC (p = 0.002). The PSMB10/8 ratio was well correlated with the UPDRS total and Part III score in the early stage of PD (Hoehn and Yahr ≤2.5) or drug-naïve PD subgroups. In terms of the protein level of immunoproteasome subunits in PBMCs, the increase of PSMB8 protein was observed in PD compared to HC (p = 0.0009), while PSMB9 and PSMB10 were not different between groups. Finally, we confirmed that immunoproteasome PSMB8 was expressed abundantly in the postmortem PD brain compared with normal control. CONCLUSION Our novel findings implicate that immunoproteasome PSMB8 is engaged in PD pathomechanism.
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Affiliation(s)
- Huu Dat Nguyen
- Department of Medical Sciences, Graduate School of Hallym University, Chuncheon, Gangwon, 24252, South Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea; Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea.
| | - Linh Thi Nhat Nguyen
- Department of Medical Sciences, Graduate School of Hallym University, Chuncheon, Gangwon, 24252, South Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - In Hee Kwak
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea; Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Yoon Kyoung Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi, South Korea
| | - Thanh Thi Hai Nguyen
- Department of Medical Sciences, Graduate School of Hallym University, Chuncheon, Gangwon, 24252, South Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Hong Ngoc Pham
- Department of Medical Sciences, Graduate School of Hallym University, Chuncheon, Gangwon, 24252, South Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Gyeonggi, 14068, South Korea; Hallym Neurological Institute, Hallym University, Anyang, Gyeonggi, 14068, South Korea
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Kwak IH, Lee YK, Ma HI, Lee S, Yun M, Kim YJ, Hwang HS, Kim YE. Striatal Subregion Analysis Associated with REM Sleep Behavior Disorder in Parkinson's Disease. J Integr Neurosci 2023; 22:18. [PMID: 36722243 DOI: 10.31083/j.jin2201018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND PURPOSE REM sleep behavior disorder (RBD) in Parkinson's disease (PD) is associated with characteristic clinical subtypes and prognosis. In addition, nigrostriatal pathway, the most vulnerable anatomical area in PD, formed neuronal network interplaying with cortical and subcortical structures, and which may cause PD clinical phenotype. We evaluated the regional selectivity of presynaptic striatal dopaminergic denervation associated with RBD in PD. METHODS We compared two groups (n = 16) of PD patients with and without RBD in terms of specific binding ratios (SBR) in subregions of the striatum, which were measured using positron emission tomography with 18F-FP-CIT. SBRs of the anterior and posterior caudate, ventral striatum, and posterior and ventral putamen regions were measured in more or less affected side, and right or left side, or bilateral sum of the striatum. RESULTS Age, disease duration, and severity of parkinsonism were not significantly different between groups. Although group differences in all areas were not significant with multiple comparison corrections, SBR of the ventral striatum and anterior caudate in sum of both sides was significantly less in the RBD than in the non-RBD group without correction (p < 0.05). In the right anterior caudate and left ventral striatum, SBR was also lower in the RBD than in the non-RBD group without correction (p < 0.05). Attention function was impaired in the RBD group compared with the non-RBD group (p < 0.05). However, these statistical significances were not definite after correction of multiple comparisons (p > 0.05). CONCLUSIONS There is a possibility that RBD in early PD may be associated with presynaptic dopaminergic denervation in the ventral striatum and anterior caudate, which may explain decreased attention in our RBD group. RBD in PD may imply a distinct pathological progression. However, further study using large numbers of participants or longitudinal observation is necessary for the statistical conclusion because of small sample size.
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Affiliation(s)
- In-Hee Kwak
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 14068 Anyang, Republic of Korea.,Hallym Neurological Institute, Hallym University, 24263 Chuncheon, Republic of Korea
| | - Yun Kyoung Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 14068 Anyang, Republic of Korea.,Hallym Neurological Institute, Hallym University, 24263 Chuncheon, Republic of Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 14068 Anyang, Republic of Korea.,Hallym Neurological Institute, Hallym University, 24263 Chuncheon, Republic of Korea
| | - Sangwon Lee
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 03722 Seoul, Republic of Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 03722 Seoul, Republic of Korea
| | - Yun Joong Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, 16995 Yongin, Republic of Korea
| | - Hee Sung Hwang
- Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 14068 Anyang, Republic of Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 14068 Anyang, Republic of Korea.,Hallym Neurological Institute, Hallym University, 24263 Chuncheon, Republic of Korea
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Nguyen TT, Kim YJ, Lai TT, Nguyen PT, Koh YH, Nguyen LTN, Ma HI, Kim YE. PTEN-Induced Putative Kinase 1 Dysfunction Accelerates Synucleinopathy. J Parkinsons Dis 2022; 12:1201-1217. [PMID: 35253778 PMCID: PMC9198758 DOI: 10.3233/jpd-213065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Mutations in PTEN-induced putative kinase 1 (PINK1) cause autosomal recessive Parkinson’s disease (PD) and contribute to the risk of sporadic PD. However, the relationship between PD-related PINK1 mutations and alpha-synuclein (α-syn) aggregation—a main pathological component of PD—remains unexplored. Objective: To investigate whether α-syn pathology is exacerbated in the absence of PINK1 after α-syn preformed fibril (PFF) injection in a PD mouse model and its effects on neurodegeneration. Methods: In this study, 10-week-old Pink1 knockout (KO) and wildtype (WT) mice received stereotaxic unilateral striatal injection of recombinant mouse α-syn PFF. Then, α-syn pathology progression, inflammatory responses, and neurodegeneration were analyzed via immunohistochemistry, western blot analysis, and behavioral testing. Results: After PFF injection, the total α-syn levels significantly increased, and pathological α-syn was markedly aggregated in Pink1 KO mice compared with Pink1 WT mice. Then, earlier and more severe neuronal loss and motor deficits occurred. Moreover, compared with WT mice, Pink1 KO mice had evident microglial/astrocytic immunoreactivity and prolonged astrocytic activation, and a higher rate of protein phosphatase 2A phosphorylation, which might explain the greater α-syn aggravation and neuronal death. Conclusion: The loss of Pink1 function accelerated α-syn aggregation, accumulation and glial activation, thereby leading to early and significant neurodegeneration and behavioral impairment in the PD mouse model. Therefore, our findings support the notion that PINK1 dysfunction increases the risk of synucleinopathy.
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Affiliation(s)
- Tinh Thi Nguyen
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Thuy Thi Lai
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, South Korea
| | - Phuong Thi Nguyen
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Ilsong Institute of Life Science, Hallym University, Seoul, South Korea
| | - Young Ho Koh
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Ilsong Institute of Life Science, Hallym University, Seoul, South Korea
| | - Linh Thi Nhat Nguyen
- Department of Medical Sciences, Graduate School of Hallym University, Chuncheon, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, South Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, South Korea
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Kwak IH, Kim NH, Ma HI, Kim YE. Huntington's Disease Presenting as Adult-Onset Parkinsonism. J Clin Neurol 2022; 18:87-89. [PMID: 35021281 PMCID: PMC8762510 DOI: 10.3988/jcn.2022.18.1.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- In Hee Kwak
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Na Hee Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
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Lai TT, Kim YJ, Nguyen PT, Koh YH, Nguyen TT, Ma HI, Kim YE. Temporal Evolution of Inflammation and Neurodegeneration With Alpha-Synuclein Propagation in Parkinson's Disease Mouse Model. Front Integr Neurosci 2021; 15:715190. [PMID: 34675786 PMCID: PMC8523784 DOI: 10.3389/fnint.2021.715190] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/01/2021] [Indexed: 12/30/2022] Open
Abstract
According to a few studies, α-synuclein (αSyn) propagation has been suggested to play a key role in the pathomechanism of Parkinson's disease (PD), but neurodegeneration and the involvement of inflammation in its pathologic progression are not well understood with regard to temporal relationship. In this study, with the help of the PD mouse model injected with intrastriatal αSyn preformed fibril (PFF), the temporal evolution of αSyn propagation, inflammation, and neurodegeneration was explored in the perspective of the striatum and the whole brain. In the PFF-injected striatum, inflammatory response cells, including microglia and astrocytes, were activated at the earliest stage and reduced with time, and the phosphorylated form of αSyn accumulation increased behind it. Afterward, the degeneration of striatal dopaminergic neurons became significant with the conspicuity of behavioral phenotype. Similar patterns of forefront eruption of inflammation and then followed by αSyn propagation were noted in the opposite striatum, which were not injured by PFF injection. In analyzing the whole brain, inflammatory responses were activated at the earliest stage, and the soluble αSyn expression increased concurrently. The inflammatory response decreased afterward, and the accumulation of the insoluble form of αSyn increased behind it. Our results suggested that the inflammatory response may precede the accumulation of the pathologic form of αSyn; thereafter, the neurodegeneration and motor dysfunction followed αSyn proliferation in the PD mouse model. From this model, recognizing the temporal relationship between inflammation, αSyn propagation, and neurodegeneration may be helpful in establishing the PD animal model and monitoring the effect of interventional therapy.
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Affiliation(s)
- Thuy Thi Lai
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, Anyang, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Phuong Thi Nguyen
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Ilsong Institute of Life Science, Hallym University, Anyang, South Korea
| | - Young Ho Koh
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Ilsong Institute of Life Science, Hallym University, Anyang, South Korea
| | - Tinh Thi Nguyen
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, South Korea.,Ilsong Institute of Life Science, Hallym University, Anyang, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, Anyang, South Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea.,Hallym Neurological Institute, Hallym University, Anyang, South Korea
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9
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Abstract
Background Although Idiopathic Parkinson’s disease (IPD) develops in considerable patients with drug-induced Parkinsonism (DIP), the association hasn’t been well defined. We aimed to evaluate the underlying association and risk factors of DIP and IPD. Methods A retrospective cohort study using National Health Insurance Claims data in 2011–2016 was conducted. New-onset DIP patients in 2012 were selected and matched with active controls having diabetes mellitus at a 1:4 ratio by age, sex, and Charlson’s Comorbidity Index score. Comorbidity, causative drugs, and prescription days were evaluated as covariates. Results A total of 441 DIP were selected. During the 4-year follow up, 14 IPD events in the DM group but 62 events in the DIP group were observed (adjusted hazard ratio, HR: 18.88, 95% CI, 9.09–39.22, adjusting for comorbidities and causative drugs). IPD diagnosis in DIP was observed high in males compared to females (15.58/13.24%). The event was the most within the 1st year follow-up, mean days 453 (SD 413.36). Subgroup analysis in DIP showed calcium channel blocker (verapamil, diltiazem, and flunarizine) was significantly associated with increased IPD risk (HR: 2.24, 95% CI, 1.27–3.93). Conclusion Increased IPD in DIP patients might not be from the causal toxicity of antidopaminergic effects but from a trigger by the causative drugs on the DIP patients who already had subclinical IPD pathology. DIP can serve as a strong proxy for IPD incidence. Subjects who develop DIP should be monitored carefully for potential IPD incidence.
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Affiliation(s)
- Sohyun Jeong
- Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, Massachusetts, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Hyemin Cho
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Yun Joong Kim
- Department of Neurology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin-si, Gyeonggi-do, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Gyeonggi-do, Korea
- * E-mail: (HM); (SJ)
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
- * E-mail: (HM); (SJ)
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10
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Kim YE, Kim YJ, Hwang HS, Ma HI. REM sleep behavior disorder in early Parkinson's disease predicts the rapid dopaminergic denervation. Parkinsonism Relat Disord 2020; 80:120-126. [PMID: 32987358 DOI: 10.1016/j.parkreldis.2020.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To test the hypothesis that REM sleep behavior disorder (RBD) in early Parkinson's disease (PD) predicts rapid progression of dopaminergic denervation. METHODS 123I-FP-CIT single photon emission computed tomography (SPECT) scans were performed sequentially at baseline, 1 year, 2 years, and 4 years in 416 de novo patients with PD. RBD screening questionnaire scores >5 at baseline placed the participant in the likely-RBD group. Temporal changes in the specific binding ratio (SBR; caudate, putamen. sum of both, striatum) were compared between the likely-RBD and the non-likely-RBD groups for more or less affected striatum with a repeated measure ANOVA. RESULTS Likely-RBD was reported in 37.7% of the drug-naïve PD patients at baseline. The likely-RBD and non-likely-RBD groups did not have significant differences in the baseline clinical features including gender, age, disease duration, UPDRS motor score, and striatal SBR. Striatal SBR decreased significantly over four years in both groups (P < .001). In the analysis of a more affected striatum, striatal SBR decreased significantly faster in the likely-RBD group than in the non-likely-RBD group (P < .05 for all), whereas it was not statistically significant for the less affected striatum. The mean striatal SBR value (mean value of both striata), especially the caudate SBR, indicated greater acceleration of denervation in the likely-RBD group than in the non-likely-RBD group over time (P < .05). CONCLUSION Likely-RBD in PD predicts accelerating dopaminergic denervation, thereby implicating it as a marker for a poor prognosis or distinctive subtype in PD.
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Affiliation(s)
- Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea; Hallym Neurological Institute, Hallym University, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yongin Yonsei University Hospital, Yonsei University, South Korea
| | - Hee Sung Hwang
- Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea; Hallym Neurological Institute, Hallym University, South Korea.
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11
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Choi JH, Lee JY, Jeon B, Koh SB, Yoon WT, Lee HW, Kwon OD, Kim JW, Kim JM, Ma HI, Kim HT, Baik JS, Cho JW. Neuropsychiatric Traits Associated with Refractory Impulse Control Disorder in Parkinson's Disease. NEURODEGENER DIS 2020; 19:171-177. [PMID: 32454490 DOI: 10.1159/000507447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/20/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Impulse control disorder (ICD) in Parkinson's disease (PD) is a critical nonmotor symptom with personality or neuropsychiatric traits contributing to ICD. OBJECTIVE This study aimed to identify predictive traits for persistent or paradoxical aggravation of ICD after dopamine agonist substitution therapy for ICD in PD. METHODS We conducted a case-control study using a database of a multicenter intervention trial for ICD in PD. The poor-outcome group was defined by showing paradoxical increases in ICD behaviors after the substitution of dopamine agonists with levodopa. We analyzed the pre-intervention personality traits associated with the poor outcome and also evaluated the risk traits for refractory ICD using a receiver-operating characteristic (ROC) curve analysis. RESULTS The poor-outcome group showed higher levels of anger expression (p =0.007) and obsessive-compulsive traits (p =0.009) compared with the good-outcome group at the pre-intervention state. In the ROC curve analysis, the Obsessive-Compulsive Inventory showed the highest area under the curve with 80.0% sensitivity and 74.3% specificity in discriminating against the poor-outcome group. CONCLUSIONS Our results suggest that assessment of obsessive compulsiveness may be useful for predicting the refractoriness of ICD behaviors in planning an interventional treatment for ICD in PD.
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Affiliation(s)
- Ji-Hyun Choi
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea,
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ho-Won Lee
- Department of Neurology, School of Medicine, Kyungpook National University, and Brain Science and Engineering Institute, Kyungpook National University, Daegu, Republic of Korea
| | - Oh Dae Kwon
- Department of Neurology, Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - Jae Woo Kim
- Department of Neurology, Dong-A University Hospital, Pusan, Republic of Korea
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Hospital, Anyang, Republic of Korea
| | - Hee Tae Kim
- Department of Neurology, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Jong Sam Baik
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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12
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An S, Ma HI, Song J, Choi HM, Kim YE. Stress cardiomyopathy associated with area postrema syndrome as a presentation of neuromyelitis optica: case report. BMC Neurol 2020; 20:201. [PMID: 32438902 PMCID: PMC7240979 DOI: 10.1186/s12883-020-01784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/13/2020] [Indexed: 11/22/2022] Open
Abstract
Background Stress cardiomyopathy (Takotsubo cardiomyopathy) is very rare in the central nervous system (CNS) demyelinating disorders. Although this dysfunction of the heart-brain axis has been reported in several case series related to multiple sclerosis (MS), stress cardiomyopathy by neuromyelitis optica (NMO), which is rarer CNS demyelinating disorder than MS, is extremely rare. Herein, we report a case of stress cardiomyopathy associated with a medullary lesion as a presentation of NMO. Case presentation A 30-year-old woman was treated by veno-arterial extracorporeal membrane oxygenation due to catastrophic cardiopulmonary dysfunction after prolonged and unexplained nausea, vomiting, and cough. Myoclonus on the limbs developed afterward. Taken with suspicion of area postrema syndrome (APS), the brain MRI showed a demyelinating lesion in the medulla oblongata. APS and severe heart failure by stress cardiomyopathy were completely resolved by ECMO and hydrocortisone therapy. However, the CNS demyelinating lesion recurred after 1 month. The patient was diagnosed with NMO evident by the presence of aquaporin-4 antibody; Steroid therapy improved her symptoms. Conclusion NMO should be considered as one of the differential diagnoses in patients with APS preceding severe cardiopulmonary distress.
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Affiliation(s)
- Sungsik An
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.,Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.,Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Jooyeon Song
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.,Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Hong-Mi Choi
- Department of Cardiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea. .,Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea.
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13
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Baik JS, Ma HI, Lee PH, Taira T. Focal Task-Specific Lower Limb Dystonia Only When Walking Stairs: Is It a New Disease Entity? Front Neurol 2019; 10:1081. [PMID: 31749753 PMCID: PMC6842934 DOI: 10.3389/fneur.2019.01081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/25/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction: Focal task-specific dystonia in the lower limb or foot often occurs only during walking, running, hiking, or cycling. Several medications and botulinum toxin injection are effective in patients with this disorder. The objective of this study was to understand the spectrum of focal task-specific dystonia in the lower limb only when walking stairs and to compare other types of task-specific dystonia. Methods: All original articles and case reports were collected and reviewed using PubMed. In addition, all video clips of published cases were evaluated, and patients' clinical findings analyzed. The present study included 12 patients described in previous studies and five new Asian patients found in the medical records. Results: Most of the patients were women, and the onset age was 42 years. Ten patients were classified as the Kicking type, including three patients with the rKicking type, and six patients were considered as the Lifting type; however, only one patient was not included in any of the types. Symptoms in most of the patients did not improve with any medications or botulinum toxin injection. The symptoms of most patients did not change over a long time. Conclusion: Most patients showed the dystonic symptom when walking downstairs rather than upstairs. Psychogenic dystonia is a disease differentially diagnosed with this dystonia. Unlike other types of focal task-specific dystonia, the response to treatment was disappointing because most of the medications and botulinum toxin injection were not effective. The prognosis is completely different from that of other types of focal task-specific dystonia.
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Affiliation(s)
- Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Hospital, Anyang, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Takaomi Taira
- Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan
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14
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Lee JY, Jeon B, Koh SB, Yoon WT, Lee HW, Kwon OD, Kim JW, Kim JM, Ma HI, Kim HT, Baik JS, Cho J. Behavioural and trait changes in parkinsonian patients with impulse control disorder after switching from dopamine agonist to levodopa therapy: results of REIN-PD trial. J Neurol Neurosurg Psychiatry 2019; 90:30-37. [PMID: 30361296 DOI: 10.1136/jnnp-2018-318942] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 09/06/2018] [Accepted: 09/23/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In this multicentre open-label trial, we compared behavioural and neuropsychiatric symptoms in Parkinson's disease (PD) patients with impulse control disorders (ICD) treated with dopamine agonists before and 12 weeks after substituting dopamine agonists with an equivalent dose of levodopa/carbidopa slow-release formulation. METHODS Baseline characteristics of 50 PD patients with ICD were compared with those of 60 medicated and 40 drug-naive PD control groups. Neuropsychiatric trait changes in the PD-ICD group were investigated 12 weeks after the intervention. ICD behaviours were assessed via modified Minnesota Impulsive Disorders Interview (mMIDI), whereas parkinsonian severity and neuropsychiatric characters were systematically assessed with the Unified PD Rating Scale (UPDRS) and a predefined neuropsychological assessment battery. RESULTS At baseline, ICD patients showed higher scores in the Neuropsychiatric Inventory and anxiety, anger and obsessive-compulsive traits compared with both PD control groups. In contrast, the three PD groups showed indifference in the impulsivity scales. At 12 weeks post intervention, ICD behaviours significantly improved (p<0.001, Δ modified MIDI score=‒5.27 ± 5.75) along with the UPDRS II daily activity scores (p=0.02, Δ=‒2.07 ± 4.53). Behavioural disinhibition tended to improve (p=0.06), although no significant changes were observed in the Neuropsychiatric Inventory and personality trait scores. Dopamine agonist withdrawal syndrome developed in 5.3% of the PD-ICD group. CONCLUSIONS This study provides class IV evidence suggesting that switching from dopamine agonists to levodopa/carbidopa slow-release formulations alleviated ICD behaviours in PD patients leading to improvement in daily activities whereas neuropsychiatric traits associated with ICD persisted after the 12-week therapy. TRIAL REGISTRATION NUMBER NCT01683253.
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Affiliation(s)
- Jee-Young Lee
- Department of Neurology, Seoul National University Boramae Hospital, Seoul, South Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Seoul, South Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ho-Won Lee
- Department of Neurology, School of Medicine, Kyungpook National University, and Brain Science and Engineering Institute, Kyungpook National University, Daegu, South Korea
| | - Oh Dae Kwon
- Department of Neurology, Daegu Catholic University Medical Center, Daegu, South Korea
| | - Jae Woo Kim
- Department of Neurology, Dong-A University Hospital, Pusan, South Korea
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Hospital, Anyang, South Korea
| | - Hee-Tae Kim
- Department of Neurology, Hanyang University Medical Center, Seoul, South Korea
| | - Jong Sam Baik
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Jinwhan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, and Neuroscience Center, Samsung Medical Center, Seoul, South Korea
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15
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Baik JS, Kim JS, Koh SB, Cho JW, Lee PH, Ma HI, Kim YJ, Ahn TB, Kim SJ, Kim YD, Choi SM, Lee HW, Kim HT. Patients and Their Caregivers' Burdens for Parkinson's Disease in Korea. J Mov Disord 2017; 10:109-115. [PMID: 28950688 PMCID: PMC5615179 DOI: 10.14802/jmd.17053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 08/17/2017] [Accepted: 08/22/2017] [Indexed: 11/24/2022] Open
Abstract
Objective Many patients with Parkinson’s disease (PD) suffer from motor and non-motor symptoms. According to these variable symptoms of PD, patients or caregivers have a poorer quality of life than patients with other neurodegenerative diseases. Since the difficulties are varied for all patients, prioritizing their difficulties differs among all cases. The goal of this study was to investigate the burdens of PD among the caregivers as well as patients and to identify areas requiring aid from the government. Methods We surveyed the awareness and perceptions of PD in patients and caregivers of PD by a face-to-face questionnaire. The questionnaire was divided into three sections: symptoms of PD (part A), desire for policies (part B), and difficulties faced by their caregivers (part C). Part A comprised 8 questions, Part B had 2 questions, and Part C had 3 questions. Results In total, 853 subjects (702 patients and 151 caregivers) were enrolled in this study. The major difficulties experienced by PD patients were physical (67%), psychiatric (60%) and socio-economic (52%). Assessing the physical difficulties, more than half the patients experienced severe difficulties (29% very severe, 39% severe). Psychiatric difficulties were assessed as severe (35%) and very severe (21%) among the patients. Severe difficulties were also experienced socio-economically, at 52% in patients and 49% in caregivers, especially among patients in their fifties (58%) and those with their spouse (65%) as caregivers. The topmost need was the introduction of new technology for treatment of PD (62%), followed by relief of costs for treatment (38%) and a family support system (31%). The majority (91%) of the patients were diagnosed with PD within two years after onset of symptoms. Conclusion We know that the difficulties of PD and the needs for government assistance are different between patients and caregivers. These results emphasize that perceiving the difficulties and needs of patients and caregivers early can help to prevent and ameliorate the burden of disease.
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Affiliation(s)
- Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jin Whan Cho
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yong Duk Kim
- Department of Neurology, Konyang University College of Medicine, Daejeon, Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University College of Medicine, Gwangju, Korea
| | - Ho-Won Lee
- Department of Neurology, Kyungpook National University College of Medicine, Daegu, Korea
| | - Hee Tae Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
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16
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Kim MK, Kim NY, Hong S, Ma HI, Kim YJ. Presynaptic Dopaminergic Degeneration in a Patient with Beta-Propeller Protein-Associated Neurodegeneration Documented by Dopamine Transporter Positron Emission Tomography Images: A Case Report. J Mov Disord 2017; 10:161-163. [PMID: 28889720 PMCID: PMC5615175 DOI: 10.14802/jmd.17044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 07/26/2017] [Accepted: 08/10/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Min Ki Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Korea
| | - Sangkyoon Hong
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.,Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Korea.,ILSONG Institute of Life Science, Hallym University, Anyang, Korea
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17
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Lee HC, Kim YE, Ma HI. Metronidazole-Induced Craniocervical Myoclonus with Reversible Bilateral Dentate Nucleus Lesions. J Mov Disord 2017; 10:67-68. [PMID: 28122422 PMCID: PMC5288659 DOI: 10.14802/jmd.16021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/04/2016] [Accepted: 10/11/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hyun Chang Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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18
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Kim JY, Song IU, Koh SB, Ahn TB, Kim SJ, Cheon SM, Cho JW, Kim YJ, Ma HI, Park MY, Baik JS, Lee PH, Chung SJ, Kim JM, Kim HJ, Sung YH, Kwon DY, Lee JH, Lee JY, Kim JS, Yun JY, Kim HJ, Hong JY, Kim MJ, Youn J, Kim JS, Oh ES, Yang HJ, Yoon WT, You S, Kwon KY, Park HE, Lee SY, Kim Y, Kim HT, Kim JS. Validation of the Korean Version of the Scale for Outcomes in Parkinson's Disease-Autonomic. J Mov Disord 2017; 10:29-34. [PMID: 28122431 PMCID: PMC5288668 DOI: 10.14802/jmd.16057] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/07/2016] [Indexed: 01/10/2023] Open
Abstract
Objective Autonomic symptoms are commonly observed in patients with Parkinson’s disease (PD) and often limit the activities of daily living. The Scale for Outcomes in Parkinson’s disease-Autonomic (SCOPA-AUT) was developed to evaluate and quantify autonomic symptoms in PD. The goal of this study was to translate the original SCOPA-AUT, which was written in English, into Korean and to evaluate its reliability and validity for Korean PD patients.
Methods
For the translation, the following processes were performed: forward translation, backward translation, expert review, pretest of the pre-final version and development of the final Korean version of SCOPA-AUT (K-SCOPA-AUT). In total, 127 patients with PD from 31 movement disorder clinics of university-affiliated hospitals in Korea were enrolled in this study. All patients were assessed using the K-SCOPA-AUT and other motor, non-motor, and quality of life scores. Test-retest reliability for the K-SCOPA-AUT was assessed over a time interval of 10−14 days.
Results
The internal consistency and reliability of the K-SCOPA-AUT was 0.727 as measured by the mean Cronbach’s α-coefficient. The test-retest correlation reliability was 0.859 by the Guttman split-half coefficient. The total K-SCOPA-AUT score showed a positive correlation with other non-motor symptoms [the Korean version of non-motor symptom scale (K-NMSS)], activities of daily living (Unified Parkinson’s Disease Rating Scale part II) and quality of life [the Korean version of Parkinson’s Disease Quality of Life 39 (K-PDQ39)].
Conclusion
The K-SCOPA-AUT had good reliability and validity for the assessment of autonomic dysfunction in Korean PD patients. Autonomic symptom severities were associated with many other motor and non-motor impairments and influenced quality of life.
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Affiliation(s)
- Ji-Young Kim
- Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - In-Uk Song
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang-Myung Cheon
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Jin Whan Cho
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Mee-Young Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, Parkinson/Alzheimer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Min Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Hee Sung
- Department of Neurology, College of Medicine, Gachon University, Incheon, Korea
| | - Do Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae-Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, College of Medicine, Seoul National University, Seoul, Korea
| | - Ji Sun Kim
- Department of Neurology, Chungbuk National University School of Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Konkuk University Medical Center, Seoul, Korea
| | - Jin Young Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi-Jung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.,Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea
| | - Jinyoung Youn
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Seon Kim
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Eung Seok Oh
- Department of Neurology, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hui-Jun Yang
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sooyeoun You
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Kyum-Yil Kwon
- Department of Neurology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, Korea
| | - Hyung-Eun Park
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Su-Yun Lee
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Younsoo Kim
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee-Tae Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Song IU, Lee JE, Kwon DY, Park JH, Ma HI. Parkinson's disease might increase the risk of cerebral ischemic lesions. Int J Med Sci 2017; 14:319-322. [PMID: 28553163 PMCID: PMC5436473 DOI: 10.7150/ijms.18025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/14/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disease in the elderly. Cerebrovascular diseases such as cerebral ischemic lesion (CIL) also commonly occur in elderly adults. However, previous studies on the relationship between PD and cerebrovascular disease have not found consistent results. Therefore, we conducted this study to evaluate whether or not PD is related to an increased prevalence of ischemic cerebrovascular lesions. METHODS This study recruited 241 patients with PD and 112 healthy controls (HCs). All subjects underwent brain magnetic resonance imaging and general neuropsychological tests. The motor severity of PD was evaluated according to the Hoehn and Yahr stage (HY stage), and the severity of CIL in all subjects was classified according to Fazekas grade. The PD patients were classified into two subgroups according to HY stage (Group 1 - HY 1, 2; Group 2 - HY 3 to 5). RESULTS Among all PD patients, 76% had small vessel disease, while 44% of all HCs had small vessel disease (p<0.001). Regarding the difference between the two subgroups according to motor severity, group 2 showed significantly higher Fazekas scale score and more severe CIL, indicating a higher prevalence of small vessel disease compared to group 1. CONCLUSION This study demonstrates that PD patients have a significantly higher prevalence of CIL compared to HCs. Therefore, although the present study is not a large-scale study, we cautiously suggest that PD can play an important role as a risk factor in the occurrence of ischemic cerebrovascular disease.
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Affiliation(s)
- In-Uk Song
- Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Ji-Eun Lee
- Department of Neurology, National Health, Insurance Corporation Ilsan Hospital, Ilsan, South Korea
| | - Do-Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University, Ansan, South Korea
| | - Jeong-Ho Park
- Department of Neurology, College of Medicine, Soonchunhyang University, Seoul, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, College of Medicine, Hallym University, Anyang, South Korea
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20
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Hong JH, Kim YK, Park JS, Lee JE, Oh MS, Chung EJ, Kim JY, Sung YH, Lyoo CH, Lee JH, Kwon DY, Kim HS, Shin HW, Park SA, Park IS, Kim JS, Lee PH, Koh SB, Baik JS, Kim SJ, Ma HI, Kim JW, Kim YJ. Lack of association between LRRK2 G2385R and cognitive dysfunction in Korean patients with Parkinson's disease. J Clin Neurosci 2016; 36:108-113. [PMID: 27839916 DOI: 10.1016/j.jocn.2016.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/15/2016] [Indexed: 01/22/2023]
Abstract
Aside from the glucocerebrosidase gene, the genetic risk factors for cognitive decline in Parkinson's disease (PD) are controversial. We investigated whether the G2385R polymorphism in leucine-rich repeat kinase 2 gene (LRRK2), a risk variant for the development of PD in East Asians, is associated with cognitive dysfunction in PD. We recruited 299 PD patients, consisting of 23 carriers and 276 non-carriers of LRRK2 G2385R, from 14 centers. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA). PD with cognitive dysfunction was defined as an MMSE Z score that, adjusting for age at study entry and years of education, was below -1.0 standard deviations. In multivariate analysis, PD duration, age at study entry and depression were significant risk factors for cognitive dysfunction as assessed by MMSE performance or the MoCA. In linear regression analysis of the association between MMSE Z scores and PD duration, there was no significant difference associated with the LRRK2 G2385R genotype. The interaction terms between PD duration and the LRRK2 G2385R genotype were not significant for the MMSE Z score but were significant for the MoCA. In conclusion, the LRRK2 G2385R genotype may not be associated with cognitive dysfunction in PD.
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Affiliation(s)
- Jeong Hoon Hong
- ILSONG Institute of Life Science, Hallym University, Anyang, South Korea
| | - Yue Kyung Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Jae Seol Park
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Ji Eun Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Ilsan, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Eun Joo Chung
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jeong-Yeon Kim
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Young-Hee Sung
- Department of Neurology, Gachon University College of Medicine, Incheon, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Do-Young Kwon
- Department of Neurology, Korea University College of Medicine, Ansan Hospital, Ansan, South Korea
| | - Hyun Sook Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Hae-Won Shin
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sun Ah Park
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - In-Seok Park
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University College of Medicine at Guro Hospital, Seoul, South Korea
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Jae Woo Kim
- Department of Neurology, Dong-A University School of Medicine, Busan, South Korea
| | - Yun Joong Kim
- ILSONG Institute of Life Science, Hallym University, Anyang, South Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea; Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang, South Korea.
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21
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Lee CY, Kang SJ, Hong SK, Ma HI, Lee U, Kim YJ. A Validation Study of a Smartphone-Based Finger Tapping Application for Quantitative Assessment of Bradykinesia in Parkinson's Disease. PLoS One 2016; 11:e0158852. [PMID: 27467066 PMCID: PMC4965104 DOI: 10.1371/journal.pone.0158852] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 05/23/2016] [Indexed: 11/19/2022] Open
Abstract
Background Most studies of smartphone-based assessments of motor symptoms in Parkinson’s disease (PD) focused on gait, tremor or speech. Studies evaluating bradykinesia using wearable sensors are limited by a small cohort size and study design. We developed an application named smartphone tapper (SmT) to determine its applicability for clinical purposes and compared SmT parameters to current standard methods in a larger cohort. Methods A total of 57 PD patients and 87 controls examined with motor UPDRS underwent timed tapping tests (TT) using SmT and mechanical tappers (MeT) according to CAPSIT-PD. Subjects were asked to alternately tap each side of two rectangles with an index finger at maximum speed for ten seconds. Kinematic measurements were compared between the two groups. Results The mean number of correct tapping (MCoT), mean total distance of finger movement (T-Dist), mean inter-tap distance, and mean inter-tap dwelling time (IT-DwT) were significantly different between PD patients and controls. MCoT, as assessed using SmT, significantly correlated with motor UPDRS scores, bradykinesia subscores and MCoT using MeT. Multivariate analysis using the SmT parameters, such as T-Dist or IT-DwT, as predictive variables and age and gender as covariates demonstrated that PD patients were discriminated from controls. ROC curve analysis of a regression model demonstrated that the AUC for T-Dist was 0.92 (95% CI 0.88–0.96). Conclusion Our results suggest that a smartphone tapping application is comparable to conventional methods for the assessment of motor dysfunction in PD and may be useful in clinical practice.
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Affiliation(s)
- Chae Young Lee
- Department of Neurology, Hallym University Sacred Heart hospital, Hallym University College of Medicine, Hallym University, Anyang, Korea
| | - Seong Jun Kang
- Department of Electronic Engineering, Hallym University, Chuncheon, Korea
| | - Sang-Kyoon Hong
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart hospital, Hallym University College of Medicine, Hallym University, Anyang, Korea
- * E-mail: (HIM); (UL); (YJK)
| | - Unjoo Lee
- Department of Electronic Engineering, Hallym University, Chuncheon, Korea
- * E-mail: (HIM); (UL); (YJK)
| | - Yun Joong Kim
- Department of Neurology, Hallym University Sacred Heart hospital, Hallym University College of Medicine, Hallym University, Anyang, Korea
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Medical Center, Anyang, Korea
- ILSONG Institute of Life Science, Hallym University, Anyang, Korea
- * E-mail: (HIM); (UL); (YJK)
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Kim YE, Kang SY, Ma HI, Ju YS, Kim YJ. A Visual Rating Scale for the Hummingbird Sign with Adjustable Diagnostic Validity. J Parkinsons Dis 2016; 5:605-12. [PMID: 26406141 DOI: 10.3233/jpd-150537] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although the hummingbird sign (HBS) is a distinctive feature of progressive supranuclear palsy (PSP) VS. idiopathic Parkinson's disease (IPD) and other parkinsonian disorders, there are no consensus criteria for its identification. OBJECTIVE To develop consensus criteria for the HBS to enable accurate communication between researchers and physicians, we developed a new radiologic rating scale for the HBS (the HBS-RS), and the inter-rater reliability (IRR) and diagnostic validity of the HBS-RS were evaluated. METHODS Two raters blinded to the clinical diagnoses reviewed T1 midsagittal magnetic resonance images of 133 patients with IPD (n = 93) or PSP (n = 40). The existence of the HBS was assessed in two steps that were separated by two weeks; the first was based on their own experience and the second was according to the HBS-RS. The HBS-RS comprises 4 items (contour of the third ventricle floor, shape of the beak, shape of the hummingbird head, and midbrain atrophy), with weighted scores from 0 to 2. RESULTS The IRR of individual items in the HBS-RS and of the composite scores showed moderate-to-good agreement (Cohen's kappa [κ], 0.479-0.766) and were observed to be highest for the contour of the third ventricle floor. The sensitivities and specificities varied depending on the cut-off for each item or for the composite scores. The sensitivities for each item were high (85.0-92.5) at a low cut-off (0 VS. 1 or 2). The specificities reached more than 80% when the composite scores of the HBS-RS were used. Receiver operating characteristic curves for the total HBS-RS scores showed fair diagnostic accuracy for PSP (AUC, 0.76 and 0.73). CONCLUSIONS The HBS-RS is a simple and measurable visual assessment tool to identify the HBS, with adjustable diagnostic validity for PSP. The results suggest that the HBS-RS may be used for objective measurements of the HBS in research and in the clinic.
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Affiliation(s)
- Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Suk Yun Kang
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hallym
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Young-Su Ju
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.,ILSONG Institute of Life Science, Hallym University, Anyang, Republic of Korea.,Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang, Republic of Korea
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23
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Kang SY, Ma HI. N30 Somatosensory Evoked Potential Is Negatively Correlated with Motor Function in Parkinson's Disease. J Mov Disord 2016; 9:35-9. [PMID: 26828214 PMCID: PMC4734986 DOI: 10.14802/jmd.15038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 11/15/2015] [Accepted: 12/14/2015] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this study was to investigate frontal N30 status in Parkinson’s disease (PD) and to examine the correlation between the amplitude of frontal N30 and the severity of motor deficits. Methods The frontal N30 was compared between 17 PD patients and 18 healthy volunteers. Correlations between the amplitude of frontal N30 and the Unified Parkinson’s Disease Rating Scale (UPDRS) motor score of the more severely affected side was examined. Results The mean latency of the N30 was not significantly different between patients and healthy volunteers (p = 0.981), but the mean amplitude was lower in PD patients (p < 0.025). There was a significant negative correlation between the amplitude of N30 and the UPDRS motor score (r = -0.715, p = 0.013). Conclusions The frontal N30 status indicates the motor severity of PD. It can be a useful biomarker reflecting dopaminergic deficits and an objective measurement for monitoring the clinical severity of PD.
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Affiliation(s)
- Suk Yun Kang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Abstract
The use of prokinetics/antiemetics is one of the leading causes of drug-induced parkinsonism (DIP) observed in neurology clinics. Cognitive dysfunction in DIP has recently been recognized, but pathologies related with cognitive dysfunction is unknown. Among our retrospective cohort of 385 consecutive parkinsonian patients enrolled in our parkinsonism registry, 14 patients were identified who satisfied our inclusion criteria: parkinsonism caused by prokinetics/antiemetics, existing T1-weighted 3D volumetric MR images, and normal [(18)F]-N-3-fluoropropyl-2-β-carboxymethoxy-3-β-(4-iodophenyl) nortropane PET scan images. For the comparison of volumetric MR data, 30 age- and sex-matched healthy individuals were included in this study. Among 14 patients with DIP, 4 patients were diagnosed with dementia, and all other patients had mild cognitive impairment (MCI). Comparisons of MR volumetric data between DIP patients with MCI and controls show that cortical gray matter volumes are reduced bilaterally in DIP (P=0.041) without changes in either total white matter volume or total intracranial volume. Among subcortical structures, the volume of the right hippocampus is reduced in DIP patients compared with controls (P=0.011, uncorrected). In DIP, cortical thickness is reduced in the bilateral lingual (P=0.002), right fusiform (P=0.032) and part of the left lateral occipital gyri (P=0.007). Our results suggests that cognitive dysfunction in DIP caused by prokinetics/antiemetics is common. Structural changes in the brain by 3D MRI may be associated with cognitive decline in DIP.
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Affiliation(s)
- Hyun Jung Ahn
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Anyang, Korea
| | - Woo-Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Anyang, Korea
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University College of Medicine, Anyang, Korea
| | - Jaeseol Park
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
- ILSONG Institute of Life Science, Hallym University College of Medicine, Anyang, Korea
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University College of Medicine, Anyang, Korea
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25
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Kim HS, Lyoo CH, Lee PH, Kim SJ, Park MY, Ma HI, Lee JH, Song SK, Baik JS, Kim JH, Lee MS. Current Status of Huntington's Disease in Korea: A Nationwide Survey and National Registry Analysis. J Mov Disord 2015; 8:14-20. [PMID: 25614781 PMCID: PMC4298714 DOI: 10.14802/jmd.14038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 12/19/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Huntington's disease (HD) is a rare neurological disorder, and its current status in Korea is not well investigated. This study aims to determine the prevalence and incidence of HD and to investigate the clinical features of HD patients in Korea. METHODS We estimated the crude prevalence and annual incidence of HD based on the databases of the Rare Diseases Registry (RDR) and the National Health Insurance (NHI). The clinical data of genetically confirmed HD patients was collected from 10 referral hospitals and analyzed. RESULTS The mean calculated annual incidence was 0.06 cases per 100,000 persons, and the mean calculated prevalence was 0.38 based on the NHI database. The estimated crude prevalence based on the RDR was 0.41. Of the sixty-eight HD patients recruited, the mean age of onset was 44.16 ± 14.08 years and chorea was most frequently reported as the initial symptom and chief complaint. The mean CAG repeat number of the expanded allele was 44.7 ± 4.8 and correlated inversely with the age of onset (p < 0.001). About two-thirds of the patients have a positive family history, and HD patients without positive family history showed a delay in onset of initial symptoms, a prolonged interval between initial symptom onset and genetic diagnosis and a delay in the age of genetic diagnosis. CONCLUSIONS To the best of our knowledge, this is the first study to estimate the prevalence and incidence of HD in Korea and the largest HD series in the Asian population. Our analyses might be useful for further studies and large-scale investigations in HD patients.
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Affiliation(s)
- Hyun Sook Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology and Brain Research Institute, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sook Kun Song
- Department of Neurology, Jeju National University Hospital, Jeju, Korea
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jin Ho Kim
- Department of Neurology, Chosun University School of Medicine, Gwangju, Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Chu MK, Kim WC, Choi JM, Hong JH, Kang SY, Ma HI, Kim YJ. Erratum: Analysis of Dosage Mutation in PARK2among Korean Patients with Early-Onset or Familial Parkinson's Disease. J Clin Neurol 2015; 11:107. [PMID: 25628044 PMCID: PMC4302174 DOI: 10.3988/jcn.2015.11.1.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Min Kyung Chu
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Won Chan Kim
- Department of Neurology, CHA University College of Medicine, Pocheon, Korea
| | - Jung Mi Choi
- Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Jeong-Hoon Hong
- Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Suk Yun Kang
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Yun Joong Kim
- Ilsong Institute of Life Science, Hallym University, Anyang, Korea
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang, Korea
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Lee HJ, Kim ES, Kim M, Chu H, Ma HI, Lee JS, Koo JW, Kim HJ, Hong SK. Isolated horizontal positional nystagmus from a posterior fossa lesion. Ann Neurol 2014; 76:905-10. [PMID: 25362860 DOI: 10.1002/ana.24292] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 09/29/2014] [Accepted: 10/05/2014] [Indexed: 11/09/2022]
Abstract
Isolated vertigo with horizontal positional nystagmus as an impending sign of a central lesion has rarely been reported. Here we present neuro-otologic findings of patients with these clinical signs. Lesion overlays from 6 patients with ageotropic positional nystagmus revealed that the nodulus and vermis are common areas of injury. In contrast, 2 patients with geotropic positional nystagmus had cerebellar peduncle and lateral medullary lesions. These clinical findings suggest that vertigo with horizontal positional nystagmus, even in the absence of other initial neurological signs, may indicate a posterior fossa lesion, including that in the nodulus, vermis, and deep cerebellar structures.
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Chu MK, Kim WC, Choi JM, Hong JH, Kang SY, Ma HI, Kim YJ. Analysis of Dosage Mutation in PARK2 among Korean Patients with Early-Onset or Familial Parkinson's Disease. J Clin Neurol 2014; 10:244-8. [PMID: 25045378 PMCID: PMC4101102 DOI: 10.3988/jcn.2014.10.3.244] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 03/30/2014] [Accepted: 04/10/2014] [Indexed: 01/27/2023] Open
Abstract
Background and Purpose There is some controversy regarding heterozygous mutations of the gene encoding parkin (PARK2) as risk factors for Parkinson's disease (PD), and all previous studies have been performed in non-Asian populations. Dosage mutation of PARK2, rather than a point mutation or small insertion/deletion mutation, was reported to be a risk factor for familial PD; dosage mutation of PARK2 is common in Asian populations. Methods We performed a gene-dosage analysis of PARK2 using real-time polymerase chain reaction for 189 patients with early-onset PD or familial PD, and 191 control individuals. In the case of PD patients with heterozygous gene-dosage mutation, we performed a sequencing analysis to exclude compound heterozygous mutations. The association between heterozygous mutation of PARK2 and PD was tested. Results We identified 22 PD patients with PARK2 mutations (11.6%). Five patients (2.6%) had compound heterozygous mutations, and 13 patients (6.9%) had a heterozygous mutation. The phase could not be determined in one patient. Three small sequence variations were found in 30 mutated alleles (10.0%). Gene-dosage mutation accounted for 90% of all of the mutations found. The frequency of a heterozygous PARK2 gene-dosage mutation was higher in PD patients than in the controls. Conclusions Heterozygous gene-dosage mutation of PARK2 is a genetic risk factor for patients with early-onset or familial PD in Koreans.
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Affiliation(s)
- Min Kyung Chu
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Won Chan Kim
- Department of Neurology, CHA University College of Medicine, Pocheon, Korea
| | - Jung Mi Choi
- Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Jeong-Hoon Hong
- Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Suk Yun Kang
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea. ; Ilsong Institute of Life Science, Hallym University, Anyang, Korea. ; Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang, Korea
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Affiliation(s)
- Dong-Won Lee
- From Hallym University Sacred Heart Hospital (D.-W.L., S.-W.E., H.-I.M., Y.J.K.), Hallym University College of Medicine, Anyang; and Sangmoo Hospital (C.O.M.), Gwangju, Korea
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Abstract
OBJECTIVES Fatigue is common in Parkinson's disease (PD), causing serious negative effects on quality of life. Despite its clinical importance, the nature of fatigue in PD is poorly understood because its underlying neurobiology is unknown. Fatigue can be more complicated in advanced PD because of its chronicity. In order to find features that are innate to fatigue in PD, it would be useful to conduct a study looking at de novo PD. Assessing fatigue in de novo patients allows excluding at least one confounding factor. METHODS We prospectively investigated 87 drug-naïve PD patients. Thirty-nine patients (44.8%) were found to have fatigue around the time of diagnosis of PD. RESULTS We found that depression and difficulties with activities of daily living were independent risk factors for fatigue; however, motor dysfunction was not related. Clinically meaningful responses to dopaminergic medication were observed. DISCUSSION Our study determined that fatigue occurs in the early stages of PD. It can inform clinical decision-making to significantly benefit PD patients with fatigue.
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Affiliation(s)
- Suk Yun Kang
- Department of Neurology, Hallym University College of Medicine Seoul, Seoul, Republic of Korea. sukyunkang @ hanmail.net
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Kwon DY, Kim JW, Ma HI, Ahn TB, Cho J, Lee PH, Chung SJ, Kim JS, Baik JS, Koh SB. Translation and validation of the korean version of the 39-item Parkinson's disease questionnaire. J Clin Neurol 2013; 9:26-31. [PMID: 23346157 PMCID: PMC3543906 DOI: 10.3988/jcn.2013.9.1.26] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 06/08/2012] [Accepted: 06/08/2012] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose The importance of health-related quality of life (HrQoL) has been increasingly emphasized when assessing and providing treatment to patients with chronic, progressive, degenerative disorders. The 39-item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient-reporting scale to assess HrQoL in Parkinson's disease (PD). This study evaluated the validity and reliability of the translated Korean version of the PDQ-39 (K-PDQ-39). Methods One hundred and two participants with PD from 10 movement disorder clinics at university-affiliated hospitals in South Korea completed the K-PDQ-39. All of the participants were also tested using the Unified Parkinson's Disease Rating Scale (UPDRS), Korean version of the Mini-Mental State Examination (K-MMSE), Korean version of the Montgomery-Asberg Depression Scale (K-MADS), Epworth Sleepiness Scale (ESS) and non-motor symptoms scale (NMSS). Retests of the K-PDQ-39 were performed over time intervals from 10 to 14 days in order to assess test-retest reliability. Results Each K-PDQ-39 domain showed correlations with the summary index scores (rS=0.559-0.793, p<0.001). Six out of eight domains met the acceptable standard of reliability (Cronbach's α coefficient ≥0.70). The Guttman split-half coefficient value of the K-PDQ-39 summary index, which is an indicator of test-retest reliability, was 0.919 (p<0.001). All of the clinical variables examined except for age, comprising disease duration, levodopa equivalent dose, modified Hoehn and Yahr stage (H&Y stage), UPDRS part I, II and III, mood status (K-MADS), cognition (K-MMSE), daytime sleepiness (ESS) and (NMSS) showed strong correlations with the K-PDQ-39 summary index (p<0.01). Conclusions The K-PDQ-39 has been validated for use in the Korean-speaking PD population. The questionnaire is a valid and reliable assessment tool for assessing the HrQoL of Korean PD patients.
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Affiliation(s)
- Do-Young Kwon
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
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Koh SB, Kim JW, Ma HI, Ahn TB, Cho JW, Lee PH, Chung SJ, Kim JS, Kwon DY, Baik JS. Validation of the korean-version of the nonmotor symptoms scale for Parkinson's disease. J Clin Neurol 2012; 8:276-83. [PMID: 23323136 PMCID: PMC3540287 DOI: 10.3988/jcn.2012.8.4.276] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 04/16/2012] [Accepted: 04/16/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE Non-motor symptoms are common in Parkinson's disease (PD), and are the primary cause of disability in many PD patients. Our aim in this study was to translate the origin non-motor symptoms scale for PD (NMSS), which was written in English, into Korean (K-NMSS), and to evaluate its reliability and validity for use with Korean-speaking patients with PD. METHODS In total, 102 patients with PD from 9 movement disorders sections of university teaching hospitals in Korea were enrolled in this study. They were assessed using the K-NMSS, the Unified Parkinson's Disease Rating Scale (UPDRS), the Korean version of the Mini-Mental Status Examination (K-MMSE), the Korean version of the Montgomery-Asberg Depression Rating Scale (K-MADS), the Epworth Sleepiness Scale (ESS), and Parkinson's Disease Questionnaire 39 (PDQ39). Test-retest reliability was assessed over a time interval of 10-14 days in all but one patient. RESULTS The K-NMSS was administered to 102 patients with PD. The internal consistency and reliability of this tool was 0.742 (mean Cronbach's α-coefficient). The test-retest correlation reliability was 0.941 (Guttman split-half coefficient). There was a moderate correlation between the total K-NMSS score and the scores for UPDRS part I [Spearman's rank correlation coefficient, (rS)=0.521, p<0.001] and UPDRS part II (rS=0.464, p=0.001), but there was only a weak correlation between the total K-NMSS score and the UPDRS part III score (rS=0.288, p=0.003). The total K-NMSS score was significantly correlated with the K-MADS (rS=0.594, p<0.001), K-MMSE (rS=-0.291, p=0.003), and ESS (rS=0.348, p<0.001). The total K-NMSS score was also significantly and positively correlated with the PDQ39 score (rS=0.814, p<0.001). CONCLUSIONS The K-NMSS exhibited good reliability and validity for the assessment of non-motor symptoms in Korean PD patients.
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Affiliation(s)
- Seong-Beom Koh
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
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Calabrese M, Oh MS, Favaretto A, Rinaldi F, Poretto V, Alessio S, Lee BC, Yu KH, Ma HI, Perini P, Gallo P. No MRI evidence of cortical lesions in neuromyelitis optica. Neurology 2012; 79:1671-6. [PMID: 22993282 DOI: 10.1212/wnl.0b013e31826e9a96] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease of the CNS in which a pathogenic role of anti-aquaporin-4 (AQP4) antibodies has been suggested. Although AQP4 is expressed in human cortex, recent histologic studies have failed to find any evidence of cortical demyelination in NMO. OBJECTIVE To evaluate, in vivo, the occurrence of focal and diffuse cortical pathology in NMO. METHODS We studied 30 patients with NMO, 30 patients with relapsing-remitting multiple sclerosis (RRMS), and 30 normal controls (NC). RRMS and NC were age- and gender-matched to NMO. The presence of cortical lesions (CLs) was evaluated on double inversion recovery sequence and cortical thickness (CTh) by the application of Freesurfer on 3 volumetric fast field echo T1-weighted images. RESULTS No CL was observed in NC or in NMO, while 83 CLs were identified in 20/30 (66.7%) patients with RRMS. Although NMO did not differ from NC in the global CTh, a mild thinning was observed in some cortical areas (postcentral [p = 0.018], precentral [p = 0.009], and calcarine [p = 0.015] gyri) and in the thalamus (p = 0.036). Global and regional cortical thickness was significantly decreased in RRMS compared to both NMO and NC. DISCUSSION Our in vivo data further suggest that the immune-mediated pathologic process occurring in NMO spares most of the cortex. NMO differs from multiple sclerosis, where CLs and atrophy are frequently found, even in early disease phases. Thus, MRI analysis of the cortex may be a potential diagnostic tool, especially in ambiguous cases.
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Affiliation(s)
- Massimiliano Calabrese
- Advanced Neuroimaging Lab of The Multiple Sclerosis Centre of Veneto Region-First Neurology Clinic, Department of Neurosciences, University Hospital of Padua, Italy.
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Kang SY, Ma HI, Lim YM, Jeong MG, Kim YJ, Kwon SB, Hwang SH. Normal Diffusion-Weighted MRI During the Acute Stage of Central Pontine Myelinolysis. Int J Neurosci 2012; 122:477-9. [DOI: 10.3109/00207454.2012.677883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kang SY, Ma HI, Lee MJ, Kwon SB, Jung S, Kim YJ, Hwang SH. Ipsilateral tilt and contralateral sensory change of neck in cortical infarction. J Clin Neurol 2011; 7:156-8. [PMID: 22087210 PMCID: PMC3212602 DOI: 10.3988/jcn.2011.7.3.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 03/16/2010] [Accepted: 03/16/2010] [Indexed: 11/17/2022] Open
Abstract
Background Numerous neck muscles are involved in neck movements, and so isolated neck weakness is extremely uncommon in cerebral infarction. Case Report We report herein the case of a 65-year-old woman with hypertension and acute cortical infarction, presenting with ipsilateral head tilt and contralateral sensory changes in the neck and shoulder area, which has never been described before. Conclusions Transient neck weakness and sensory deficits can occur in acute cortical infarction. The motor representation of the neck muscles can be at the same level of the cortical sensory representation, near to the level of the trunk representation, which is in contrast to Penfield's findings. Several possible mechanisms for the ipsilateral tilt are described.
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Affiliation(s)
- Suk Yun Kang
- Department of Neurology, Hallym University College of Medicine, Seoul, Korea
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Oh MS, Yu KH, Chu MK, Ma HI, Kim YJ, Kim JY, Lee BC. Long-term prognosis of symptomatic isolated middle cerebral artery disease in Korean stroke patients. BMC Neurol 2011; 11:138. [PMID: 22050999 PMCID: PMC3227588 DOI: 10.1186/1471-2377-11-138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 11/04/2011] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to investigate the long-term mortality and recurrence rate of stroke in first-time stroke patients with symptomatic isolated middle cerebral artery disease (MCAD) under medical management. Methods We identified 141 first ever stroke patients (mean age, 64.4 ± 12.5 years; 53% male) with symptomatic isolated MCAD. MCAD was defined as significant stenosis of more than 50% or occlusion of the MCA as revealed by MR angiography. The median follow-up was 27.7 months. We determined a cumulative rate of stroke recurrence and mortality by Kaplan-Meier survival analyses and sought predictors using the Cox proportional hazard model. Results The cumulative composite outcome rate (stroke recurrence or any-cause death) was 14%, 19%, 22%, and 28% at years 1, 2, 3, and 5, respectively. The annual recurrence rate of stroke was 4.1%. The presence of diabetes mellitus was the only significant independent predictor of stroke recurrence or any cause of death in multivariate analyses of Cox proportional hazard model adjusted for any plausible potential confounding factors. Conclusions We estimated the long-term prognosis of stroke patients with isolated symptomatic MCAD under current medical management in Korea. Diabetes mellitus was found to be a significant predictor for stroke recurrence and mortality.
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Affiliation(s)
- Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
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Choi JM, Hong JH, Chae MJ, Ngyuen PH, Kang HS, Ma HI, Kim YJ. Analysis of mutations and the association between polymorphisms in the cerebral dopamine neurotrophic factor (CDNF) gene and Parkinson disease. Neurosci Lett 2011; 493:97-101. [PMID: 21320571 DOI: 10.1016/j.neulet.2011.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 01/25/2011] [Accepted: 02/06/2011] [Indexed: 11/30/2022]
Abstract
Neurotrophic factors support the survival of dopaminergic neurons. The cerebral dopamine neurotrophic factor (CDNF) is a novel neurotrophic factor with strong trophic activity on dopaminergic neurons comparable to that of glial cell line-derived neurotrophic factor (GDNF). To investigate whether rare or common variants in CDNF are associated with Parkinson disease (PD), we performed mutation analysis of CDNF and a genetic association study between CDNF polymorphisms and PD. We screened 110 early-onset Parkinson disease (EOPD) patients for CDNF mutations. Allelic and genotype frequencies of 3 CDNF single nucleotide polymorphisms (SNPs) (rs1901650, rs7094179, and rs11259365) were compared in 215 PD patients and age- and sex-matched controls. We failed to identify any mutations in CDNF among the EOPD patient sample population. We observed a trend towards increased risk for PD in patients carrying the C allele of SNP rs7094179 (odds ratio (OR)=1.27, 95% confidence interval (CI) 0.96-1.67). Patients carrying the C allele were susceptible to PD in both dominant (CC+CA vs. AA; OR=7.20, 95% CI 0.88-59.1) and recessive (CA+AA vs. CC; OR=0.64, 95% CI 0.41-0.99) models. Genotype and allele frequencies of SNPs rs1901650 and rs11259365 did not differ between PD patients and controls. Our study suggests that the C allele of an intronic CDNF SNP (rs7094179) might be an allele for susceptibility to PD. Further studies with larger sample size are required to confirm our results.
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Affiliation(s)
- Jung-Mi Choi
- ILSONG Institute of Life Science, Hallym University, Rm 607, ILSONG Bldg, 1605-4 Gwanyang-dong, Dongan-gu, Anyang, Gyonggi-do 431-060, Republic of Korea
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Kao JH, Chen SL, Ma HI, Law PY, Tao PL, Loh HH. Intrathecal delivery of a mutant micro-opioid receptor activated by naloxone as a possible antinociceptive paradigm. J Pharmacol Exp Ther 2010; 334:739-45. [PMID: 20554907 DOI: 10.1124/jpet.109.165399] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Direct injection of double-stranded adeno-associated virus type 2 (dsAAV2) with a mu-opioid receptor (MOR) mutant [S4.45(196)A], and a reporter protein (enhanced green fluorescent protein) into the spinal cord (S2/S3) dorsal horn region of ICR mice resulted in antinociceptive responses to systemic injection of opioid antagonist naloxone without altering the acute agonist morphine responses and no measurable tolerance or dependence development during subchronic naloxone treatment. To develop further such mutant MORs into a therapeutic agent in pain management, a less invasive method for virus delivery is needed. Thus, in current studies, the dsAAV2 was locally injected into the subarachnoid space of the spinal cord by intrathecal administration. Instead of using the MORS196A mutant, we constructed the dsAAV2 vector with the MORS196ACSTA mutant, a receptor mutant in which naloxone has been shown to exhibit full agonistic properties in vitro. After 2 weeks of virus injection, naloxone (10 mg/kg s.c.) elicited antinociceptive effect (determined by tail-flick test) without tolerance (10 mg/kg s.c., b.i.d. for 6 days) and significant withdrawal symptoms. On the other hand, subchronic treatment with morphine (10 mg/kg s.c., b.i.d.) for 6 days induced significant tolerance (4.8-fold) and withdrawal symptoms. Furthermore, we found that morphine, but not naloxone, induced the rewarding effects (determined by conditioned place preference test). These data suggest that local expression of MORS196ACSTA in spinal cord and systemic administration of naloxone has the potential to be developed into a new strategy in the management of pain without addiction liability.
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Affiliation(s)
- J H Kao
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Kim JH, Han SW, Kim YJ, Kim J, Oh MS, Ma HI, Lee BC. A case of painful hemimasticatory spasm with masseter muscle hypertrophy responsive to botulinum toxin. J Mov Disord 2009; 2:95-7. [PMID: 24868368 PMCID: PMC4027721 DOI: 10.14802/jmd.09026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 10/23/2009] [Accepted: 11/06/2009] [Indexed: 11/24/2022] Open
Abstract
Hemimasticatory spasm (HMS) is a rare disorder of the trigeminal nerve characterized by paroxysmal involuntary contractions of the unilateral jaw-closing muscles. HMS has been frequently described in association with facial hemiatrophy or localized scleroderma. A 42-year-old female presented with involuntary paroxysmal spasms of the left face, of 6 months duration. Her lower face on the left was markedly hypertrophied without skin lesions. An electrophysiological study indicated that the masseter reflexes and masseteric silent period were attenuated on the affected side. Surface electromyography demonstrated irregular bursts of motor unit potentials at high frequencies up to 200 Hz. Magnetic resonance imaging of the head showed marked hypertrophy of the left masseter muscle. Biopsy of the hypertrophied masseter muscle was normal. Repeated local injections of botulinum toxin noticeably reduced the size of the hypertrophied muscle as well as improved the patient’s symptoms.
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Affiliation(s)
- Jin-Hyuck Kim
- Department of Neurology, Keyo Medical Foundation Keyo Hospital, Uiwang, Korea
| | - Seok-Won Han
- Department of Neurology, Hallym University, College of Medicine, Anyang, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University, College of Medicine, Anyang, Korea
| | - Jooyong Kim
- Department of Neurology, Hallym University, College of Medicine, Anyang, Korea
| | - Mi-Suh Oh
- Department of Neurology, Hallym University, College of Medicine, Anyang, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University, College of Medicine, Anyang, Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University, College of Medicine, Anyang, Korea
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Sung YH, Park KH, Lee YB, Park HM, Shin DJ, Park JS, Oh MS, Ma HI, Yu KH, Kang SY, Kim YJ, Lee BC. Midbrain atrophy in subcortical ischemic vascular dementia. J Neurol 2009; 256:1997-2002. [DOI: 10.1007/s00415-009-5226-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Revised: 04/03/2009] [Accepted: 04/27/2009] [Indexed: 11/28/2022]
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Ma HI, Kim JH, Chu MK, Oh MS, Yu KH, Kim J, Hahm W, Kim YJ, Lee BC. Diabetes mellitus and drug-induced Parkinsonism: a case-control study. J Neurol Sci 2009; 284:140-3. [PMID: 19467671 DOI: 10.1016/j.jns.2009.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2008] [Revised: 04/29/2009] [Accepted: 05/07/2009] [Indexed: 11/28/2022]
Abstract
To investigate if diabetes is more common in drug-induced parkinsonism patients. We performed a hospital-based retrospective case-control study on 44 drug-induced parkinsonism (DIP) patients, 177 Parkinson disease patients, and 176 acute stroke patients matched for age and sex who were seen over the same period at the same hospital. The frequency of diabetes, age-at onset and sex were compared between DIP and IPD or acute stroke. Multivariate analysis showed that patients with diabetes are more frequent in DIP compared with IPD (p<0.001, adjusted OR 5.48; 95% CI, 2.52-11.94). The frequency of diabetes in DIP was comparable to that in acute stroke patients (p=0.16, adjusted OR 0.62; 95% CI, 0.32-1.21). These data suggest that diabetes may be a risk factor for DIP. Drugs with dopamine receptor blocking potency should be avoided in elderly with diabetes.
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Affiliation(s)
- Hyeo-Il Ma
- Department of Neurology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Kang SY, Byun SY, Jung S, Kwon SB, Lee MJ, Ma HI, Lee J, Hwang SH. PO16.7 Klebsiella Pneumoniae Cerebritis Detected by Diffusion-Weighted MRI. Clin Neurophysiol 2009. [DOI: 10.1016/s1388-2457(09)60325-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Choi JM, Woo MS, Ma HI, Kang SY, Sung YH, Yong SW, Chung SJ, Kim JS, Shin HW, Lyoo CH, Lee PH, Baik JS, Kim SJ, Park MY, Sohn YH, Kim JH, Kim JW, Lee MS, Lee MC, Kim DH, Kim YJ. Analysis of PARK genes in a Korean cohort of early-onset Parkinson disease. Neurogenetics 2008; 9:263-9. [PMID: 18704525 DOI: 10.1007/s10048-008-0138-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 07/07/2008] [Indexed: 12/16/2022]
Abstract
Mutations in five PARK genes (SNCA, PARKIN, DJ-1, PINK1, and LRRK2) are well-established genetic causes of Parkinson disease (PD). Recently, G2385R substitution in LRRK2 has been determined as a susceptibility allele in Asian PD. The objective of this study is to determine the frequency of mutations in these PARK genes in a Korean early-onset Parkinson disease (EOPD) cohort. The authors sequenced 35 exons in SNCA, PARKIN, DJ-1, PINK1, and LRRK2 in 72 unrelated EOPD (age-at-onset <or=50) recruited from ten movement disorders clinics in South Korea. Gene dosage change of the aforementioned genes was studied using multiple ligation-dependent probe amplification. We found four patients with PARKIN mutations, which were homozygous deletion of exon 4, compound heterozygous deletion of exon 2 and exon 4, heterozygous deletion of exon 4, and heterozygous nonsense mutation (Q40X). Four patients had PINK1 mutations; a compound heterozygous mutation (N367S and K520RfsX522) and three heterozygous mutations (G32R, R279H, and F385L). A missense mutation of SNCA (A53T) was found in a familial PD with autosomal dominant inheritance. Nine patients (12.5%) had heterozygous G2385R polymorphism of LRRK2, whereas none had G2019S mutation. However, no mutations were detected in DJ-1 and UCHL1 in our series. We identified genetic variants in PARKIN, PINK1, LRRK2, and SNCA as a cause or genetic risk factors for PD in 25% of Korean EOPD, and mutation of PARKIN was the most common genetic cause.
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Affiliation(s)
- Jung Mi Choi
- Department of Neurology, Hallym University Sacred Heart Hospital, ILSONG Institute of Life Science, Hallym University, Dongan-gu, Anyang-si, Gyeonggi-do, Korea
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Abstract
OBJECTIVE When teaching clients a multistep functional task, therapists tend to break down the task into part tasks with discrete movements. The purpose of this study was to compare the kinematic performance between part and whole tasks in elderly persons. METHOD A counterbalanced repeated-measures design was used. Twenty elderly persons without motor problems (7 men, 13 women) performed a signature task in two conditions. For the part-task condition, the participants did the task in a step-by-step manner: (a) reach for a pen, (b) bring the pen to the paper, and (c) sign the name. For the whole-task condition, the participants performed the task in an integrated continuous flow. Kinematic performances for two movement segments (i.e., reaching for the pen, bringing the pen to the paper) were compared between conditions. RESULTS Generally, the whole-task condition elicited a more efficient, more forceful, and smoother movement than the part-task condition. CONCLUSION The results suggest the importance of keeping a multistep functional task whole.
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Affiliation(s)
- H I Ma
- Boston University, Boston, Massachusetts, USA.
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Tsai TH, Chen SL, Chiang YH, Lin SZ, Ma HI, Kuo SW, Tsao YP. Recombinant adeno-associated virus vector expressing glial cell line-derived neurotrophic factor reduces ischemia-induced damage. Exp Neurol 2000; 166:266-75. [PMID: 11085892 DOI: 10.1006/exnr.2000.7505] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To explore the potential of using the recombinant adeno-associated viral (rAAV) vector, expressing glial cell line-derived neurotrophic factor (GDNF) as the gene therapy for stroke, we injected rAAV vectors expressing GDNF (rAAV-GDNF) into the cortex of rats which had been experiencing transient bilateral common carotid artery ligation and right middle cerebral artery ligation for 90 min. GDNF levels in cortical tissues of rAAV-GDNF-injected animals were significantly higher than in the control animals injected with rAAV-expressing lacZ (rAAV-lacZ), indicating that rAAV can deliver and express the GDNF gene in cortical tissues. Triphenyltetrazolium chloride tissue stain analysis revealed that the rAAV-delivered GDNF gene could rescue the brain tissues from ischemia-induced injury. Cortical tissues which received rAAV-GDNF injections had both significantly smaller total volumes of infarction and smaller areas of infarction on each brain slice than those which were injected with rAAV-lacZ. An in situ labeling analysis demonstrated significantly less apoptotic cells in cortical tissues rescued by rAAV-GDNF, indicating prevention of apoptosis as the mechanism of cortical cell protection. Moreover, immunohistochemistry staining of Neu-N indicated that the rescued brain tissues contained the same number of Neu-N-positive neuronal cells as contralateral undamaged brain tissues. This provides strong evidence that cortical neuronal cells can be rescued by GDNF gene therapy. Indeed, these findings show that the rAAV is a potential delivery vector of GDNF gene for the therapy of stroke.
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Affiliation(s)
- T H Tsai
- Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Republic of China
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Abstract
OBJECTIVE A major concern of occupational therapy is the identification of context characteristics that optimize performance. The purpose of this study was to examine the effect of context on skill acquisition and transfer. METHOD Forty college students without disabilities (12 men, 28 women) were randomly assigned to the task of learning to use chopsticks in either a natural or a simulated context. Each participant practiced 60 trials in an acquisition phase on 1 day and was tested on a transfer task 24 hr after the acquisition phase. Their performances in the acquisition and transfer phases were measured with the variables of success rate and reaching kinematics. RESULTS The natural context elicited significantly larger improvement of success rate in the acquisition phase and a significantly higher success rate in the transfer phase than the simulated context. No major difference was found in kinematic variables between the two contexts. CONCLUSION These results suggested the use of natural contexts to facilitate the outcome of motor skill learning.
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Affiliation(s)
- H I Ma
- Department of Occupational Therapy, Boston University, Massachusetts 02155, USA
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47
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Abstract
We monitored the compositional change of host RNA polymerase in Xp 10 infected cells by one-step immunoprecipitation with core enzyme-specific antiserum. Results showed a rapid loss of sigma subunit from the RNA polymerase complex by 3 min after infection. In addition, some putative binding proteins were reduced to various extents. In contrast, increasing levels of several other polypeptides were detected. The de novo host protein synthesis was inhibited within 1 min after Xp 10 infection. On the other hand, a sequential expression of phage specific proteins was found and can be categorized as early, middle, and late stage. The alteration of host RNA polymerase and the shutdown of early class proteins took place in parallel.
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Affiliation(s)
- B C Yang
- Institutes of Molecular Biology, Academia Sinica, Taipei, Taiwan, Republic of China
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