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Sekimoto S, Oyama G, Bito K, Tsuchiya M, Kikuchi S, Takimoto B, Ichihashi T, Bautista JMP, Nuermaimaiti M, Sasaki F, Nakamura R, Iwamuro H, Ito M, Umemura A, Hattori N. Three-dimensional gait analysis of the effect of directional steering on gait in patients with Parkinson's disease. Parkinsonism Relat Disord 2023; 114:105770. [PMID: 37499354 DOI: 10.1016/j.parkreldis.2023.105770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Deep Brain Stimulation (DBS) is an option to treat advanced Parkinson's Disease (PD), but can cause gait disturbance due to stimulation side efffects. This study aims to evaluate the objective effect of directional current steering by DBS on gait performance in PD, utilizing a three-dimensional gait analysis system. METHODS Eleven patients diagnosed with PD and were implanted with directional lead were recruited. The direction of the pyramidal tract (identified by the directional mode screening) was set as 0°. Patients performed the six-meter-walk test and the time up-and-go (TUG) test while an analysis system recorded gait parameters utilizing a three-dimensional motion capture camera. The gait parameters were measured for the baseline, the directional steering at eight angles (0°, 45°, 90°, 135°, 180°, 225°, 270°, and 315°), and the conventional ring mode with 1, 2, and 3 mA. Pulse width and frequency were fixed. Placebo stimulation (0 mA) was used for a control. RESULTS Eleven patients completed the study. No significant difference were observed between gait parameters during the directional, baseline, placebo, or ring modes during the six-meter-walk test (p > 0.05). During the TUG test, stride length was significantly different between 0° and other directions (p < 0.001), but no significant differences were observed for the other gait parameters. Stride width was non-significantly narrower in the direction of 0°. CONCLUSION Controlling stimulation using directional steering may improve gait in patients with PD, while avoiding pyramidal side effects.
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Affiliation(s)
- Satoko Sekimoto
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurodegenerative and Demented Disorders, Juntendo University School of Medicine, Tokyo, Japan; Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan.
| | - Kotatsu Bito
- Analytical Science Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Masaru Tsuchiya
- Analytical Science Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Sho Kikuchi
- Analytical Science Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Baku Takimoto
- Analytical Science Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Toshiki Ichihashi
- Analytical Science Research Laboratories, Kao Corporation, Tokyo, Japan
| | | | | | - Fuyuko Sasaki
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ryota Nakamura
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hirokazu Iwamuro
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Masanobu Ito
- Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsushi Umemura
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurodegenerative and Demented Disorders, Juntendo University School of Medicine, Tokyo, Japan; Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan
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Lee ML, Bautista JMP. Guillain-Barré Syndrome Following the Administration of Adenovirus Vector-Based COVID-19 Vaccine. Cureus 2023; 15:e42316. [PMID: 37614248 PMCID: PMC10442713 DOI: 10.7759/cureus.42316] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 08/25/2023] Open
Abstract
As countries worldwide deployed their respective coronavirus disease 2019 (COVID-19) vaccination programs to mitigate the risk of COVID-19 to their citizens, several side effects and complications from the use of the various types of COVID-19 vaccines were documented and are continued to be monitored to further study the safety and efficacy of these vaccines. One such complication, the Guillain-Barré syndrome (GBS), was reported in some individuals who received a COVID-19 adenovirus vector-based vaccine. In this particular report, we describe one such case. The patient had diarrhea and fever one day after vaccination, which was a triggering event. Seven days post vaccination, the patient had bilateral symmetrical weakness with absent deep tendon reflexes. However, causality between the vaccine administered and the suspected adverse reaction cannot be readily assumed. The benefits and risk profiles of each available vaccine should be assessed continuously for it to be improved and truly useful in this pandemic. Thorough post-vaccination surveillance, along with national reporting mechanisms are needed to help establish and confirm possible links between GBS and adenovirus vector-based COVID-19 vaccines. This link needs to be probed further in prospective studies and clinical trials.
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Affiliation(s)
- Mardy L Lee
- Neurology, Quirino Memorial Medical Center, Quezon City, PHL
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Caritativo ECA, Yu JRT, Bautista JMP, Nishioka K, Jamora RDG, Yalung PM, Ng AR, Hattori N. Genetic screening of Filipinos suspected with familial Parkinson's disease: A pilot study. Parkinsonism Relat Disord 2023; 108:105319. [PMID: 36774704 DOI: 10.1016/j.parkreldis.2023.105319] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/27/2023] [Accepted: 02/05/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Although genetic factors are known to play a role in the pathogenesis of Parkinson's disease (PD), true prevalence of familial PD is unknown. We conducted this pilot study to identify genes implicated in familial Parkinson's disease among Filipinos. METHODS Eighteen Filipino patients belonging to 11 families with personal and family history of PD underwent thorough evaluation by movement disorders specialists. Samples were analyzed in Juntendo University, Tokyo, Japan. Sanger sequencing of polymerase chain reaction products was performed. Each sample was screened for 23 genes (SNCA, PARK 2, UCHL1, PINK 1, DJ-1, LRRK2, ATP13A2, GIGYF2, HTRA2, PLA266, FBX07, VPS35, EIF461, DNAJC13, CHCHD2, GCH1, MAPT, NR4A2, VPS13c, PSEN1, and GRN). RESULTS Out of 18 patients, six harbored Parkinson-related gene mutations. Five individuals from three families were positive for PINK1 c.10140T > C(p.L347P) mutation while one had heterozygous variant PRKN c.136G>T(p.A465) gene mutation. Three families displayed autosomal recessive pattern while one family with PINK1 mutation showed autosomal dominant mode of inheritance. Bradykinesia and tremor were predominant symptoms. Mean age at onset of symptoms was 40.4 years among those with PINK1 mutations. CONCLUSION In this study, we presented the clinical profiles and identified two genetic mutations among a small group of Filipino patients with familial PD. They were congruent with most studies showing these mutations as the most common causes of autosomal recessive early-onset PD. Preliminary data from this pilot study will guide planning for larger scale studies, such as collaborative projects including The Global Parkinson's Genetics Program (GP2).
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Affiliation(s)
| | - Jeryl Ritzi T Yu
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Global City, Philippines; Cleveland Clinic Center for Neurological Restoration, Neurological Institute, OH, USA
| | - Juan Miguel P Bautista
- Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Global City, Philippines.
| | - Kenya Nishioka
- Juntendo University School of Medicine, Department of Neurology, Tokyo, Japan
| | - Roland Dominic G Jamora
- Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Global City, Philippines; Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Patrick M Yalung
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Global City, Philippines
| | - Arlene R Ng
- Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Global City, Philippines
| | - Nobutaka Hattori
- Juntendo University School of Medicine, Department of Neurology, Tokyo, Japan
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Yu JRT, Jamora RDG, Silverio EL, Bautista JMP, Luspian KJL, Tiongson RM, Ng AR. Spectrum of Movement Disorders in two Movement Disorders Centers in the Philippines. Acta Neurol Taiwan 2021; 30(3):94-101. [PMID: 34841504] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Presently, there are no epidemiologic data on the prevalence of movement disorders in the Philippines. We aim to describe the most common phenomenologies and movement disorders in two specialty centers in Metro Manila dedicated to movement disorders. METHODS We investigated the clinical spectrum and etiologies of movement disorders referred to our centers from January 2007-December 2019 using a standardized collection form. RESULTS A total of 1438 patients presenting with complaints relating to movement disorders were evaluated between 2007 to 2019. There were 770 (53.5%) men. The mean age was 57.1 ± 17.9 years. The most common movement disorders were parkinsonism (n=677, 47.1%), myoclonus (n=212, 14.7%) and tremor (n=208, 14.5%). The least common was restless legs syndrome (n=4, 0.3%). There were 78 (37.7% of total dystonia cases) X-linked dystonia-parkinsonism patients referred to our clinic. Majority of the botulinum toxin injections were for hemifacial spasms (n=206). A small number of patients (n=41) were also seen at the center for deep brain stimulation programming. CONCLUSION The most common movement disorders managed were parkinsonism, myoclonus and tremor. The most common diagnoses were Parkinson's disease, hemifacial spasm and essential tremor. This study highlights the spectrum of movement disorders encountered in two specialty clinics in two Philippine tertiary hospitals. Given these varied cases, there is also a need for more movement specialists and centers dedicated to movement disorders to manage these cases.
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Affiliation(s)
- Jeryl Ritzi T Yu
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Roland Dominic G Jamora
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Estrela L Silverio
- Movement Disorders Service, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Juan Miguel P Bautista
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Kathleen Jaye L Luspian
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Rosemarie M Tiongson
- Movement Disorders Service, Institute for Neurosciences, St. Luke's Medical Center, Global City, Philippines
| | - Arlene R Ng
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
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