-
Movement Disorders 05/2013; · 4.51 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: To identify the prevalence and clinical features of musculoskeletal problems in patients with Parkinson disease (PD) compared to controls. METHODS: 400 PD patients and 138 age- and sex-matched controls were interviewed by physicians about their musculoskeletal problems. RESULTS: The prevalence of musculoskeletal problems was significantly higher in the PD group than in the control group (66.3% vs. 45.7%, P < 0.001). Commonly involved body sites were the low back, knee, and shoulder in that order. The low back was more frequently involved in the PD group than in the control group (44.3% vs. 24.6%, P < 0.001), and the shoulder tended to be more involved in the PD group than in the control group (15.0% vs. 8.7%, P = 0.061). However, the knee was similarly involved in both group (12.3% vs. 18.0%, P = 0.121). Among the past diagnoses associated with musculoskeletal problems, frozen shoulder, low back pain, osteoporosis and fracture were more common in the PD group than in the control group (P < 0.05). Older age, female, and a higher score on the Unified Parkinson's Disease Rating Scale I & II were associated with musculoskeletal problems in the PD group. Only 26.8% of the PD patients and 52.5% of the controls with musculoskeletal problems answered that their musculoskeletal problems were recovering. Furthermore, musculoskeletal problems in the PD group tended to receive less treatment than that of the control group (P = 0.052). CONCLUSION: Musculoskeletal problems were more common in the PD group than in the controls. Furthermore, despite PD patients having a higher prevalence, they did not receive adequate treatment.
Parkinsonism & Related Disorders 04/2013; · 3.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Recent reports show that dementia occurs in 5-26% of multiple system atrophy (MSA) patients. However, the structural or pathological correlates of dementia in MSA are unclear yet. METHODS: Of 152 patients with MSA, 59 fulfilled the criteria of probable MSA and 9 (15%) had dementia. Six of those patients and 9 without dementia, in addition to 10 controls, were included. All subjects underwent clinical evaluation including UMSARS, neuropsychological examinations, 3T-MRI, and Pittsburgh Compound B (PIB) PET imaging. The cortical thickness was assessed using surface-based morphometry. RESULTS: Age and disease duration were similar between MSA with dementia and without dementia, while motor disability was more severe in MSA with dementia. In neuropsychological tests, attention, visuospatial function, and language function were impaired in MSA with dementia. Mean PIB binding was similar among the three groups. Cortical thickness was reduced in precuneus/cuneus, uncus, and posterior cingulate in MSA with dementia compared to the controls, and in parahippocampal and lingual cortices compared to MSA without dementia. CONCLUSIONS: Dementia was found in 15% of the probable MSA patients, which was similar to those reported in previous studies. It appears that amyloid pathology has limited role in dementia in MSA, although some patients had increased cortical amyloid burden. Cortical thinning in MSA-D was observed in areas where cortical thinning was reported in Alzheimer disease or Parkinson disease dementia, but its pathological relevance is unclear. The neuropathological processes leading to the development of dementia in MSA appears to be multifactorial and heterogenous.
Parkinsonism & Related Disorders 03/2013; · 3.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Since its establishment in 1982, the Korean Neurological Association (KNA) has demonstrated stable growth over the last 3 decades, and a lot of effort has been made to take the KNA to a global level. During this period of transition, the KNA has held a number of regular domestic conferences and several international conferences, conferred academic support to members, and issued domestic and international journals. The KNA has grown to about 1,800 members, and has many subspecialties and related societies. The quantitative and qualitative growth of the KNA has led to the remarkable development of the neurology and neuroscience fields in Korea. This article outlines the clinical, academic, and scientific development of the KNA, its present activities, and current concerns in Korea, having overcome the devastation of occupation and war to rapidly become a modern and developed state.
Neurology 03/2013; 80(12):1145-1147. · 8.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Musculoskeletal problems are very common and are an important contributor to poor quality of life in Parkinson's disease. However, they are under-appreciated, under-evaluated, and under-treated. This paper will address the prevalence of musculoskeletal problems in Parkinson's disease, and review the clinical characteristics of selected musculoskeletal conditions, such as shoulder problems, low back pain, arthritis, deformity, osteoporosis and fracture. Finally, a variety of treatment modalities for musculoskeletal problems will be reviewed.
Acta Neurovegetativa 02/2013; · 2.73 Impact Factor
-
The Lancet 02/2013; 381(9866):598. · 38.28 Impact Factor
-
Sleep Medicine 12/2012; · 3.40 Impact Factor
-
Movement Disorders 12/2012; · 4.51 Impact Factor
-
Manu Sharma,
John P A Ioannidis,
Jan O Aasly,
Grazia Annesi,
Alexis Brice,
Lars Bertram,
Maria Bozi,
Maria Barcikowska,
David Crosiers,
Carl E Clarke, [......],
Christine Van Broeckhoven,
Karin Wirdefeldt,
Zbigniew Wszolek,
Georgia Xiromerisiou,
Harumi S Yomono,
Kuo-Chu Yueh,
Yi Zhao,
Thomas Gasser,
Demetrius Maraganore,
Rejko Krüger
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Two recent studies identified a mutation (p.Asp620Asn) in the vacuolar protein sorting 35 gene as a cause for an autosomal dominant form of Parkinson disease . Although additional missense variants were described, their pathogenic role yet remains inconclusive. METHODS AND RESULTS: We performed the largest multi-center study to ascertain the frequency and pathogenicity of the reported vacuolar protein sorting 35 gene variants in more than 15,000 individuals worldwide. p.Asp620Asn was detected in 5 familial and 2 sporadic PD cases and not in healthy controls, p.Leu774Met in 6 cases and 1 control, p.Gly51Ser in 3 cases and 2 controls. Overall analyses did not reveal any significant increased risk for p.Leu774Met and p.Gly51Ser in our cohort. CONCLUSIONS: Our study apart from identifying the p.Asp620Asn variant in familial cases also identified it in idiopathic Parkinson disease cases, and thus provides genetic evidence for a role of p.Asp620Asn in Parkinson disease in different populations worldwide.
Journal of Medical Genetics 11/2012; 49(11):721-726. · 6.36 Impact Factor
-
Current Neurology and Neuroscience Reports 09/2012; · 3.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Recently reports on toxocariasis are increasing by serodiagnosis in Korea. A previously healthy 17-yr-old boy complained of headache, fever, dyspnea, and anorexia. He showed symptoms and signs of eosinophilic meningitis with involvement of the lungs and liver. Specific IgG antibody to Toxocara canis larval antigen was positive in serum and cerebrospinal fluid by ELISA. He took raw ostrich liver with his parents 4 weeks before the symptom onset. His parents were seropositive for T. canis antigen but had no symptoms or signs suggesting toxocariasis. This is the first report of toxocariasis in a family due to ingestion of raw ostrich liver in Korea.
Journal of Korean medical science 09/2012; 27(9):1105-8. · 0.84 Impact Factor
-
Journal of the neurological sciences 08/2012; · 2.32 Impact Factor
-
Movement Disorders 05/2012; 27(8):1067-8. · 4.51 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Multiple system atrophy (MSA) rarely begins before the age of 40 and detailed descriptions of young-onset MSA are lacking.
Among 455 patients included in our MSA cohort, four developed disease before the age of 40. We reviewed the medical records of these patients.
Case 1 and 2 presented with cerebellar symptoms. Case 1 had clinical features and a course typical of MSA. Case 2 had a rapid course and died 3 years after onset. Case 3 and Case 4 presented with levodopa-responsive parkinsonism. Both developed motor fluctuations and peak-dose limb dyskinesias. Subthalamic deep brain stimulation (DBS) resulted in some improvements in motor symptoms, but they became totally dependent within a few years.
Young-onset MSA is rare but does exist. Young-onset MSA with predominant parkinsonism may closely resemble Parkinson disease at onset and is likely to develop motor complications. Attention should be given to the possibility of young-onset MSA in selecting DBS candidates.
Journal of the neurological sciences 05/2012; 319(1-2):168-70. · 2.32 Impact Factor
-
03/2012; , ISBN: 978-953-51-0329-5
-
[show abstract]
[hide abstract]
ABSTRACT: Duplication of alpha-synuclein gene (SNCA) is a recognized cause of Parkinson's disease (PD). However, the penetrance in families with SNCA duplication is as low as 30%, indicating that factors other than the SNCA gene dosage have an important role in neuronal death. In this study, using lymphoblastoid cell lines (LCLs) derived from a parkinsonian kindred with SNCA duplication, we examined whether there is difference in (1) the level of SNCA mRNA and protein expression and cell viability and (2) the vulnerability to various insults relevant to PD between a patient, asymptomatic carrier, and unaffected control. Expression of SNCA mRNA and protein increased in the LCLs from subjects with SNCA gene duplication, irrespective of the disease status. In the absence of treatment, LCLs from the patient and carrier showed decreased viability compared with the LCL from the control. The LCL from the patient also showed decreased viability compared to the carrier. When susceptibility to various insults including lactacystin, dexamethasone, 3-methyladenine, H(2)O(2), and rotenone was examined, surprisingly, the LCL from the patient was more resistant than the LCL from the control to all agents except for lactacystin. This study shows that both intrinsic and extrinsic factors and their interaction have important roles in cell death and in the development of PD and further indicates that the relationship between cell death and the level of alpha-synuclein may be more complicated than previously thought.
Journal of Molecular Neuroscience 03/2012; 47(2):249-55. · 2.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Antecollis is a frequent complication in multiple system atrophy but is rare in Parkinson's disease (PD). We report an 80-year-old patient with a four-year history of PD who developed antecollis six weeks after taking pramipexole (1 mg/day). When assessed in the outpatient clinic, she had antecollis, cogwheel rigidity on the right side, and mild bradykinesia. We found no evidence of myopathic or neurogenic changes in the neck muscles on needle electromyography. We withdrew the pramipexole immediately, and, one week later, her antecollis improved dramatically. This report emphasizes the importance of considering dopamine agonists as a possible cause of antecollis and shows that immediate withdrawal of these drugs may reverse the symptoms.
Journal of Clinical Neuroscience 02/2012; 19(6):903-4. · 1.25 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate anatomical changes in the substantia nigra (SN) of Parkinson disease (PD) patients with age-matched controls by using ultra-high field magnetic resonance imaging (MRI).
We performed 7T MRI in 10 PD and 10 age-matched control subjects. Magnetic resonance images of the SN were obtained from a 3-dimensional (3D) T(2)*-weighted gradient echo sequence. Region of interest-based 3D shape analysis was performed to quantitatively compare images from the 2 groups.
The boundary between the SN and crus cerebri was not smooth in PD subjects. Undulation in the lateral surface of the SN appeared more intense in the side contralateral to that with the more severe symptoms, and more prominent at the rostral level of the SN than at the intermediate or caudal levels. In addition to the lateral surface, there was a striking difference in the dorsomedial aspects of the SN between PD and control subjects. In control subjects, a brighter signal region was observed along the dorsomedial surface of the lateral portion of SN, whereas in PD subjects, this region was observed as a dark region containing a hypointense signal in T(2)*-weighted images. The measurement of SN volumes, normalized to the intracranial volumes, showed higher values in PD subjects than in control subjects.
This study demonstrates that 3D 7T MRI can definitively visualize anatomical alterations occurring in the SN of PD subjects. Further pathological studies are required to elucidate the nature of these anatomical alterations.
Annals of Neurology 02/2012; 71(2):267-77. · 11.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Freezing of gait (FOG) is one of the most disabling symptoms in Parkinsonism. Open-label studies have suggested that intravenous (IV) amantadine is effective against FOG resistant to dopaminergic therapy in Parkinson's disease (PD). We evaluated the efficacy of IV amantadine on FOG resistant to dopaminergic therapy.
This was a randomized, double-blind, placebo-controlled, cross-over study on IV amantadine. The placebo (normal saline) and amantadine (400 mg/day) were injected for 2 days with a 52-hour washout period. The instruments for the outcome measures were the Freezing of Gait Questionnaire (FOGQ), Unified Parkinson's disease rating Scale (UPDRS), and the duration of the 4×10 m walking test. The placebo arm was compared to the amantadine arm. Ten patients were enrolled but two patients withdrew, one from each arm. The FOGQ and UPDRS scores and the duration of the 4×10 m walking test improved in both arms compared to the baseline (P<0.05 in all). However, there were no differences in these values between the amantadine arm and placebo arm (P = 0.368, P = 0.583, P = 0.206, respectively). Follow-up measures 2weeks after discharge in an open-label study showed the beneficial effects of an amantadine tablet on FOG (FOGQ, P = 0.018; UPDRS, P = 0.012 respectively).
This double blind, placebo-controlled study did not show the efficacy of IV amantadine on FOG when compared with the placebo. This study provides Class II evidence due to small sample size for the lack of benefit of IV amantadine on FOG resistant to dopaminergic therapy
Clinicaltrials.gov NCT01313819.
PLoS ONE 01/2012; 7(11):e48890. · 4.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To determine the role of a serotonin 2A receptor gene (=HTR2A) variant in the development of impulse control and repetitive behaviors in Parkinson's disease.
We performed a genetic association analysis to a cohort of 404 Korean patients with Parkinson's disease who had been enrolled in a previous study. Presence of impulse control and repetitive behaviors was screened using modified version of Minnesota Impulsive Disorders Interview and genotyping for HTR2A c.102T > C was performed using the TaqMan assay.
The T allele, which is presumably linked to higher receptor expression, was marginally associated with impulse control and repetitive behaviors in Parkinson's disease; the genetic influence was significantly enhanced in the lower levodopa-equivalent-dose group, increasing the risk by 2.8 and 6.9 times in CT and TT carriers, respectively (p-trend = 0.011). There was no significant interaction between the c.102T > C variant and clinical risk variables such as sex, age at onset, total daily levodopa-equivalent-dose, use of dopamine agonist and daily dose of dopamine agonist.
Our data support a possible contribution of genetic variation in the HTR2A to the susceptibility to impulse control and repetitive behaviors in Parkinson's disease.
Parkinsonism & Related Disorders 09/2011; 18(1):76-8. · 3.80 Impact Factor
