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JMD : Journal of Movement Disorders

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Original Articles
Ocular vestibular-evoked myogenic potential assists in differentiation of multiple system atrophy from Parkinson’s disease
Keun-Tae Kim, Kyoungwon Baik, Sun-Uk Lee, Euyhyun Park, Chan-Nyoung Lee, Donghoon Woo, Yukang Kim, Seoui Kwag, Hyunsoh Park, Ji-Soo Kim
Received May 19, 2024  Accepted July 8, 2024  Published online July 9, 2024  
DOI: https://doi.org/10.14802/jmd.24120    [Accepted]
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AbstractAbstract PDF
Vestibular-evoked myogenic potentials (VEMPs) can help assess otolithic neural pathway in the brainstem that may also participate in cardiovascular autonomic function. Parkinson’s disease (PD) is associated with altered VEMP responses; however, the association between VEMP abnormalities and multiple system atrophy (MSA) remains unknown. Therefore, we compared the extent of otolith dysfunction using ocular (oVEMP) and cervical VEMP (cVEMP) between MSA and PD. We analyzed the clinical features and VEMP and head-up tilt table test (HUT) findings using the Finometer in 24 patients with MSA and 52 with de-novo PD, who had undergone neurotologic evaluation in a referral-based university hospital in South Korea from January 2021 to March 2023. MSA was associated with bilateral oVEMP abnormality (odds ratio [95% confidence interval] = 9.19 [1.77–47.76], p=0.008). n1–p1 amplitude was negatively correlated with Unified Multiple System Atrophy Rating Scale I-II scores in patients with MSA (r=-0.571, p=0.033), whereas it did not correlate with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale-III scores in patients with PD (r=-0.051, p=0.687). n1 latency was negatively correlated with maximum changes in systolic blood pressure within 15 s during HUT in patients with PD (r=-0.335, p=0.040) but not in those with MSA (r=0.277, p=0.299). In conclusion, bilaterally abnormal oVEMP responses may indicate the extent of brainstem dysfunction in MSA. oVEMP reflects the integrity of otolith-autonomic interplay, reliably assists in differentiating between MSA and PD, and helps infer clinical decline.
Pain characteristics of Parkinson’s disease using validated Arabic versions of the King’s Parkinson’s Disease Pain Scale and Questionnaire: A Multicenter Egyptian Study
Ali Shalash, Salma R Mohamed, Marwa Y Badr, Shimaa Elgamal, Shaimaa A. Elaidy, Eman E. Elhamrawy, Hayam Abdel-Tawab, Haidy Elshebawy, Heba Mohamed, Tamer Roushdy, Wafik S. Bahnasy, Haitham H. Salem, Ehab A.El-Seidy, Hatem S Shehata, Hazem Marouf, K Ray Chaudhuri, Eman Hamid
Received April 9, 2024  Accepted June 25, 2024  Published online June 25, 2024  
DOI: https://doi.org/10.14802/jmd.24088    [Accepted]
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AbstractAbstract PDF
Objective
Pain is one of the most common non-motor symptoms in Parkinson’s disease (PD), with variable characteristics among populations. This multicenter Egyptian study aimed to translate and validate the King’s Parkinson’s Disease Pain Scale (KPPS) and questionnaire (KPPQ) into Arabic versions and to investigate the pain characteristics in Egyptian people with PD (PWP).
Methods
192 PWP and 100 sex and age-matched controls were evaluated by KPPS-Arabic and KPPQ-Arabic. Both tools were assessed for test-retest reliability, floor or ceiling effects, construct validity and convert validity. PWP were assessed also by MDS-UPDRS, Hoehn and Yahr, NMSS, PD Questionnaire-39, and the Non-Motor Fluctuation Assessment (NoMoFA).
Results
KPPS-Arabic and KPPQ-Arabic showed inter and intra-rater consistency and high validity, with an acceptable ceiling effect. 188 PWP (97.9%) reported at least 1 type of pain, (p<0.001). The severity and prevalence of KPPS-Arabic domains were significantly higher in all pain domains among PWP compared to controls (p < 0.001). Fluctuation-related and musculoskeletal pains were the most common (81.3% and 80.7%, respectively). In the PD group, the total and domains of KPPS-Arabic were significantly correlated to the MDS-UPDRS total, parts I, II, III, PIGD, axial, and H &Y scores, but not age or age of onset. Predictors of KPPS-Arabic included the total MDS-UPDRS, part III-Off, disease duration, total NMSS, and NoMoFA.
Conclusion
The current multicentre study provided a validated Arabic versions of KPPS and KPPQ, with high reliability and validity, and demonstrated a high prevalence and severity of pain within Egyptian PWP and characterized its determinants.
Association between exposure to particulate matter and incidence of Parkinson's disease: A nationwide cohort study in Taiwan
Ting-Bin Chen, Chih-Sung Liang, Ching-Mao Chang, Cheng-Chia Yang, Hwa-Lung Yu, Yuh-Shen Wu, Winn-Jung Huang, I-Ju Tsai, Yuan-Horng Yan, Cheng-Yu Wei, Chun-Pai Yang
Received January 2, 2024  Accepted June 18, 2024  Published online June 18, 2024  
DOI: https://doi.org/10.14802/jmd.24003    [Accepted]
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AbstractAbstract PDF
Objective
Emerging evidence suggests that air pollution exposure may increase the risk of Parkinson’s disease (PD). We aimed to investigate the association between exposure to fine particulate matter (PM2.5) and the risk of incident PD nationwide.
Methods
We utilized data from the Taiwan National Health Insurance Research Database, which was spatiotemporally linked with air quality data from the Taiwan Environmental Protection Administration website. The study population consisted of participants who were followed from the index date (January 1st, 2005) until the occurrence of PD or the end of the study period (December 31st, 2017). Participants who had a prior diagnosis of PD before the index date were excluded. To evaluate the association between exposure to PM2.5 and incident PD, we employed a Cox regression to estimate the hazard ratio with a 95% confidence interval (CI).
Results
A total of 454,583 participants were included, with a mean (SD) age of 63.1 (9.9) years and a male proportion of 50%. Over a mean follow-up period of 11.1 (3.6) years, 4% of the participants (n = 18,862) developed PD. We observed a significant positive association between PM2.5 exposure and the risk of PD, with a hazard ratio of 1.22 (95% CI, 1.20–1.23) per interquartile range increase in exposure (10.17 μg/m3) when adjusting for both SO2 and NO2.
Conclusion
We provide further evidence of an association between PM2.5 exposure and risk of PD. These findings underscore the urgent need for public health policies aimed at reducing ambient air pollution and its potential impact on PD.
Fatigue in PD is due to decreased efficiency of the frontal network: quantitative EEG analysis
Min Seung Kim, SangUk Park, Ukeob Park, Seung Wan Kang, Suk Yun Kang
Received February 17, 2024  Accepted June 5, 2024  Published online June 10, 2024  
DOI: https://doi.org/10.14802/jmd.24038    [Accepted]
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AbstractAbstract PDF
Objective
Fatigue is a common, debilitating non-motor symptom of Parkinson’s disease (PD), but its mechanism is poorly understood. We aimed to determine whether electroencephalography (EEG) could measure fatigue objectively and to expound on the pathophysiology of fatigue in PD.
Methods
We studied 32 de novo PD patients who underwent electroencephalography (EEG). We compared brain activity between 19 PD patients without fatigue and 13 PD patients with fatigue via EEG power spectrum and graph including global efficiency (GE), characteristic path length (CPL), clustering coefficient (CCO), small worldness (SW), local efficiency (LE), degree centrality (DC), closeness centrality (CCE), and betweenness centrality (BC).
Results
No significant differences in absolute and relative powers were seen between PD without and with fatigue (all ps > 0.02, Bonferroni-corrected). In network analysis, the brain network efficiency differed by frequency band. Generally, the brain network in the frontal area for theta and delta bands showed greater efficiency, and in the temporal area, the alpha1 band was less efficient in PD without fatigue (p= 0.0000, p = 0.0011, ps ≤ 0.0007, respectively, Bonferroni-corrected).
Conclusions
Our study suggests that PD patients with fatigue have less efficient networks in the frontal area compared with networks of those with PD without fatigue. These findings may explain why fatigue is common in PD, a frontostriatal disorder. Increased efficiency in the temporal area in PD with fatigue is assumed to be compensation. Brain network analysis using graph theory is more valuable than power spectrum analysis in revealing the brain mechanism related to fatigue.
Review Article
Functional Movement Disorders: Updates and Clinical Overview
Jung E Park
Received May 26, 2024  Accepted July 1, 2024  Published online July 1, 2024  
DOI: https://doi.org/10.14802/jmd.24126    [Accepted]
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AbstractAbstract PDF
Functional movement disorder(FMD) is a type of functional neurological disorder(FND) that is common, but often difficult to diagnose or manage. FMD can present as various phenotypes including tremor, dystonia, myoclonus, gait disorders and Parkinsonism. Conducting a clinical examination appropriate for the assessment of a patient with suspected FMD is important, and various diagnostic testing maneuvers may also be helpful. Treatment involving a multi-disciplinary team, either outpatient or inpatient, has been found to be most effective. Examples of such treatment protocols are also discussed in this review. While recognition and understanding of the disorder appears to have improved over the past few decades, as well as development of treatments, it is not uncommon for patients and physicians to continue to experience various difficulties when dealing with this disorder. In this review, I provide a practical overview of FMD and discuss how the clinical encounter itself can play a role in patients’ acceptance of the diagnosis. Updates on recent neuroimaging studies that aid in the understanding of the pathophysiology are also discussed.
Letters to the editor
Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) Masquerading as Charcot-Marie-Tooth (CMT) Disease: A Case Study and Literature Review of Korean Patients
Yongmoo Kim, Seungbok Lee, Jae So Cho, Jihoon G Yoon, Sheehyun Kim, Man Jin Kim, Jong Hee Chae, Manho Kim, Jangsup Moon
Received March 3, 2024  Accepted July 8, 2024  Published online July 9, 2024  
DOI: https://doi.org/10.14802/jmd.24054    [Accepted]
  • 285 View
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PDF
Potential Psychosis Induced by Sustained High Plasma Levodopa Concentration via Continuous Subcutaneous Foslevodopa/Foscarbidopa Infusion in Parkinson’s Disease: A Case Report
Toshiki Tezuka, Tomonori Nukariya, Yuta Kizuka, Shohei Okusa, Ryotaro Okochi, Yuto Sakai, Yoshihiro Nihei, Jin Nakahara, Morinobu Seki
Received May 13, 2024  Accepted June 28, 2024  Published online June 28, 2024  
DOI: https://doi.org/10.14802/jmd.24114    [Accepted]
  • 254 View
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PDF
Olfactory and Gustatory Function in Early-stage Parkinson’s Disease: Implication for Cognitive Association
Jeongjae Lee, Young Eun Kim, Joong Seob Lee, Suk Yun Kang, Min Seung Kim, In Hee Kwak, Jaeseol Park, Jung Yeon Nam, Hyeo-il Ma
Received November 20, 2023  Accepted June 27, 2024  Published online June 27, 2024  
DOI: https://doi.org/10.14802/jmd.23243    [Accepted]
  • 276 View
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PDF
Thalamic deep brain stimulation for SPG-56 related focal hand dystonia
Momo Uchida, Shiro Horisawa, Kenkou Azuma, Hiroyuki Akagawa, Shinichi Tokushige, Takakazu Kawamata, Takaomi Taira
Received January 27, 2024  Accepted June 26, 2024  Published online June 27, 2024  
DOI: https://doi.org/10.14802/jmd.24022    [Accepted]
  • 329 View
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PDF
The first East Asian Parkinson’s disease caused by A53E SNCA mutation with early progression to dementia
Yeo Jun Yoon, Chan Wook Park, Jin Ju Kim, Seok Jong Chung, Yun Joong Kim
Received May 17, 2024  Accepted June 13, 2024  Published online June 13, 2024  
DOI: https://doi.org/10.14802/jmd.24118    [Accepted]
  • 476 View
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PDF
Adult-Onset Alexander Disease with late-presenting vestibulopathy: A case report
Hee Jin Chang, Seong-Hae Jeong, Eungseok Oh
Received November 7, 2023  Accepted May 24, 2024  Published online May 27, 2024  
DOI: https://doi.org/10.14802/jmd.23230    [Accepted]
  • 385 View
  • 23 Download
PDF
Dopamine Dysregulation Syndrome Presenting as Overuse of Mucuna pruriens Levodopa Supplement
David O. Sohutskay, Rachel M. Suen, Farwa Ali, David J. Rosenman
Received March 16, 2024  Accepted May 18, 2024  Published online May 21, 2024  
DOI: https://doi.org/10.14802/jmd.24067    [Accepted]
  • 482 View
  • 33 Download
PDF
Tremulous dystonia due to GNAL haploinsufficiency caused by 18p deletion syndrome
Arianna Braccia, Miryam Carecchio, Francesca Luisa Sciacca, Anna Castagna, Antonio Emanuele Elia, Luigi Michele Romito
Received March 29, 2024  Accepted May 13, 2024  Published online May 13, 2024  
DOI: https://doi.org/10.14802/jmd.24080    [Accepted]
  • 699 View
  • 65 Download
PDF
Tremors in Infantile Tremor Syndrome mimicking Epilepsia Partialis Continua
Tonyot Gailson, Pradeep Kumar Gunasekaran, ArushiGahlot Saini, Chaitanya Reddy
Received March 22, 2024  Accepted May 8, 2024  Published online May 8, 2024  
DOI: https://doi.org/10.14802/jmd.24074    [Accepted]
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PDF
Brief communication
Efficacy and safety of zolpidem for musician’s dystonia
Shiro Horisawa, Kilsoo Kim, Masato Murakami, Masahiko Nishitani, Takakazu Kawamata, Takaomi Taira
Received May 20, 2024  Accepted June 28, 2024  Published online July 1, 2024  
DOI: https://doi.org/10.14802/jmd.24121    [Accepted]
  • 269 View
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AbstractAbstract PDF
Background
The efficacy and safety of zolpidem in treating musician’s dystonia are not well understood.
Objective
We aimed to retrospectively investigate the efficacy and safety of zolpidem for musician’s dystonia.
Methods
We retrospectively reviewed medical records between January 2021 and December 2023 to identify patients with musician’s dystonia who had been prescribed zolpidem. The Tubiana’s musician’s dystonia rating scale (range, 1-5; lower scores indicating greater severity) was used to evaluate musician’s dystonia.
Results
Fifteen patients were included in this study. The mean effective dose of zolpidem was 5.3±2.0 mg. The mean effective duration of zolpidem was 4.3±1.2 h. With zolpidem administration, the Tubiana’s musician’s dystonia rating scale score significantly improved from 2.2±1.0 to 4.3±0.8 (48.9% improvement, p<0.001). Two patients (13.3%) discontinued the drug owing to unsatisfactory results or sleepiness.
Conclusion
This study suggests that zolpidem may be an alternative treatment option for musician’s dystonia.

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