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JMD : Journal of Movement Disorders

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Original Article
Gait instability and compensatory mechanisms in Parkinson's disease with camptocormia: An exploratory study
Hideyuki Urakami, Yasutaka Nikaido, Yuta Okuda, Yutaka Kikuchi, Ryuichi Saura, Yohei Okada
Received November 8, 2024  Accepted December 27, 2024  Published online December 27, 2024  
DOI: https://doi.org/10.14802/jmd.24226    [Accepted]
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AbstractAbstract PDF
Objective
Camptocormia has been considered to contribute to vertical gait instability and, at times, may also lead to forward instability in experimental settings in Parkinson's disease (PD). However, these aspects, along with compensatory mechanisms, remain largely unexplored. This study comprehensively investigated gait instability and compensatory strategies in PD patients with camptocormia (PD+CC).
Methods
Ten PD+CC, 30 without camptocormia (PD-CC), and 27 healthy controls (HCs) participated. Self-paced gait tasks were analyzed using three-dimensional motion capture systems to assess gait stability, spatiotemporal, and kinematic parameters. Unique cases with pronounced forward gait stability or instability were first identified, followed by group comparisons. Correlation analysis was performed to examine associations between trunk flexion angles (lower/upper) and gait parameters. Significance level was set at 0.05.
Results
Excluding one unique case, the PD+CC group showed a significantly lower vertical center of mass (COM) position (p=0.019), along with increased mediolateral COM velocity (p=0.004) and step width (p=0.013), compared to PD-CC group. Both PD groups showed higher anterior-posterior margin of stability than HCs (p<0.001). Significant correlations were found between lower/upper trunk flexion angles and a lower vertical COM position (r=-0.690/-0.332), as well as increased mediolateral COM velocity (r=0.374/0.446) and step width (r=0.580/0.474).
Conclusions
Most PD+CC patients exhibited vertical gait instability, increasing fall risk, and adopted compensatory strategies involving greater lateral COM shift and wider base of support, with these trends intensifying as trunk flexion angles increased. These findings may guide targeted interventions for gait instability in PD+CC.
Letters to the editor
Spastic paraplegia 82 in two Asian Indian siblings with PCYT2 mutation
Anil Dash, Farsana Mustafa, Divyani Garg, Sreeja Samineni, Ayush Agarwal, Ajay Garg, Achal Kumar Srivastava
Received December 16, 2024  Accepted January 24, 2025  Published online January 31, 2025  
DOI: https://doi.org/10.14802/jmd.24259    [Accepted]
  • 345 View
  • 5 Download
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Diagnosing Cerebrotendinous Xanthomatosis in a Middle-Aged Woman with Cervical Dystonia
Wei-Sheng Wang, Yu-Ping Chiu, Meng-Han Tsai, Shey-Lin Wu, Yen-Chung Chen
Received September 28, 2024  Accepted January 17, 2025  Published online January 20, 2025  
DOI: https://doi.org/10.14802/jmd.24202    [Accepted]
  • 399 View
  • 13 Download
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Levodopa Pharmacokinetics in Switching from Levodopa/Carbidopa Intestinal Gel to Continuous Subcutaneous Foslevodopa/Foscarbidopa Infusion in a Patient with Parkinson's Disease: a case report
Tomonori Nukariya, Toshiki Tezuka, Shohei Okusa, Ryotaro Okochi, Yuto Sakai, Yoshihiro Nihei, Jin Nakahara, Morinobu Seki
Received November 28, 2024  Accepted January 6, 2025  Published online January 6, 2025  
DOI: https://doi.org/10.14802/jmd.24247    [Accepted]
  • 472 View
  • 111 Download
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Two cases of genetically proven SCARB2-Related Progressive Myoclonic Epilepsy without renal failure: A report from India
Pavankumar Katragadda, Vikram V Holla, Gautham Arunachal, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal
Received October 27, 2024  Accepted December 17, 2024  Published online December 27, 2024  
DOI: https://doi.org/10.14802/jmd.24222    [Accepted]
  • 271 View
  • 17 Download
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Brief communications
Pre-DBS modified Tremor/Postural instability and gait difficulty score ratio as indicator of short-term outcome of subthalamic nucleus DBS in Parkinson’s disease
Chakradhar Reddy, Kanchana Pillai, Shejoy Joshua, Anup Nair, Harshad Chavotiya, Manas Chacko, Asha Kishore
Received August 5, 2024  Accepted January 2, 2025  Published online January 2, 2025  
DOI: https://doi.org/10.14802/jmd.24175    [Accepted]
  • 236 View
  • 14 Download
AbstractAbstract PDF
Purpose
-The outcomes of motor and non-motor features of Parkinson’s disease (PD) following DBS vary among its subtypes. We tested whether pre-operative motor subtyping using the modified Tremor/PIGD ratio, could indicate the short-term motor, non-motor and quality of life (QOL) outcomes of STN-DBS.
Method
In this prospective study, 39 consecutive STN-DBS cases were assessed in Drug-OFF state before surgery and subtyped using the ratio of tremor and PIGD scores (T/P ratio). 6 months after surgery patients were reassessed in Stimulation ON-Drug OFF state and the percentage change in motor, non-motor and QOL scores (PDQ39) was calculated.
Results
The modified T/P ratio had a moderate, positive correlation with the percentage change in scores of UPDRS III in OFF, sum of cardinal motor signs, non-motor symptoms scale (NMSS) and quality of life (PDQ39).
Conclusion
Preoperative PD motor subtyping can be used as an indicator of the short-term, outcomes of STN-DBS in PD.
Validation of the Korean Version of the Huntington’s Disease Quality of Life Battery for Carers
Hee Jin Chang, Eungseok Oh, Won Tae Yoon, Chan Young Lee, Kyum-Yil Kwon, Yun Su Hwang, Chaewon Shin, Jee-Young Lee
Received October 21, 2024  Accepted December 20, 2024  Published online December 30, 2024  
DOI: https://doi.org/10.14802/jmd.24217    [Accepted]
  • 319 View
  • 18 Download
AbstractAbstract PDF
Objectives
The Huntington's Disease Quality of Life Battery for Carers (HDQoL-C) evaluates caregiver quality of life. This study aims to develop and validate the Korean version (K-HDQoL-C) to assess the burden on Korean caregivers of HD patients.
Methods
Nineteen HD caregivers (7 females, mean age 55.4±14.6 years) participated. The K-HDQoL-C, a translation of the English version, consisted of demographic information, caring aspects, life satisfaction, and feelings about life. It was administered twice, two weeks apart. Internal consistency was evaluated using Cronbach’s α, and test-retest reliability was assessed with intraclass correlation coefficients. The relationship with the Zarit Burden Interview-12 (ZBI-12) was analyzed.
Results
Internal consistencies of K-HDQoL-C were 0.771 (part 2), 0.938 (part 3), and 0.891 (part 4). Test-retest reliability ranged from 0.908 to 0.936. Part 3 negatively correlated with ZBI-12, and part 4 positively correlated (R = -0.780, 0.923; p < 0.001).
Conclusion
The K-HDQoL-C effectively evaluates challenges faced by HD caregivers, particularly in care aspects and life satisfaction.

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