Journal of Movement Disorders

Original Article

Longitudinal implications of BDNF rs6265 polymorphism on motor and non-motor features of Parkinson’s disease in Korean population: Sang-Won Yoo, Yun Joong Kim, Dong-Woo Ryu, Yoonsang Oh, Seunggyun Ha, Joong-Seok Kim; Received November 7, 2025 Accepted January 16, 2026 Published online January 20, 2026; DOI: https://doi.org/10.14802/jmd.25300 [Accepted]

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Abstract PDF: Background
Brain-derived neurotrophic factor (BDNF) has been suggested to support dopaminergic neuron’s endurance and dopamine release. Its Val66Met polymorphism might modify Parkinson’s disease (PD) evolution, although evidence in Asian populations remains limited. This study aimed to explore how the BDNF rs6265 genotypes are associated with the clinical characteristics and longitudinal progression patterns of PD patients in a Korean population.
Methods
A total of 247 patients were enrolled and followed for a mean duration of 50.9 ± 23.9 months. Baseline and/or periodic assessments captured motor severity, non-motor burden, cognition, orthostatic stress, cardiac denervation, and presynaptic dopamine transporter availability. The repeated measures were manipulated to infer any genotypic differences in the trajectories of each clinical domain.
Results
Genotype frequencies were 31.2% (77/247) for Val/Val and 68.8% (170/247) for Met-allele carriers. Baseline clinical characteristics and presynaptic dopamine transporter availability were comparable between genotypes; however, Val homozygotes showed more preserved myocardial innervation and poorer non-frontal cognitive performance. Longitudinal analyses demonstrated genotype-specific increases in motor and cognitive severity. Compared to Met-allele carriers, the homozygous Val group exhibited accelerated motor progression and more rapid decline in frontal domain after three years of follow-up.
Conclusions
The differences in myocardial denervation at diagnosis, cognitive profiles, and motor progression might suggest a potential modulatory role of BDNF polymorphism in PD progression in the Korean population.

Review Article

Cardiac ¹²³I-Meta-Iodobenzylguanidine Imaging as a Biomarker for Body-First Parkinson’s Disease: Linking Peripheral α-Synuclein to Clinical Subtyping: Dong-Woo Ryu, Sang-Won Yoo, Yoonsang Oh, Joong-Seok Kim; J Mov Disord. 2026;19(1):1-10. Published online August 4, 2025; DOI: https://doi.org/10.14802/jmd.25137

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Recent neuropathological and imaging studies support the concept of “brain-first vs. body-first” Parkinson’s disease (PD), which is based on the α-synuclein origin site and connectome model. The body-first phenotype is characterized by early involvement of the peripheral autonomic nervous system, particularly the cardiac sympathetic nerves and enteric nerves. ¹²³I-meta-iodobenzylguanidine (¹²³I-MIBG) myocardial scintigraphy is a well-established method for evaluating cardiac sympathetic innervation. This review explores the potential of ¹²³I-MIBG scintigraphy as a biomarker to differentiate the body-first phenotype from the brain-first phenotype. Reduced ¹²³I-MIBG uptake has been observed in idiopathic rapid eye movement (REM) sleep behavior disorder, pure autonomic failure, and incidental Lewy body disease—conditions strongly associated with prodromal or early-stage PD. Postmortem and biopsy evidence indicates α-synuclein accumulation in cardiac nerves and other peripheral sites, which is consistent with bottom-up progression. α-Synuclein seed amplification assays further corroborate the association between the peripheral α-synuclein burden and reduced ¹²³I-MIBG uptake. While ¹²³I-MIBG myocardial scintigraphy is a promising tool, its limitations include cost, limited availability, and potential confounding from underlying cardiac conditions. Nonetheless, early detection of cardiac sympathetic denervation via ¹²³I-MIBG imaging may enhance diagnosis, support subtype classification, and improve the understanding of PD pathogenesis.

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Letter to the editor: B-type natriuretic peptide in Parkinson's disease: a novel biomarker of dysautonomia
Manxing Zhou, Tianmei Zhou
Parkinsonism & Related Disorders.2026; 142: 108123. CrossRef

Original Articles

Factors Associated With the Response to Exercise in Patients With Parkinson’s Disease: Myung Jun Lee, Jinse Park, Dong-Woo Ryu, Dallah Yoo, Sang-Myung Cheon; J Mov Disord. 2025;18(4):308-316. Published online May 16, 2025; DOI: https://doi.org/10.14802/jmd.25068

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Abstract PDF Supplementary Material: Objective
Exercises have been proposed as adjuvants for the treatment of Parkinson’s disease (PD); however, responses to exercise interventions have shown inconsistent results. We investigated the clinical factors associated with improvements in motor deficits after exercise.
Methods
A total of 85 patients with PD were enrolled from five tertiary hospitals and classified into four exercise groups: home exercise, strength training, Tai Chi, and yoga groups. Clinical measurements of the motor and nonmotor features of patients with PD were performed at baseline and 12 weeks after the exercise intervention. We employed principal component analysis (PCA) to reduce variables into ten factors and then examined associations of baseline characteristics with percentage improvement in the Movement Disorder Society sponsored Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III) score via a Bayesian regression model.
Results
In the multivariate Bayesian regression model including ten PCA-derived factors, the percentage improvement in the MDS-UPDRS III score was associated with factors including prominent motor deficits (posterior interval [mean±standard deviation]: 2.5±1.5) and nonmotor symptoms such as depression, anxiety, and subjective memory impairment (3.3±1.7). Another factor related to functional impairments in gait and postural control was associated with less improvement after the exercise intervention (-3.9±1.7). According to the subgroup analyses, motor features were associated with improvements in the home exercise and strength training groups, whereas mood disturbance, fatigue, and subjective cognitive impairment were related to changes in the home exercise and Tai Chi groups.
Conclusion
Our results suggest that the individual phenotypes of patients with PD may be associated with clinical improvement following exercise.

Comparison of the Impact of Various Exercise Modalities on Parkinson’s Disease: Jinse Park, Sang-Myung Cheon, Myung Jun Lee, Dong-Woo Ryu, Dallah Yoo; J Mov Disord. 2025;18(3):222-230. Published online April 15, 2025; DOI: https://doi.org/10.14802/jmd.25038

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Abstract PDF Supplementary Material

Objective
Exercise is a critical nonpharmacological intervention for Parkinson’s disease (PD); however, comparative evidence on the efficacy of different exercise modalities is limited. This study aimed to compare the effects of tai chi, strength training, yoga, and home-based exercises on motor function in patients with PD.
Methods
In this multicenter, open-label, randomized clinical trial, 99 patients with PD were allocated to one of four exercise interventions: tai chi, strength training, yoga, or home-based exercises. Each intervention consisted of 12 weeks of supervised sessions, followed by 12 weeks of independent practice. The primary outcomes included the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III and timed up-and-go (TUG) test parameters. The assessed secondary outcomes included physical activity (measured via short physical performance battery and the 6-minute walking test [6MWT]), balance (measured via the Mini-BEST), and freezing of gait (measured via the New Freezing of Gait Questionnaire).
Results
Home exercise and tai chi demonstrated significant improvements in the MDS-UPDRS Part III scores over 24 weeks. The 6MWT was improved by home exercises and tai chi; additionally, the Mini-BEST test scores were enhanced by strength exercises and yoga. The total duration and forward movement of the TUG test, as well as the turning duration measured via the wearable sensor, were markedly improved in the yoga group.
Conclusion
Our results support the notion that various types of adherence to and outcomes of exercise can be observed in real-world settings, even though the effectiveness of exercise is well established. These findings highlight the importance of tailoring exercise regimens by considering individual patients in PD management.

Citations

Citations to this article as recorded by

Telerehabilitation for Parkinson’s disease: a systematic review and meta-analysis based on randomized controlled trials
Renfei Li, Lili Wang, Jian Zhang
Neurological Sciences.2026;[Epub] CrossRef
Summary of the best evidence for non-pharmaceutical interventions for mild cognitive impairment in Parkinson’s disease
Yud Dan Liu, Hui Fang Li, Ya Xian Zhai, Yun Xia Shen, Jinmei Yang, Li Mei He, Ting Shen
Frontiers in Neurology.2025;[Epub] CrossRef
Symptom Networks and Associations with Quality of Life in Patients with Early to Mid-Stage Parkinson’s Disease: A Network Analysis
Qiu Deng, Yaoling Duan, Zhengting Yang, Puqing Wang, Ziwei Liu, Min Zhou
Degenerative Neurological and Neuromuscular Disease.2025; Volume 15: 101. CrossRef
Factors Associated With the Response to Exercise in Patients With Parkinson’s Disease
Myung Jun Lee, Jinse Park, Dong-Woo Ryu, Dallah Yoo, Sang-Myung Cheon
Journal of Movement Disorders.2025; 18(4): 308. CrossRef

Trends in Physiotherapy Interventions and Medical Costs for Parkinson’s Disease in South Korea, 2011–2020: Dong-Woo Ryu, Jinse Park, Myung Jun Lee, Dallah Yoo, Sang-Myung Cheon; J Mov Disord. 2024;17(3):270-281. Published online March 19, 2024; DOI: https://doi.org/10.14802/jmd.23269

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Abstract PDF Supplementary Material

Objective
Physiotherapy (PT), which is an effective strategy for managing Parkinson’s disease (PD), can influence health care utilization. We analyzed trends in health care utilization, PT interventions, and medical costs among patients with PD.
Methods
Using data from the Korean National Health Insurance Service from 2011 to 2020, we analyzed the number of patients with PD and their health care utilization and assessed the odds ratio (OR) for receiving regular PTs.
Results
Over 10 years, 169,613 patients with PD were included in the analysis. The number of patients with PD increased annually from 49,417 in 2011 to 91,841 in 2020. The number of patients with PD receiving PT increased from 4,847 (9.81%) in 2011 to 13,163 (14.33%) in 2020, and the number of PT prescriptions increased from 81,220 in 2011 to 377,651 in 2019. Medical costs per patient with PD increased from 1,686 United States dollars (USD) in 2011 to 3,202 USD in 2020. The medical expenses for each patient with PD receiving PT increased from 6,582 USD in 2011 to 13,475 USD in 2020. Moreover, regular PTs were administered to 31,782 patients (18.74%) and were administered only through hospitalization. Those patients in their 50s with disabilities demonstrated a high OR for regular PTs, whereas those aged 80 years or older and residing outside of Seoul had a low OR.
Conclusion
The PD burden increased in South Korea between 2011 and 2020, as did health care utilization and medical costs. A significant increase in medical expenses can be associated with increased PD incidence and PT interventions. Regular PT applications remain restricted and have barriers to access.

Citations

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AI FRAMEWORK FOR PREDICTING PHYSIOLOGICAL INDICATORS FROM HIGH-RESOLUTION IRIS IMAGES IN PARKINSON’S DISEASE PATIENTS
HAKWON KIM, JEONG-WOO SEO, SEONG-IL PARK, JUNYOUNG HUR, MISO S. PARK, HORYONG YOO
Journal of Mechanics in Medicine and Biology.2025;[Epub] CrossRef

Fasting Plasma Glucose Levels and Longitudinal Motor and Cognitive Outcomes in Parkinson’s Disease Patients: Ko-Eun Choi, Dong-Woo Ryu, Yoon-Sang Oh, Joong-Seok Kim; J Mov Disord. 2024;17(2):198-207. Published online March 6, 2024; DOI: https://doi.org/10.14802/jmd.23264

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Abstract PDF Supplementary Material

Objective
Hyperglycemia and diabetes mellitus have been identified as poor prognostic factors for motor and nonmotor outcomes in patients with Parkinson’s disease (PD), although there is some controversy with this finding. In the present study, we investigated the effects of fasting plasma glucose (FPG) levels on longitudinal motor and cognitive outcomes in PD patients.
Methods
We included a total of 201 patients who were diagnosed with PD between January 2015 and January 2020. The patients were categorized based on FPG level into euglycemia (70 mg/dL < FPG < 100 mg/dL), intermediate glycemia (100 mg/dL ≤ FPG < 126 mg/dL), and hyperglycemia (FPG ≥ 126 mg/dL), and longitudinal FPG trajectories were analyzed using group-based trajectory modeling. Survival analysis was conducted to determine the time until motor outcome (Hoehn and Yahr stage ≥ 2) and the conversion from normal cognition to mild cognitive impairment.
Results
Among the patient cohort, 82 had euglycemia, 93 had intermediate glycemia, and 26 had hyperglycemia. Intermediate glycemia (hazard ratio 1.747, 95% confidence interval [CI] 1.083–2.816, p = 0.0221) and hyperglycemia (hazard ratio 3.864, 95% CI 1.996–7.481, p < 0.0001) were found to be significant predictors of worsening motor symptoms. However, neither intermediate glycemia (hazard ratio 1.183, 95% CI 0.697–2.009, p = 0.5339) nor hyperglycemia (hazard ratio 1.297, 95% CI 0.601–2.800, p = 0.5078) demonstrated associations with the longitudinal progression of cognitive impairment. Diabetes mellitus, defined by self-reported medical history, was not related to poor motor or cognitive impairment outcomes.
Conclusion
Our results suggest that both impaired glucose tolerance and hyperglycemia could be associated with motor progression in PD patients.

Citations

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Type 2 Diabetes Mellitus and Parkinson's Disease: An Emerging Link
Shubham Teli, Mallappa Shalavadi, Chandrashekhar V.M., Lingaraj Anawal
Current Signal Transduction Therapy.2025;[Epub] CrossRef
Early diagnosis of Parkinson's disease by highly sensitive monitoring of glucose using an atomic-level defect-enriched MoS2/Au SERS sensor enabled by LSPR-PICT synergy
Yingjiao Zhai, Yu Zhang, Fujun Liu, Kaixi Shi, Wenhui Fang, Zhiying Wang, Jinhua Li
Applied Physics Letters.2025;[Epub] CrossRef
Association of triglyceride glucose-waist to height ratio index with Parkinson’s disease and the mediating role of systemic inflammatory response index: A cross-sectional study
Keyu Shi, Zikai Pei, Sijie Quan, Yue Shi, Yi Zhou
Medicine.2025; 104(52): e46737. CrossRef
Peripheral inflammatory markers and clinical phenotypes reflecting the impact of diabetes on Parkinson's disease
In Hee Kwak, Hyeo-il Ma, Yun Joong Kim, Hye-Mi Noh, Jeongjae Lee, Je Kook Yu, Young Eun Kim
Journal of Parkinson’s Disease.2025; 15(8): 1431. CrossRef

Erratum

The Impact of Impulsivity on Quality of Life in Early Drug-Naïve Parkinson’s Disease Patients: Dong-Woo Ryu, Joong-Seok Kim, Sang-Won Yoo, Yoon-Sang Oh, Kwang-Soo Lee; J Mov Disord. 2021;14(2):176-176. Published online May 26, 2021; DOI: https://doi.org/10.14802/jmd.19004.e; Corrects: J Mov Disord 2019;12(3):172

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Original Article

The Impact of Impulsivity on Quality of Life in Early Drug-Naïve Parkinson’s Disease Patients: Dong-Woo Ryu, Joong-Seok Kim, Sang-Won Yoo, Yoon-Sang Oh, Kwang-Soo Lee; J Mov Disord. 2019;12(3):172-176. Published online August 9, 2019; DOI: https://doi.org/10.14802/jmd.19004; Correction in: J Mov Disord 2021;14(2):176

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Abstract PDF

Objective
Impulse control disorders (ICDs) in Parkinson’s disease (PD) are mostly related to dopamine replacement therapy (DRT); however, drug-naïve PD patients have also frequently experienced impulsivity. This phenomenon makes clinicians hesitate treating patients with DRT. In this study, we assessed the effect of impulsivity on quality of life (QOL) in drug-naïve PD patients.
Methods
Two hundred three newly diagnosed, nonmedicated PD patients were enrolled, and they received structured clinical interviews, physical examinations and validated questionnaires to evaluate motor and nonmotor symptoms and QOL. Impulsivity was evaluated using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS).
Results
Thirty-eight patients (18.7%) had impulsivity with QUIP-RS scores ≥ 1 and 4 patients (2.0%) were diagnosed with combined ICDs. Motor and nonmotor symptoms were significantly correlated with the Parkinson’s Disease Questionnaire-39 summary index. Female sex and QUIP-RS scores were also correlated with QOL in drug-naïve PD patients.
Conclusion
The results of the present study showed that impulsivity negatively influences QOL in early drug-naïve PD patients. In addition, more severe motor and nonmotor symptoms were also associated with lower QOL. Such findings complicate treatment but provide valuable information for managing early PD.

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Neurological Sciences.2025; 46(11): 5829. CrossRef
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Alexandros Kapsomenakis, Dimitrios Kasselimis, Emily Vaniotis, Anastasia Bougea, Christos Koros, Athina Maria Simitsi, Leonidas Stefanis, Constantin Potagas
Medicina.2023; 59(11): 1942. CrossRef
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Frontiers in Neurology.2021;[Epub] CrossRef
Dopamine genetic risk score predicts impulse control behaviors in Parkinson’s disease
Alison Hall, Samuel R. Weaver, Lindsey J. Compton, Winston D. Byblow, Ned Jenkinson, Hayley J. MacDonald
Clinical Parkinsonism & Related Disorders.2021; 5: 100113. CrossRef
A Review of the Concept of Impulsivity
Mohammed Munther Al-Hammouri, Jehad A. Rababah, Celeste Shawler
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Assessment of therapeutic strategies for management of impulse control disorder in Parkinson’s disease
Mayela Rodríguez-Violante, Yazmín Ríos-Solís, Oscar Esquivel-Zapata, Fanny Herrera, Susana López-Alamillo, Cynthia Sarabia-Tapia, Amin Cervantes-Arriaga
Arquivos de Neuro-Psiquiatria.2021; 79(11): 989. CrossRef

Letter to the editor

Camptocormia with Transient Ischemic Attack: Ju-Hee Oh, Dong-Woo Ryu, Si-Hoon Lee, Joong-Seok Kim; J Mov Disord. 2017;10(1):62-63. Published online January 18, 2017; DOI: https://doi.org/10.14802/jmd.16043

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