Journal of Movement Disorders

Review Article

Digital Technology for Sleep Symptoms in Parkinson’s Disease: A Scoping Review: Kye Won Park, Ki-Young Jung, Han-Joon Kim, Jung Hwan Shin; J Mov Disord. 2026;19(2):119-134. Published online April 14, 2026; DOI: https://doi.org/10.14802/jmd.26098

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Abstract PDF Supplementary Material: Sleep disturbances are highly prevalent and clinically significant nonmotor features of Parkinson’s disease (PD). Although in-laboratory polysomnography remains the gold standard method for investigating these disturbances, its limited scalability and ecological validity constrain longitudinal and real-world assessments. Recent advances in digital health technologies have introduced a broad spectrum of portable, wearable, and contactless tools for sleep monitoring. In this scoping review, we systematically map the landscape of digital sleep technologies in PD by using a tiered framework based on technical maturity and clinical validation (Tiers 1–4); moreover, we further classify them by signal modality and sleep symptom domain. Through a systematic review of the literature, we identified 19 studies (Tiers 2–4) that applied digital biomarkers to assess sleep disturbances in PD, including REM sleep behavior disorder, nocturnal immobility, insomnia, circadian rhythm disturbances, excessive daytime sleepiness, and sleep-related respiratory and movement disorders. We additionally contextualize these findings against the rapid expansion of multimodal and AI-driven Tier 3–4 platforms in the general population. Despite this technological progress, a major translational gap persists in PD, which is characterized by limited disease-specific validation, small cohort sizes, and insufficient multimodal benchmarking. Multimodal systems leveraging machine learning offer a promising direction by enabling the more precise characterization of complex and overlapping sleep phenotypes. Emerging contactless systems further expand the potential for continuous, low-burden monitoring, although their clinical validity remains to be established. Future development of digital sleep biomarkers in PD will require prospective validation against established standards and the integration of multimodal data to enable scalable, longitudinal phenotyping and clinical trial applications.

Erratum

Efficacy and Safety of Taltirelin Hydrate in Patients With Ataxia Due to Spinocerebellar Degeneration: Jin Whan Cho, Jee-Young Lee, Han-Joon Kim, Joong-Seok Kim, Kun-Woo Park, Seong-Min Choi, Chul Hyoung Lyoo, Seong-Beom Koh; J Mov Disord. 2026;19(2):244-245. Published online February 20, 2026; DOI: https://doi.org/10.14802/jmd.24127e; Corrects: J Mov Disord 2025;18(1):35

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Letter to the editor

Patient-Perceived Response to Medical Treatment for Hemifacial Spasm: Su Hyeon Ha, Seoyeon Kim, Seungmin Lee, Bora Jin, Kyung Ah Woo, Jung Hwan Shin, Han-Joon Kim; J Mov Disord. 2026;19(1):114-116. Published online October 28, 2025; DOI: https://doi.org/10.14802/jmd.25248

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Original Article

Differential Peripheral NLRP3 Inflammasome Expression in Patients With Parkinson’s Disease and Patients With Multiple System Atrophy: Jeongjae Lee, Han-Joon Kim, Huu Dat Nguyen, Suk Jun Song, Trung Nguyen Thanh, In Hee Kwak, Hye Joung Choi, Hyeo-il Ma, Young Eun Kim; J Mov Disord. 2026;19(1):31-38. Published online September 30, 2025; DOI: https://doi.org/10.14802/jmd.25124

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Abstract PDF Supplementary Material: Objective
The NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome has been proposed to be a downstream mediator of neuroinflammation in individuals with Parkinson’s disease (PD). However, its involvement across disease stages and related synucleinopathies, such as multiple system atrophy (MSA), remains unclear. We aimed to analyze the peripheral mRNA expression of NLRP3-related genes and cytokines across individuals with isolated REM sleep behavior disorder (iRBD), early-stage PD, late-stage PD, and MSA.
Methods
Peripheral blood mononuclear cells (PBMCs) were collected from 151 participants: 35 healthy controls (HCs), 31 patients with iRBD, 41 patients with early-stage PD, 21 patients with late-stage PD, and 23 patients with MSA. mRNA expression was measured using quantitative real-time polymerase chain reaction. Statistical comparisons were performed using analysis of variance (ANOVA) or Welch’s ANOVA, and associations with clinical variables were analyzed through stepwise multiple linear regression.
Results
NLRP3 expression was significantly lower in patients with iRBD (p=0.0263) and patients with early-stage PD (p= 0.0101) than in HCs. NIMA-related kinase 7 (NEK7) expression progressively decreased across the disease spectrum (HCs vs. patients with early-stage PD, p=0.0008; vs. patients with late-stage PD, p<0.0001). In contrast, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) and caspase-1 were elevated in patients with PD, especially those in the late stages. Levels of patients with MSA resembled those of HCs but differed from those of patients with PD. Interleukin (IL)-1β and IL-18 levels were not significantly different. In patients with early-stage PD, NLRP3 expression was negatively correlated with disease duration, the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale Part II score, and the cognitive score.
Conclusion
Our findings challenge the prevailing hypothesis that NLRP3 inflammasome activation directly contributes to PD pathogenesis. Instead, the observed increase in ASC and caspase-1 expression suggests the potential involvement of alternative inflammasome pathways during disease progression.

Brief communication

Spatiotemporal Gait Parameters During Turning and Imbalance in Parkinson’s Disease: Video-Based Analysis From a Single Camera: HoYoung Jeon, Jung Hwan Shin, Ri Yu, Min Kyung Kang, Seungmin Lee, Seoyeon Kim, Bora Jin, Kyung Ah Woo, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2025;18(1):87-92. Published online December 23, 2024; DOI: https://doi.org/10.14802/jmd.24210

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Abstract PDF Supplementary Material

Objective
This study aims to objectively evaluate turning gait parameters in Parkinson’s disease (PD) patients using 2D-RGB video-based analysis and explore their relationships with imbalance.
Methods
We prospectively enrolled PD patients for clinical assessment, balance analysis and gait with 180º turning. Spatiotemporal gait parameters during turning were derived using video-based analysis and correlated with modified Hoehn and Yahr (mHY) stages and center of pressure (COP) oscillations.
Results
A total of 64 PD patients were enrolled. The PD patients with higher mHY stages (≥2.5) had significantly longer turning times, greater numbers of steps, wider step bases and less variability in step length during turns. COP oscillations were positively correlated with the mean turning time on both the anterior-posterior and right-left axes.
Conclusion
Spatiotemporal gait parameter during turning, derived from video-based gait analysis, may represent apromising biomarker for monitoring postural instability in PD patients.

Citations

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Uncovering the Kinematic Signature of Freezing of Gait in Parkinson’s Disease Through Wearable Inertial Sensors
Francesco Castelli Gattinara Di Zubiena, Alessandro Zampogna, Martina Patera, Giovanni Cusolito, Ludovica Apa, Ilaria Mileti, Antonio Cannuli, Antonio Suppa, Marco Paoloni, Zaccaria Del Prete, Eduardo Palermo
Sensors.2025; 25(16): 5054. CrossRef
Gait Patterns and Balance Impairment in Parkinson’s Disease With Correlation to Disease Severity
Danyeong Kim, Da-Eun Jeong, Hyunkyung Yi, Min Ju Kang
Dementia and Neurocognitive Disorders.2025; 24(4): 259. CrossRef
Clinical and neuroimaging correlates of disease related gait patterns in patients with multiple system atrophy cerebellar type
Seungmin Lee, Minchul Kim, Kyu Sung Choi, Chanhee Jeong, Ri Yu, Jee-Young Lee, Jung Hwan Shin, Han-Joon Kim, Beomseok Jeon
Scientific Reports.2025;[Epub] CrossRef

Original Article

Efficacy and Safety of Taltirelin Hydrate in Patients With Ataxia Due to Spinocerebellar Degeneration: Jin Whan Cho, Jee-Young Lee, Han-Joon Kim, Joong-Seok Kim, Kun-Woo Park, Seong-Min Choi, Chul Hyoung Lyoo, Seong-Beom Koh; J Mov Disord. 2025;18(1):35-44. Published online October 21, 2024; DOI: https://doi.org/10.14802/jmd.24127; Correction in: J Mov Disord 2026;19(2):244

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Abstract PDF Supplementary Material

Objective
We conducted this study to assess the efficacy and safety of taltirelin hydrate (TH) in patients with ataxia due to spinocerebellar degeneration (SCD).
Methods
Patients were randomly assigned to either the taltirelin group (5 mg orally, twice daily) or the control group. The primary endpoint was the change in the Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) score at 24 weeks. The secondary endpoints included changes in the K-SARA score at 4 and 12 weeks as well as the Clinical Global Impression Scale, the five-level version of the EuroQol five-dimensional questionnaire, the Tinetti balance test, and gait analysis at 4, 12, and 24 weeks.
Results
A total of 149 patients (hereditary:nonhereditary=86:63) were enrolled. There were significant differences in the change in the K-SARA score at 24 weeks from baseline between the taltirelin group and the control group (-0.51±2.79 versus 0.36±2.62, respectively; p=0.0321). For the K-SARA items, the taltirelin group had significantly lower “Stance” and “Speech disturbance” subscores than the control group (-0.04±0.89 versus 0.23±0.79 and -0.07±0.74 versus 0.18±0.67; p=0.0270 and 0.0130, respectively). However, there were no significant differences in changes in other secondary efficacy outcome measures at 24 weeks from baseline between the two treatment arms (p>0.05).
Conclusion
Clinicians might consider the use of TH in the treatment of patients with ataxia due to SCD.

Citations

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Taltirelin treatment alleviates PTSD-like symptoms and restores neural oscillations in male mice receiving single prolonged stress
Keke Ding, Zhengrong Zhang, Jingwen Niu, Mingyue Zhu, Junjie Zhang, Lixia Chen, Shaojie Yang, Jingji Wang, Guoqi Zhu
Neuropharmacology.2026; 284: 110791. CrossRef
Long-term efficacy and disease-specific responsiveness to protirelin in patients with spinocerebellar degeneration: A retrospective study
Shohei Okusa, Toshiki Tezuka, Jin Nakahara, Morinobu Seki
Parkinsonism & Related Disorders.2026; 145: 108238. CrossRef

Brief communication

Evaluating the Validity and Reliability of the Korean Version of the Scales for Outcomes in Parkinson’s Disease–Cognition: Jinse Park, Eungseok Oh, Seong-Beom Koh, In-Uk Song, Tae-Beom Ahn, Sang Jin Kim, Sang-Myung Cheon, Yoon-Joong Kim, Jin Whan Cho, Hyeo-Il Ma, Mee Young Park, Jong Sam Baik, Phil Hyu Lee, Sun Ju Chung, Jong-Min Kim, Han-Joon Kim, Young-Hee Sung, Do Young Kwon, Jae-Hyeok Lee, Jee-Young Lee, Ji Seon Kim, Ji Young Yun, Hee Jin Kim, Jin Yong Hong, Mi-Jung Kim, Jinyoung Youn, Hui-Jun Yang, Won Tae Yoon, Sooyeoun You, Kyum-Yil Kwon, Su-Yun Lee, Younsoo Kim, Hee-Tae Kim, Joong-Seok Kim, Ji-Young Kim; J Mov Disord. 2024;17(3):328-332. Published online April 3, 2024; DOI: https://doi.org/10.14802/jmd.24061

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Abstract PDF Supplementary Material

Objective
The Scales for Outcomes in Parkinson’s Disease–Cognition (SCOPA-Cog) was developed to assess cognition in patients with Parkinson’s disease (PD). In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPACog (K-SCOPA-Cog).
Methods
We enrolled 129 PD patients with movement disorders from 31 clinics in South Korea. The original version of the SCOPA-Cog was translated into Korean using the translation-retranslation method. The test–retest method with an intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient were used to assess reliability. Spearman’s rank correlation analysis with the Montreal Cognitive Assessment-Korean version (MOCA-K) and the Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity.
Results
The Cronbach’s alpha coefficient was 0.797, and the ICC was 0.887. Spearman’s rank correlation analysis revealed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively).
Conclusion
Our results demonstrate that the K-SCOPA-Cog has good reliability and validity.

Citations

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Clinical Outcome Assessments in Parkinson's Disease: A Scoping Review of Current Rating Scales and Future Needs
Evita Papathoma, Panagiota Tsitsi, Nirosen Vijiaratnam, Camila Aquino, Stephen R. Duma, Norbert Kovacs, Kigocha Lameck Okeng'o, Aparna Wagle Shukla, Roongroj Bhidayasiri, Tiago A. Mestre, Alvaro Sanchez Ferro, Alberto J. Espay, Michelle H.S. Tosin, Matej
Movement Disorders Clinical Practice.2026; 13(5): 1124. CrossRef
Validation of the Korean Moss Attention Rating Scale in Traumatic Brain Injury: Reliability and Validity
Sung Hoon Jeong, Jun Hee Won, Byung-Mo Oh, Junghoon J. Kim, Ja-Ho Leigh, Gain Shin, Sodam Lee, Hoo Young Lee
Korean Journal of Neurotrauma.2026; 22(1): 24. CrossRef

Original Article

Caregiver Burden of Patients With Huntington’s Disease in South Korea: Chan Young Lee, Chaewon Shin, Yun Su Hwang, Eungseok Oh, Manho Kim, Hyun Sook Kim, Sun Ju Chung, Young Hee Sung, Won Tae Yoon, Jin Whan Cho, Jae-Hyeok Lee, Han-Joon Kim, Hee Jin Chang, Beomseok Jeon, Kyung Ah Woo, Seong-Beom Koh, Kyum-Yil Kwon, Jangsup Moon, Young Eun Kim, Jee-Young Lee; J Mov Disord. 2024;17(1):30-37. Published online September 11, 2023; DOI: https://doi.org/10.14802/jmd.23134

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Abstract PDF Supplementary Material

Objective
This is the first prospective cohort study of Huntington’s disease (HD) in Korea. This study aimed to investigate the caregiver burden in relation to the characteristics of patients and caregivers.
Methods
From August 2020 to February 2022, we enrolled patients with HD from 13 university hospitals in Korea. We used the 12-item Zarit Burden Interview (ZBI-12) to evaluate the caregiver burden. We evaluated the clinical associations of the ZBI-12 scores by linear regression analysis and investigated the differences between the low- and high-burden groups.
Results
Sixty-five patients with HD and 45 caregivers were enrolled in this cohort study. The average age at onset of motor symptoms was 49.3 ± 12.3 years, with an average cytosine-adenine-guanine (CAG)n of 42.9 ± 4.0 (38–65). The median ZBI-12 score among our caregivers was 17.6 ± 14.2. A higher caregiver burden was associated with a more severe Shoulson–Fahn stage (p = 0.038) of the patients. A higher ZBI-12 score was also associated with lower independence scale (B = -0.154, p = 0.006) and functional capacity (B = -1.082, p = 0.002) scores of patients. The caregiving duration was longer in the high- than in the low-burden group. Caregivers’ demographics, blood relation, and marital and social status did not affect the burden significantly.
Conclusion
HD patients’ neurological status exerts an enormous impact on the caregiver burden regardless of the demographic or social status of the caregiver. This study emphasizes the need to establish an optimal support system for families dealing with HD in Korea. A future longitudinal analysis could help us understand how disease progression aggravates the caregiver burden throughout the entire disease course.

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Quality of life and care burden of people living with amyotrophic lateral sclerosis who need home-based medical care in Korea and their family caregivers
Shin Hye Yoo, Belong Cho, Kyae Hyung Kim, In Young Hwang, Woohyeon Cho, Seok-Jin Choi, Jung-Joon Sung, Sun Young Lee
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration.2026; 27(3-4): 274. CrossRef
Impact of X-linked dystonia-parkinsonism on caregiver strain, anxiety and depression
Paulo Cataniag, Jed Noel Ong, Cid Czarina Diesta
BMJ Neurology Open.2026; 8(1): e001612. CrossRef
The holistic burden of Huntington's disease: A qualitative study of multigenerational impact on individuals and family caregivers across Europe
Charlie Albert Smith, Savita Bakhshi Anand, Astri Arnesen, Cecilia Jimenez-Moreno, Charles Patrick Khoury, Helen Luck, Joshua Trivlidis, Doorsa Tarazi, Mai-Lise Nguyen, Anna Kotzeva, Kunal Samanta, Carla Dias Barbosa
Journal of Huntington's Disease.2026;[Epub] CrossRef
Attitude toward physical activity among Asian American family caregivers of persons living with dementia
JiWon Choi, Van Park, Andrew Jung, Janice Tsoh
Geriatric Nursing.2025; 62: 276. CrossRef
Non-Pharmacological Interventions for Caregivers of People with Motor Neurone Disease: A Scoping Review of Psychosocial Outcomes
Chidera Okoh, Leighanne Mayall, Selina M. Makin, Cliff Chen, Nicolò Zarotti
Brain Sciences.2025; 15(2): 112. CrossRef
A Practical Guide for Diagnostic Investigations and Special Considerations in Patients With Huntington’s Disease in Korea
Jangsup Moon, Eungseok Oh, Minkyeong Kim, Ryul Kim, Dallah Yoo, Chaewon Shin, Jee-Young Lee, Jong-Min Kim, Seong-Beom Koh, Manho Kim, Beomseok Jeon
Journal of Movement Disorders.2025; 18(1): 17. CrossRef
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
Journal of Movement Disorders.2025; 18(2): 160. CrossRef
Mapping the landscape of caregiver burden in Huntington's Disease: Current evidence and future directions
Katerina Poprelka, Theodoros Fasilis, Panayiotis Patrikelis, Evniki Ntinopoulou, Anastasia Verentzioti, Maria Stefanatou, Athanasia Alexoudi, Lampis C Stavrinou, Stefanos Korfias, Stylianos Gatzonis
Journal of Huntington's Disease.2025; 14(4): 304. CrossRef
A Practical Guide for Clinical Approach to Patients With Huntington’s Disease in Korea
Chaewon Shin, Ryul Kim, Dallah Yoo, Eungseok Oh, Jangsup Moon, Minkyeong Kim, Jee-Young Lee, Jong-Min Kim, Seong-Beom Koh, Manho Kim, Beomseok Jeon
Journal of Movement Disorders.2024; 17(2): 138. CrossRef

Brief communication

A Survey of Perspectives on Telemedicine for Patients With Parkinson’s Disease: Jae Young Joo, Ji Young Yun, Young Eun Kim, Yu Jin Jung, Ryul Kim, Hui-Jun Yang, Woong-Woo Lee, Aryun Kim, Han-Joon Kim; J Mov Disord. 2024;17(1):89-93. Published online August 22, 2023; DOI: https://doi.org/10.14802/jmd.23130

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Abstract PDF Supplementary Material

Objective
Parkinson’s disease (PD) patients often find it difficult to visit hospitals because of motor symptoms, distance to the hospital, or the absence of caregivers. Telemedicine is one way to solve this problem.
Methods
We surveyed 554 PD patients from eight university hospitals in Korea. The questionnaire consisted of the clinical characteristics of the participants, possible teleconferencing methods, and preferences for telemedicine.
Results
A total of 385 patients (70%) expressed interest in receiving telemedicine. Among them, 174 preferred telemedicine whereas 211 preferred in-person visits. The longer the duration of disease, and the longer the time required to visit the hospital, the more patients were interested in receiving telemedicine.
Conclusion
This is the first study on PD patients’ preferences regarding telemedicine in Korea. Although the majority of patients with PD have a positive view of telemedicine, their interest in receiving telemedicine depends on their different circumstances.

Citations

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Effects of Telehealth Interventions for People With Parkinson Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Minyue Sun, Fuyou Tang, Luo min, Shiyu Wen, Shuang Wang, Huiping Jiang
JMIR mHealth and uHealth.2026; 14: e70994. CrossRef
Hospital utilization and telemedicine preferences in patients with late-stage Parkinson’s disease and caregivers
Seo Hyun Hong, Seoyeon Kim, Seungmin Lee, Bora Jin, Jung Hwan Shin, Kyung Ah Woo, Han-Joon Kim
Clinical Parkinsonism & Related Disorders.2025; 12: 100296. CrossRef
Remote real time digital monitoring fills a critical gap in the management of Parkinson’s disease
Aarushi S. Negi, Shreesh Karjagi, Laura Parisi, Kerry W. Daley, Annie K. Abay, Aryaman S. Gala, Kevin B. Wilkins, Shannon L. Hoffman, Margaret S. Ferris, Hengameh Zahed, Gaurav M. Chattree, Bianca Palushaj, Helen M. Bronte-Stewart
npj Parkinson's Disease.2025;[Epub] CrossRef
Feasibility and Satisfaction of a Smartphone Application-based Voice and Speech Training Program for Parkinson’s Disease: A Preliminary Rater-blinded Single Arm Pretest-Posttest Study (Preprint)
Sol-Hee Lee, Jiae Kim, Han-Joon Kim
Journal of Medical Internet Research.2024;[Epub] CrossRef

Letters to the editor

Investigation of the Long-Term Effects of Amantadine Use in Parkinson’s Disease: Sangmin Park, Jung Hwan Shin, Seung Ho Jeon, Chan Young Lee, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2023;16(2):224-226. Published online May 24, 2023; DOI: https://doi.org/10.14802/jmd.23037

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A review of treatment methods for movement disorders
Mahdi Khezri, Shakiba Afsar
Behavioural Brain Research.2026; 500: 115979. CrossRef
Amantadine: a first option for symptomatic relief in young-onset Parkinson's disease?
Hyeyoung Park, Bastiaan R. Bloem, Beomseok Jeon
Parkinsonism & Related Disorders.2026; 144: 108215. CrossRef
Altered Mental Status Due to Amantadine Withdrawal: A Case Report
Nicole J. Asal, Elisa Piraino, Cristina Hamacher, Husam Abu Nejim
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M.S. Bouchetara, A. Chentouf
Pratique Neurologique - FMC.2026; 17(2): 103. CrossRef
Approaches for treating cardiovascular symptoms in Parkinson’s disease
Wolfgang H. Jost, Jiri Koschel
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The Effect of Dopaminergic Therapies in Parkinson’s Disease on Non-Motor Symptoms
Monika Jampolska, Katarzyna Kaczyńska
International Journal of Molecular Sciences.2025; 26(24): 11996. CrossRef

Absence of Alpha-Synuclein Pathology in the Stomach of a Patient With Prodromal Dementia With Lewy Bodies: Chaewon Shin, Seong-Ik Kim, Sung-Hye Park, Jung Hwan Shin, Chan Young Lee, Han-Joon Kim, Hyuk-Joon Lee, Seong-Ho Kong, Yun-Suhk Suh, Han-Kwang Yang, Beomseok Jeon; J Mov Disord. 2023;16(2):213-216. Published online April 26, 2023; DOI: https://doi.org/10.14802/jmd.22219

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First Cases of Spinocerebellar Ataxia 42 in Two Korean Families: Hyoshin Son, Jihoon G. Yoon, Man Jin Kim, Jangsup Moon, Han-Joon Kim; J Mov Disord. 2023;16(1):110-113. Published online January 12, 2023; DOI: https://doi.org/10.14802/jmd.22150

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Implementing genomic medicine in clinical practice for adults with undiagnosed rare diseases
Jong Hyeon Ahn, Jihoon G. Yoon, Jaeso Cho, Seungbok Lee, Sheehyun Kim, Man Jin Kim, Soo Yeon Kim, Soon-Tae Lee, Kon Chu, Sang Kun Lee, Han-Joon Kim, Jinyoung Youn, Ja-Hyun Jang, Jong-Hee Chae, Jangsup Moon, Jin Whan Cho
npj Genomic Medicine.2024;[Epub] CrossRef
Targeting Ion Channels and Purkinje Neuron Intrinsic Membrane Excitability as a Therapeutic Strategy for Cerebellar Ataxia
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Viewpoint

Challenges in Parkinson’s Disease Care—In Light of the COVID-19 Pandemic: Kyung Ah Woo, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2023;16(1):52-54. Published online November 10, 2022; DOI: https://doi.org/10.14802/jmd.22085

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Efficacy of telerehabilitation with digital and robotic tools for the continuity of care of people with chronic neurological disorders: The TELENEURO@REHAB protocol for a randomized controlled trial
Federica Rossetto, Fabiola Giovanna Mestanza Mattos, Elisa Gervasoni, Marco Germanotta, Arianna Pavan, Davide Cattaneo, Irene Aprile, Francesca Baglio
DIGITAL HEALTH.2024;[Epub] CrossRef

Brief communication

Sensitivity of Detecting Alpha-Synuclein Accumulation in the Gastrointestinal Tract and Tissue Volume Examined: Chaewon Shin, Seong-Ik Kim, Sung-Hye Park, Jung Hwan Shin, Chan Young Lee, Han-Kwang Yang, Hyuk-Joon Lee, Seong-Ho Kong, Yun-Suhk Suh, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2022;15(3):264-268. Published online July 26, 2022; DOI: https://doi.org/10.14802/jmd.22042

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Abstract PDF Supplementary Material

Objective
This study aimed to evaluate whether a larger tissue volume increases the sensitivity of detecting alpha-synuclein (AS) pathology in the gastrointestinal (GI) tract.
Methods
Nine patients with Parkinson’s disease (PD) or idiopathic rapid eye movement sleep disorder (iRBD) who underwent GI operation and had full-depth intestinal blocks were included. All patients were selected from our previous study population. A total of 10 slides (5 serial sections from the proximal and distal blocks) per patient were analyzed.
Results
In previous studies, pathologic evaluation revealed phosphorylated AS (+) in 5/9 patients (55.6%) and in 1/5 controls (20.0%); in this extensive examination, this increased to 8/9 patients (88.9%) but remained the same in controls (20.0%). The severity and distribution of positive findings were similar between patients with iRBD and PD.
Conclusion
Examining a large tissue volume increased the sensitivity of detecting AS accumulation in the GI tract.

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Gut-initiated alpha synuclein fibrils drive parkinsonism phenotypes: temporal mapping of REM sleep behavior disorder-like and other non-motor symptoms
Daniel Dautan, Wojciech Paslawski, Sergio G. Montejo, Daniel C. Doyon, Valentina I. Brioschi, Roberta Marongiu, Michael G. Kaplitt, Rong Chen, Valina L. Dawson, Xiaoqun Zhang, Ted M. Dawson, Per Svenningsson
Translational Neurodegeneration.2026;[Epub] CrossRef
Tracking prodromal Parkinson’s disease: a five-year follow-up of the PARCAS cohort
Kristina Kulcsarova, Petronela Christova, Martina Bekeova, Sona Muranska, Sona Mrazova, Zuzana Mrazova, Barbora Zecova, Filip Faglic, Simona Suvakova, Norbert Lesko, Laura Gombosova, Zuzana Gdovinova, Matej Skorvanek
Frontiers in Neurology.2025;[Epub] CrossRef
Symmetric and Profound Monoaminergic Degeneration in Parkinson’s Disease with Premotor REM Sleep Behavior Disorder
Kyung Ah Woo, Han-Joon Kim, Jung Hwan Shin, Kangyoung Cho, Hongyoon Choi, Beomseok Jeon
Journal of Parkinson’s Disease.2024; 14(4): 823. CrossRef

Original Articles

Long-Term Outcomes of Deep Brain Stimulation in Pantothenate Kinase-Associated Neurodegeneration-Related Dystonia: Kyung Ah Woo, Han-Joon Kim, Seung-Ho Jeon, Hye Ran Park, Kye Won Park, Seung Hyun Lee, Sun Ju Chung, Jong-Hee Chae, Sun Ha Paek, Beomseok Jeon; J Mov Disord. 2022;15(3):241-248. Published online July 26, 2022; DOI: https://doi.org/10.14802/jmd.22002

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Abstract PDF Supplementary Material

Objective
To investigate the long-term clinical outcomes of pallidal deep brain stimulation (GPi-DBS) in patients with pantothenate kinase-associated neurodegeneration (PKAN).
Methods
We reviewed the records of patients with genetically confirmed PKAN who received bilateral GPi-DBS for refractory dystonia and were clinically followed up for at least 2 years postoperatively at two centers in Korea. Pre- and postoperative Burke– Fahn–Marsden Dystonia Rating Scale motor subscale (BFMDRS-M) scores, disability subscale (BFMDRS-D) scores, and qualitative clinical information were prospectively collected. Descriptive analysis was performed for BFMDRS-M scores, BFMDRSD scores, and the orofacial, axial, and limb subscores of the BFMDRS-M at 6–12, 24–36, and 60–72 months postoperatively.
Results
Five classic-type, four atypical-type, and one unknown-type PKAN cases were identified. The mean preoperative BFMDRS-M score was 92.1 for the classic type and 38.5 for the atypical or unknown type, with a mean BFMDRS follow-up of 50.7 months and a clinical follow-up of 69.0 months. The mean improvements in BFMDRS-M score were 11.3%, 41.3%, and 30.5% at 6–12, 24–36, and 60–72 months, respectively. In four patients with full regular evaluations until 60–72 months, improvements in the orofacial, axial, and limb subscores persisted, but the disability scores worsened from 24–36 months post-operation compared to the baseline, mainly owing to the aggravation of eating and feeding disabilities.
Conclusion
The benefits of GPi-DBS on dystonia may persist for more than 5 years in PKAN. The effects on patients’ subjective disability may have a shorter duration despite improvements in dystonia owing to the complex manifestations of PKAN.

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Imaging Findings of Intracerebral Infection after Deep Brain Stimulation: Pediatric Case Series and Literature Review
Andrew Z. Yang, Alexandre Boutet, Vivek Pai, Michael J. Colditz, Artur Vetkas, Brendan Santyr, Nardin Samuel, Jurgen Germann, Sara Breitbart, Lior Elkam, Birgit Ertl‐Wagner, Alfonso Fasano, Andres M. Lozano, George M Ibrahim, Carolina Gorodetsky
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L. B. Novikova, A. P. Akopyan, K. M. Ziultsle
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Lindsey M. Vogt, Han Yan, Brendan Santyr, Sara Breitbart, Melanie Anderson, Jürgen Germann, Karlo J. Lizarraga, Angela L. Hewitt, Alfonso Fasano, George M. Ibrahim, Carolina Gorodetsky
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Illustration of the long-term efficacy of pallidal deep brain stimulation in a patient with PKAN dystonia
Luigi M. Romito, Fabiana Colucci, Giovanna Zorzi, Barbara Garavaglia, Ahmet Kaymak, Alberto Mazzoni, Celeste Panteghini, Nico Golfrè Andreasi, Sara Rinaldo, Vincenzo Levi, Miryam Carecchio, Roberto Eleopra
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Patient Selection for Deep Brain Stimulation for Pantothenate Kinase-Associated Neurodegeneration
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Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism: Woong-Woo Lee, Han-Joon Kim, Hong Ji Lee, Han Byul Kim, Kwang Suk Park, Chul-Ho Sohn, Beomseok Jeon; J Mov Disord. 2022;15(3):232-240. Published online July 26, 2022; DOI: https://doi.org/10.14802/jmd.21178

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Objective
Putaminal iron deposition is an important feature that helps differentiate multiple system atrophy with predominant parkinsonism (MSA-p) from Parkinson’s disease (PD). Most previous studies used visual inspection or quantitative methods with manual manipulation to perform this differentiation. We investigated the value of a new semiautomated diagnostic algorithm using 3T-MR susceptibility-weighted imaging for MSA-p.
Methods
This study included 26 MSA-p, 68 PD, and 41 normal control (NC) subjects. The algorithm was developed in 2 steps: 1) determine the image containing the remarkable putaminal margin and 2) calculate the phase-shift values, which reflect the iron concentration. The next step was to identify the best differentiating conditions among several combinations. The highest phaseshift value of each subject was used to assess the most effective diagnostic set.
Results
The raw phase-shift values were present along the lateral margin of the putamen in each group. It demonstrates an anterior- to-posterior gradient that was identified most frequently in MSA-p. The average of anterior 5 phase shift values were used for normalization. The highest area under the receiver operating characteristic curve (0.874, 80.8% sensitivity, and 86.7% specificity) of MSA-p versus PD was obtained under the combination of 3 or 4 vertical pixels and one dominant side when the normalization methods were applied. In the subanalysis for the MSA-p patients with a longer disease duration, the performance of the algorithm improved.
Conclusion
This algorithm detected the putaminal lateral margin well, provided insight into the iron distribution of the putaminal rim of MSA-p, and demonstrated good performance in differentiating MSA-p from PD.

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Ocular Vestibular-Evoked Myogenic Potential Assists in the Differentiation of Multiple System Atrophy From Parkinson’s Disease
Keun-Tae Kim, Kyoungwon Baik, Sun-Uk Lee, Euyhyun Park, Chan-Nyoung Lee, Tonghoon Woo, Yukang Kim, Seoui Kwag, Hyunsoh Park, Ji-Soo Kim
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Biological Function Analysis of MicroRNAs and Proteins in the Cerebrospinal Fluid of Patients with Parkinson’s Disease
Ji Su Hwang, Seok Gi Kim, Nimisha Pradeep George, Minjun Kwon, Yong Eun Jang, Sang Seop Lee, Gwang Lee
International Journal of Molecular Sciences.2024; 25(24): 13260. CrossRef

Development of Clinical Milestones in Parkinson’s Disease After Bilateral Subthalamic Deep Brain Stimulation: Jed Noel A. Ong, Jung Hwan Shin, Seungho Jeon, Chan Young Lee, Han-Joon Kim, Sun Ha Paek, Beomseok Jeon; J Mov Disord. 2022;15(2):124-131. Published online May 26, 2022; DOI: https://doi.org/10.14802/jmd.21106

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Objective
Deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson’s disease (PD) patients does not halt disease progression, as these patients will progress and develop disabling non-levodopa responsive symptoms. These features may act as milestones that represent the overall functionality of patients after DBS. The objective of this study was to investigate the development of clinical milestones in advanced PD patients who underwent bilateral STN-DBS.
Methods
The study evaluated PD patients who underwent STN-DBS at baseline up to their last follow-up using the Unified Parkinson’s Disease Rating Scale and Hoehn and Yahr scale. The symptoms of hallucinations, dysarthria, dysphagia, frequent falls, difficulty walking, cognitive impairment and the loss of autonomy were chosen as the clinical milestones.
Results
A total of 106 patients with a mean age of 47.21 ± 10.52 years at disease onset, a mean age of 58.72 ± 8.74 years at surgery and a mean disease duration of 11.51 ± 4.4 years before surgery were included. Initial improvement of motor symptoms was seen after the surgery with the appearance of clinical milestones over time. Using the moderately disabling criteria, 81 patients (76.41%) developed at least one clinical milestone, while 48 patients (45.28%) developed a milestone when using the severely disabling criteria.
Conclusion
STN-DBS has a limited effect on axial and nonmotor symptoms of the PD patients, in contrast to the effect on motor symptoms. These symptoms may serve as clinical milestones that can convey the status of PD patients and its impact on the patients and their caregivers. Therefore, advanced PD patients, even those treated with bilateral STN-DBS, will still require assistance and cannot live independently in the long run.

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Survival after Subthalamic Deep Brain Stimulation for Parkinson's Disease: 25‐Year Experience from a Single Center
Sayooja Sachithanandan, Athul Sreelatha Sanjeev, Jissa Vinoda Thulaseedharan, Krishnakumar Kesavapisharady, Divya Kalikavil Puthanveedu, Asish Vijayaraghavan, Gangadhara Sarma, Syam Krishnan, Asha Kishore
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Yuta Terasawa, Koki Ikuno, Shintaro Fujii, Yuki Nishi, Emi Tanizawa, Sachio Nabeshima, Yohei Okada
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Brief communication

Automatic Measurement of Postural Abnormalities With a Pose Estimation Algorithm in Parkinson’s Disease: Jung Hwan Shin, Kyung Ah Woo, Chan Young Lee, Seung Ho Jeon, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2022;15(2):140-145. Published online January 19, 2022; DOI: https://doi.org/10.14802/jmd.21129

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Objective
This study aims to develop an automated and objective tool to evaluate postural abnormalities in Parkinson’s disease (PD) patients.
Methods
We applied a deep learning-based pose-estimation algorithm to lateral photos of prospectively enrolled PD patients (n = 28). We automatically measured the anterior flexion angle (AFA) and dropped head angle (DHA), which were validated with conventional manual labeling methods.
Results
The automatically measured DHA and AFA were in excellent agreement with manual labeling methods (intraclass correlation coefficient > 0.95) with mean bias equal to or less than 3 degrees.
Conclusion
The deep learning-based pose-estimation algorithm objectively measured postural abnormalities in PD patients.

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A novel multimodal AI framework for early diagnosis of idiopathic Parkinson’s disease
Efe Yılmaz Taşyürek, Şaban Murat Altun, Ata Emir Uncu, Sefa Tunca, Sevinç İlhan Omurca, Meltem Kurt Pehlivanoğlu, Aybala Neslihan Alagöz, Oğulcan Kalkan
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Validating Single-Camera Pose Estimation Against Multi-Camera Motion Capture for Accessible Biomechanical Assessment
Aniket Pratapneni, Ryan Halvorson, Pavlos Silvestros, Nicholas Harris, Jeannie F. Bailey
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Relationship between body segment movements and center of pressure shifts during trunk lean movements while sitting in healthy adults
Boqun Liu, Shintaro Uehara, Akiko Yuasa, Hirofumi Ota, Kazuki Ushizawa, Yohei Otaka
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Yilin Lu, Xiang Zhang, Junyu Li, Weishi Li, Miao Yu
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Spatiotemporal Gait Parameters During Turning and Imbalance in Parkinson’s Disease: Video-Based Analysis From a Single Camera
HoYoung Jeon, Jung Hwan Shin, Ri Yu, Min Kyung Kang, Seungmin Lee, Seoyeon Kim, Bora Jin, Kyung Ah Woo, Han-Joon Kim, Beomseok Jeon
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Jung Hwan Shin, Seungmin Lee, Kyung Ah Woo, Hyder A. Jinnah, Aasef Shaikh, Mark Hallett, Sanjay Pandey, Rick C. Helmich, Marie Vidailhet, Victor Fung, Alfonso Fasano, Han‐Joon Kim, Beomseok Jeon
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Camptocormia in Parkinson’s disease: state of the art and future directions
Valeria Sajin, Mark Goodall, Antonella Macerollo
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Lazzaro di Biase, Pasquale Maria Pecoraro, Francesco Bugamelli
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Chiau Wen Yeong, Tee Connie, Thian Song Ong, Nor Izzati Saedon, Ahmad Al-Khatib, Mahmoud Farfoura
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Botulinum Toxin for Axial Postural Abnormalities in Parkinson’s Disease: A Systematic Review
Marialuisa Gandolfi, Carlo Alberto Artusi, Gabriele Imbalzano, Serena Camozzi, Mauro Crestani, Leonardo Lopiano, Michele Tinazzi, Christian Geroin
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Robin Wolke, Olga Gavriliuc, Oliver Granert, Günther Deuschl, Nils G. Margraf
Movement Disorders Clinical Practice.2023; 10(3): 472. CrossRef
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Carlo Alberto Artusi, Christian Geroin, Gabriele Imbalzano, Serena Camozzi, Stefano Aldegheri, Leonardo Lopiano, Michele Tinazzi, Nicola Bombieri
Movement Disorders Clinical Practice.2023; 10(4): 636. CrossRef
Camera- and Viewpoint-Agnostic Evaluation of Axial Postural Abnormalities in People with Parkinson’s Disease through Augmented Human Pose Estimation
Stefano Aldegheri, Carlo Alberto Artusi, Serena Camozzi, Roberto Di Marco, Christian Geroin, Gabriele Imbalzano, Leonardo Lopiano, Michele Tinazzi, Nicola Bombieri
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Letter to the editor

A Case of AOA2 With Compound Heterozygous SETX Mutations: Hee Jin Chang, Ryul Kim, Minchae Kim, Jangsup Moon, Man Jin Kim, Han-Joon Kim; J Mov Disord. 2022;15(2):178-180. Published online December 24, 2021; DOI: https://doi.org/10.14802/jmd.21139

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Implementing genomic medicine in clinical practice for adults with undiagnosed rare diseases
Jong Hyeon Ahn, Jihoon G. Yoon, Jaeso Cho, Seungbok Lee, Sheehyun Kim, Man Jin Kim, Soo Yeon Kim, Soon-Tae Lee, Kon Chu, Sang Kun Lee, Han-Joon Kim, Jinyoung Youn, Ja-Hyun Jang, Jong-Hee Chae, Jangsup Moon, Jin Whan Cho
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Brief communication

Investigation of Nocturnal Hypokinesia and Health-Related Quality of Life in Parkinsonian Patients with the Korean Version of the Nocturnal Hypokinesia Questionnaire: Ji-Hyun Choi, Jee-Young Lee, Chaewon Shin, Dallah Yoo, Jin Hee Im, Kyung Ah Woo, Han-Joon Kim, Tae-Beom Ahn, Jong-Min Kim, Beomseok Jeon; J Mov Disord. 2021;14(3):221-225. Published online May 26, 2021; DOI: https://doi.org/10.14802/jmd.20172

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Abstract PDF Supplementary Material

Objective
To assess nocturnal hypokinesia using the Korean version of the Nocturnal Hypokinesia Questionnaire (NHQ-K) in Parkinson’s disease (PD) patients across disease stages.
Methods
We developed the NHQ-K and performed questionnaire-based interviews with 108 PD patients from three referral hospitals. Clinical associations of nocturnal hypokinesia and its impact on health-related quality of life (HRQoL) were also analyzed.
Results
The NHQ-K showed acceptable internal consistency (0.83) and interrater reliability (0.95). Nocturnal hypokinesia significantly affected HRQoL in PD patients at both the early and advanced stages (adjusted p < 0.001). Increased severity of nocturnal hypokinesia was associated with dyskinesias, off-period disability, apathy, and anxious mood in PD patients (adjusted p < 0.01) after controlling for disease severity and medication dose.
Conclusion
The NHQ-K is useful for screening nocturnal hypokinesia in PD patients. Given the high impact of nocturnal hypokinesia on HRQoL, comprehensive management of nocturnal disability is needed for PD patients.

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Clinical Outcome Assessments in Parkinson's Disease: A Scoping Review of Current Rating Scales and Future Needs
Evita Papathoma, Panagiota Tsitsi, Nirosen Vijiaratnam, Camila Aquino, Stephen R. Duma, Norbert Kovacs, Kigocha Lameck Okeng'o, Aparna Wagle Shukla, Roongroj Bhidayasiri, Tiago A. Mestre, Alvaro Sanchez Ferro, Alberto J. Espay, Michelle H.S. Tosin, Matej
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Telerehabilitation for the treatment of nocturnal hypokinesia in people with Parkinson’s disease: a pilot study
Edoardo Bianchini, Francesco Bianchini, Pietro Lombardo, Silvia Galli, Flavia D’Audino, Marika Alborghetti, Domiziana Rinaldi
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Opicapone for the Treatment of Nocturnal Hypokinesia in Patients With Parkinson’s Disease: An Open-Label Pilot Clinical Trial
Chaewon Shin, Jong-Min Kim
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Digital Technology for Sleep Symptoms in Parkinson’s Disease: A Scoping Review
Kye Won Park, Ki-Young Jung, Han-Joon Kim, Jung Hwan Shin
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Deep profiling of nocturnal hypokinesia in multiple system atrophy and its clinical implications
Jongmok Ha, Suin Lee, Yoonha Hwang, Jinyoung Youn, Jin Whan Cho, Eun Yeon Joo
Sleep Medicine.2025; 131: 106516. CrossRef
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Jirada Sringean, Chusak Thanawattano, Roongroj Bhidayasiri
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Case Report

Young-Onset Parkinson’s Disease with Impulse Control Disorder Due to Novel Variants of F-Box Only Protein 7: Dallah Yoo, Ji-Hyun Choi, Jin-Hee Im, Man Jin Kim, Han-Joon Kim, Sung Sup Park, Beomseok Jeon; J Mov Disord. 2020;13(3):225-228. Published online September 9, 2020; DOI: https://doi.org/10.14802/jmd.20026

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Abstract PDF

F-box only protein 7 (FBXO7) is a rare monogenic cause of hereditary Parkinson’s disease (PD) with an autosomal recessive mode of inheritance and a broad spectrum of clinical manifestations. Here, we report a de novo PD patient with onset at the age of 28 with novel compound heterozygous variants in the FBXO7 gene (c.1162C>T, p.Gln388X; c.80G>A, p.Arg27His). The clinical features of the patient were problematic impulse control disorder behaviors and pyromania, and pyramidal signs were negative. We describe the novel pathogenic variants of the FBXO7 gene with detailed clinical pictures to report the expanding genotypes and phenotypes of FBXO7-associated parkinsonism.

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Sara Al Rawi, Pamela Tyers, Roger A. Barker, Heike Laman
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Martina Lucchesi, Letizia Biso, Marco Bonaso, Biancamaria Longoni, Bianca Buchignani, Roberta Battini, Filippo Maria Santorelli, Stefano Doccini, Marco Scarselli
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Loss of the parkinsonism‐associated protein FBXO7 in glutamatergic forebrain neurons in mice leads to abnormal motor behavior and synaptic defects
Jingbo Wang, Sabitha Joseph, Siv Vingill, Ekrem Dere, Lars Tatenhorst, Anja Ronnenberg, Paul Lingor, Christian Preisinger, Hannelore Ehrenreich, Jörg B. Schulz, Judith Stegmüller
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Letter to the editor

A Rare Case of Late Adult-Onset Niemann-Pick Disease Type C: Ryul Kim, Dallah Yoo, Sangmin Park, Jung Hwan Shin, Ji-Hyun Choi, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2020;13(2):163-165. Published online March 18, 2020; DOI: https://doi.org/10.14802/jmd.19077

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Review Article

Immunotherapy Targeting Neurodegenerative Proteinopathies: α-Synucleinopathies and Tauopathies: Junghwan Shin, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2020;13(1):11-19. Published online December 19, 2019; DOI: https://doi.org/10.14802/jmd.19057

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Abstract PDF

α-Synuclein and tau deposition in the central nervous system is responsible for various parkinsonian syndromes, including Parkinson’s disease, multiple system atrophy, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration. Emerging evidence has suggested that pathologic α-synuclein and tau are transmitted from cell to cell and further accelerate the aggregation of pathologic proteins in neighboring cells. Furthermore, extracellular pathologic proteins have also been reported to provoke inflammatory responses that lead to neurodegeneration. Therefore, immunotherapies targeting extracellular α-synuclein and tau have been proposed as potential disease-modifying strategies. In this review, we summarize completed phase I trials and ongoing phase II trials of immunotherapies against α-synuclein and tau and further discuss concerns and hurdles to overcome in the future.

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Letter to the editor

Successful Pallidal Deep Brain Stimulation in a Patient with Childhood-Onset Generalized Dystonia with ANO3 Mutation: Dallah Yoo, Han-Joon Kim, Jong-Hee Chae, Sun Ha Paek, Beomseok Jeon; J Mov Disord. 2019;12(3):190-191. Published online July 17, 2019; DOI: https://doi.org/10.14802/jmd.19016

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PDF Supplementary Material

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The Clinical Spectrum of ANO3—Report of a New Family and Literature Review
Marco Percetti, Michela Zini, Paola Soliveri, Filippo Cogiamanian, Mariarosa Ferrara, Eva Orunesu, Alessandra Ranghetti, Carlo Ferrarese, Gianni Pezzoli, Barbara Garavaglia, Ioannis Ugo Isaias, Giorgio Sacilotto
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The role of genetics in the treatment of dystonia with deep brain stimulation: Systematic review and Meta-analysis
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A novel ANO3 variant in two siblings with different phenotypes
Marcello Esposito, Assunta Trinchillo, Francesca Piceci-Sparascio, Maria Cecilia D'Asdia, Federica Consoli, Alessandro De Luca
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DBS-Evoked Pallidal Activity Correlates with Clinical Improvement in a Patient with ANO3-Related Dystonia
Aditya Boddu, Adam Bashir, Mohammad Awad, Barton Guthrie, Harrison Walker
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Original Article

Nonmotor and Dopamine Transporter Change in REM Sleep Behavior Disorder by Olfactory Impairment: Jee-Young Lee, Eun Jin Yoon, Yu Kyeong Kim, Chae Won Shin, Hyunwoo Nam, Jae Min Jeong, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2019;12(2):103-112. Published online May 30, 2019; DOI: https://doi.org/10.14802/jmd.18061

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Abstract PDF Supplementary Material

Objective
It is unclear whether the decline in dopamine transporters (DAT) differs among idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with different levels of olfactory impairment. This study aimed to characterize DAT changes in relation to nonmotor features in iRBD patients by olfactory loss.
Methods
This prospective cohort study consisted of three age-matched groups: 30 polysomnography-confirmed iRBD patients, 30 drug-naïve Parkinson’s disease patients, and 19 healthy controls without olfactory impairment. The iRBD group was divided into two groups based on olfactory testing results. Participants were evaluated for reported prodromal markers and then underwent 18F-FP-CIT positron emission tomography and 3T MRI. Tracer uptakes were analyzed in the caudate, anterior and posterior putamen, substantia nigra, and raphe nuclei.
Results
Olfactory impairment was defined in 38.5% of iRBD patients. Mild parkinsonian signs and cognitive functions were not different between the two iRBD subgroups; however, additional prodromal features, constipation, and urinary and sexual dysfunctions were found in iRBD patients with olfactory impairment but not in those without. Tracer uptake showed significant group differences in all brain regions, except the raphe nuclei. The iRBD patients with olfactory impairment had uptake reductions in the anterior and posterior putamen, caudate, and substantia nigra (p < 0.016 in all, adjusted for age), which ranged from 0.6 to 0.8 of age-normative values. In contrast, those without olfactory impairment had insignificant changes in all regions ranging above 0.8.
Conclusion
There was a clear distinction in DAT loss and nonmotor profiles by olfactory status in iRBD.

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Longitudinal Trajectory of Multimodal Markers in a Patient with Isolated REM Sleep Behavior Disorder
Seohee Choi, Ryul Kim, Kyung Ah Woo, Jung Hwan Shin, Eun Jin Yoon, Heejung Kim, Yu Kyeong Kim, Jee‐Young Lee
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Cholinergic basal forebrain degeneration in isolated REM sleep behaviour disorder
Ryul Kim, Bora Jin, Heejung Kim, Kyung Ah Woo, Eun Jin Yoon, Seoyeon Kim, Jung Hwan Shin, Hyunwoo Nam, Yu Kyeong Kim, Beomseok Jeon, Jee-Young Lee
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Caterina Leitner, Giada D’Este, Laura Verga, Shady Rahayel, Samantha Mombelli, Marco Sforza, Francesca Casoni, Marco Zucconi, Luigi Ferini-Strambi, Andrea Galbiati
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Case Report

A Patient with Myotonic Dystrophy Type 1 Presenting as Parkinsonism: Ji-Hyun Choi, Jee-Young Lee, Han-Joon Kim, Beomseok Jeon; J Mov Disord. 2018;11(3):145-148. Published online September 30, 2018; DOI: https://doi.org/10.14802/jmd.18028

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Abstract PDF: The current body of literature contains 5 reports of myotonic dystrophy (DM) with parkinsonism: 4 reports of DM type 2 and 1 report of clinically suspected DM type 1. To date, there have been no genetically proven cases of DM type 1 with parkinsonism. Here, we report the first case of genetically proven DM type 1 and parkinsonism that developed ahead of muscle symptoms with bilateral putaminal, presynaptic dopaminergic deficits on imaging. A 54-year-old female patient presented with bradykinesia, axial and bilateral limb rigidity, stooped posture, and hypomimia, which did not respond to levodopa. At age 56, she developed neck flexion weakness. Examination showed bilateral facial weakness, percussion and grip myotonia, and electromyography confirmed myotonic discharges. A genetic study of DM type 1 showed a DMPK mutation. At age 58, gait freezing, postural instability, and frequent falling developed and did not respond to increasing doses of levodopa. At age 59, the patient died from asphyxia.

Original Articles

Musculoskeletal Problems Affect the Quality of Life of Patients with Parkinson’s Disease: Young Eun Kim, Han-Joon Kim, Ji Young Yun, Woong-Woo Lee, Hui-Jun Yang, Jong-Min Kim, Beomseok Jeon; J Mov Disord. 2018;11(3):133-138. Published online September 30, 2018; DOI: https://doi.org/10.14802/jmd.18022

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Abstract PDF

Objective
Musculoskeletal problems are more common in patients with Parkinson’s disease (PD) than in normal elderly, but the impact of musculoskeletal problems on health-related quality of life (HRQoL) in patients with PD is unknown.
Methods
Four hundred consecutive patients with PD were enrolled for the evaluation of musculoskeletal problems and HRQoL. HRQoL was assessed by the 36-Item Short Form Health Survey, which comprised physical health and mental health.
Results
Of the total patients, 265 patients had musculoskeletal problems, and 135 patients did not have musculoskeletal problems. Patients with musculoskeletal problems reported lower levels of HRQoL in terms of physical health than did patients without musculoskeletal problems (p < 0.05). In women, all components of physical health were lower in patients with musculoskeletal problems than in patients without musculoskeletal problems (p < 0.05). Meanwhile, in men, only the bodily pain score of physical health was lower in patients with musculoskeletal problems than in patients without musculoskeletal problems. Mental health and physical health were negatively correlated with depression, Unified Parkinson’s Disease Rating Scale I & II scores, and pain severity from musculoskeletal problems, in that order (p < 0.01 for all).
Conclusion
These results suggest that musculoskeletal problems in patients with PD affect HRQoL significantly, mainly in terms of physical health rather than mental health and especially in women rather than men. Musculoskeletal problems should not be overlooked in the care of patients with PD.

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Amantadine and the Risk of Dyskinesia in Patients with Early Parkinson’s Disease: An Open-Label, Pragmatic Trial: Aryun Kim, Young Eun Kim, Ji Young Yun, Han-Joon Kim, Hui-Jun Yang, Woong-Woo Lee, Chae Won Shin, Hyeyoung Park, Yu Jin Jung, Ahro Kim, Yoon Kim, Mihee Jang, Beomseok Jeon; J Mov Disord. 2018;11(2):65-71. Published online May 30, 2018; DOI: https://doi.org/10.14802/jmd.18005

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Abstract PDF Supplementary Material

Objective
We examined whether amantadine can prevent the development of dyskinesia.
Methods
Patients with drug-naïve Parkinson’s disease (PD), younger than 70 years of age and in the early stage of PD (Hoehn and Yahr scale < 3), were recruited from April 2011 to December 2014. The exclusion criteria included the previous use of antiparkinsonian medication, the presence of dyskinesia, significant psychological disorders, and previous history of a hypersensitivity reaction. Patients were consecutively assigned to one of 3 treatment groups in an open label fashion: Group A-1, amantadine first and then levodopa when needed; Group A-2, amantadine first, dopamine agonist when needed, and then levodopa; and Group B, dopamine agonist first and then levodopa when needed. The primary endpoint was the development of dyskinesia, which was analyzed by the Kaplan-Meier survival rate.
Results
A total of 80 patients were enrolled: Group A-1 (n = 27), Group A-2 (n = 27), and Group B (n = 26). Twenty-four patients were excluded from the analysis due to the following: withdrawal of amantadine or dopamine agonist (n = 9), alternative diagnosis (n = 2), withdrawal of consent (n = 1), and breach in the protocol (n = 12). After exclusion, 5 of the 56 (8.93%) patients developed dyskinesia. Patients in Group A-1 and A-2 tended to develop dyskinesia less often than those in Group B (cumulative survival rates of 0.933, 0.929, and 0.700 for A-1, A-2, and B, respectively; p = 0.453).
Conclusion
Amantadine as an initial treatment may decrease the incidence of dyskinesia in patients with drug-naïve PD.

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Letter to the editor

Myotonia Congenita Can Be Mistaken as Paroxysmal Kinesigenic Dyskinesia: Aryun Kim, Mihee Jang, Han-Joon Kim, Yoon Kim, Dae-Seong Kim, Jin-Hong Shin, Beomseok Jeon; J Mov Disord. 2018;11(1):49-51. Published online January 23, 2018; DOI: https://doi.org/10.14802/jmd.17056

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Original Articles

Validation of the Conversion between the Mini-Mental State Examination and Montreal Cognitive assessment in Korean Patients with Parkinson’s Disease: Ryul Kim, Han-Joon Kim, Aryun Kim, Mi-Hee Jang, Hyun Jeong Kim, Beomseok Jeon; J Mov Disord. 2018;11(1):30-34. Published online January 11, 2018; DOI: https://doi.org/10.14802/jmd.17038

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Abstract PDF

Objective
Two conversion tables between the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) have recently been established for Parkinson’s disease (PD). This study aimed to validate them in Korean patients with PD and to evaluate whether they could be influenced by educational level.
Methods
A total of 391 patients with PD who undertook both the Korean MMSE and the Korean MoCA during the same session were retrospectively assessed. The mean, median, and root mean squared error (RMSE) of the difference between the true and converted MMSE scores and the intraclass correlation coefficient (ICC) were calculated according to educational level (6 or fewer years, 7–12 years, or 13 or more years).
Results
Both conversions had a median value of 0, with a small mean and RMSE of differences, and a high correlation between the true and converted MMSE scores. In the classification according to educational level, all groups had roughly similar values of the median, mean, RMSE, and ICC both within and between the conversions.
Conclusion
Our findings suggest that both MMSE-MoCA conversion tables are useful instruments for transforming MoCA scores into converted MMSE scores in Korean patients with PD, regardless of educational level. These will greatly enhance the utility of the existing cognitive data from the Korean PD population in clinical and research settings.

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Կոգնիտիվ վիճակի գնահատման Mini-Mental State Examination (MMSE) սանդղակի հայերեն տարբերակի ադապտացում և վալիդացում
Մ.Ա. Իսայան, Հ.Ա. Հովակիմյան, Լ.Վ. Վարդանյան, Ս.Գ. Խաչատրյան, Զ.Դ. Թավադյան
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Validation of the Korean Version of the Scale for Outcomes in Parkinson’s Disease-Autonomic: Ji-Young Kim, In-Uk Song, Seong-Beom Koh, Tae-Beom Ahn, Sang Jin Kim, Sang-Myung Cheon, Jin Whan Cho, Yun Joong Kim, Hyeo-Il Ma, Mee-Young Park, Jong Sam Baik, Phil Hyu Lee, Sun Ju Chung, Jong-Min Kim, Han-Joon Kim, Young-Hee Sung, Do Young Kwon, Jae-Hyeok Lee, Jee-Young Lee, Ji Sun Kim, Ji Young Yun, Hee Jin Kim, Jin Young Hong, Mi-Jung Kim, Jinyoung Youn, Ji Seon Kim, Eung Seok Oh, Hui-Jun Yang, Won Tae Yoon, Sooyeoun You, Kyum-Yil Kwon, Hyung-Eun Park, Su-Yun Lee, Younsoo Kim, Hee-Tae Kim, Joong-Seok Kim; J Mov Disord. 2017;10(1):29-34. Published online January 18, 2017; DOI: https://doi.org/10.14802/jmd.16057

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Abstract PDF Supplementary Material

Objective
Autonomic symptoms are commonly observed in patients with Parkinson’s disease (PD) and often limit the activities of daily living. The Scale for Outcomes in Parkinson’s disease-Autonomic (SCOPA-AUT) was developed to evaluate and quantify autonomic symptoms in PD. The goal of this study was to translate the original SCOPA-AUT, which was written in English, into Korean and to evaluate its reliability and validity for Korean PD patients.
Methods
For the translation, the following processes were performed: forward translation, backward translation, expert review, pretest of the pre-final version and development of the final Korean version of SCOPA-AUT (K-SCOPA-AUT). In total, 127 patients with PD from 31 movement disorder clinics of university-affiliated hospitals in Korea were enrolled in this study. All patients were assessed using the K-SCOPA-AUT and other motor, non-motor, and quality of life scores. Test-retest reliability for the K-SCOPA-AUT was assessed over a time interval of 10−14 days.
Results
The internal consistency and reliability of the K-SCOPA-AUT was 0.727 as measured by the mean Cronbach’s α-coefficient. The test-retest correlation reliability was 0.859 by the Guttman split-half coefficient. The total K-SCOPA-AUT score showed a positive correlation with other non-motor symptoms [the Korean version of non-motor symptom scale (K-NMSS)], activities of daily living (Unified Parkinson’s Disease Rating Scale part II) and quality of life [the Korean version of Parkinson’s Disease Quality of Life 39 (K-PDQ39)].
Conclusion
The K-SCOPA-AUT had good reliability and validity for the assessment of autonomic dysfunction in Korean PD patients. Autonomic symptom severities were associated with many other motor and non-motor impairments and influenced quality of life.

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Survival of Korean Huntington’s Disease Patients: Han-Joon Kim, Chae-Won Shin, Beomseok Jeon, Hyeyoung Park; J Mov Disord. 2016;9(3):166-170. Published online September 21, 2016; DOI: https://doi.org/10.14802/jmd.16022

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Abstract PDF

Objective
The survival of Huntington’s disease (HD) patients is reported to be 15–20 years. However, most studies on the survival of HD have been conducted in patients without genetic confirmation with the possible inclusion of non-HD patients, and all studies have been conducted in Western countries. The survival of patients with HD in East Asia, where its prevalence is 10–50-fold lower compared with Western populations, has not yet been reported.
Methods
Forty-seven genetically confirmed Korean HD patients from independent families were included in this retrospective medical record review study.
Results
The mean age at onset among the 47 patients was 46.1 ± 14.0 years. At the time of data collection, 25 patients had died, and these patients had a mean age at death of 57.8 ± 13.7 years. The Kaplan-Meier estimate of the median survival from onset in the 47 patients was 14.5 years (95% confidence interval: 12.3–16.6). None of the following factors were associated with the survival time in the univariate Cox regression analysis: gender, age at onset, normal CAG repeat size, mutant CAG repeat size, and the absence or presence of non-motor symptoms at onset.
Conclusion
This is the first Asian study on survival in HD patients. Survival in Korean HD patients may be shorter than that reported for Western populations, or at least is in the lower range of expected survival. A larger longitudinal observation study is needed to confirm the results found in this study.

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Letter to the editor

Dural Arteriovenous Fistula-Associated Reversible Parkinsonism with Presynaptic Dopaminergic Loss: Hang Rai Kim, Jee-Young Lee, Yu Kyeong Kim, Hyeyoung Park, Han-Joon Kim, Young-Je Son, Beom Seok Jeon; J Mov Disord. 2015;8(3):141-143. Published online September 10, 2015; DOI: https://doi.org/10.14802/jmd.15021

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Review Article

Nonmotor Symptoms and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Han-Joon Kim, Beom S. Jeon, Sun Ha Paek; J Mov Disord. 2015;8(2):83-91. Published online May 31, 2015; DOI: https://doi.org/10.14802/jmd.15010

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Abstract PDF

Subthalamic deep brain stimulation (STN DBS) is an established treatment for the motor symptoms in patients with advanced Parkinson’s disease (PD). In addition to improvements in motor symptoms, many studies have reported changes in various nonmotor symptoms (NMSs) after STN DBS in patients with PD. Psychiatric symptoms, including depression, apathy, anxiety, and impulsivity, can worsen or improve depending on the electrical stimulation parameters, the locations of the stimulating contacts within the STN, and changes in medications after surgery. Global cognitive function is not affected by STN DBS, and there is no increase in the incidence of dementia after STN DBS compared to that after medical treatment, although clinically insignificant declines in verbal fluency have been consistently reported. Pain, especially PD-related pain, improves with STN DBS. Evidence regarding the effects of STN DBS on autonomic symptoms and sleep-related problems is limited and remains conflicting. Many symptoms of nonmotor fluctuations, which are occasionally more troublesome than motor fluctuations, improve with STN DBS. Although it is clear that NMSs are not target symptoms for STN DBS, NMSs have a strong influence on the quality of life of patients with PD, and clinicians should thus be aware of these NMSs when deciding whether to perform surgery and should pay attention to changes in these symptoms after STN DBS to ensure the optimal care for patients.

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Case Reports

Stiff-Person Syndrome: Case Series: Yu Jin Jung, Han G. Jeong, Ryul Kim, Han-Joon Kim, Beom S. Jeon; J Mov Disord. 2014;7(1):19-21. Published online April 30, 2014; DOI: https://doi.org/10.14802/jmd.14004

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Abstract PDF

Stiff-person syndrome (SPS) is a rare disorder, characterized by progressive fluctuating muscular rigidity and spasms. Glutamic acid decarboxylase (GAD) antibody is primarily involved in the pathogenesis of SPS and SPS is strongly associated with other autoimmune disease. Here we report three cases of patients with classical SPS finally confirmed by high serum level of GAD antibodies. All of our patients respond favorably to gamma amino butyric acid-enhancing drugs and immunotherapies.

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Amantadine Induced Corneal Edema in a Patient with Primary Progressive Freezing of Gait: Young Eun Kim, Ji Young Yun, Hui-Jun Yang, Han-Joon Kim, Mee Kum Kim, Won Ryang Wee, Beom S. Jeon; J Mov Disord. 2013;6(2):34-36. Published online October 30, 2013; DOI: https://doi.org/10.14802/jmd.13008

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12 Crossref

Abstract PDF

Amantadine is commonly used for Parkinsonism. However amantadine can induce adverse corneal reaction. Here we report a patient with primary progressive freezing of gait who had severe corneal edema associated with amantadine, which was reversible after discontinuation of the amantadine. This report alerts neurologists for this reversible but potentially critical corneal edema in patients with Parkinsonism who are receiving amantadine.

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A Case of Adrenoleukodystrophy Presenting as Progressive Cerebellar Dysfunction: Seunguk Jung, Jong Won Chung, Ji Young Yun, Han-Joon Kim, Beom Seok Jeon; J Mov Disord. 2009;2(2):91-94.; DOI: https://doi.org/10.14802/jmd.09025

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Abstract PDF

X-linked adrenoleukodystrophy (X-ALD) is a hereditary neurological disorder affecting the nervous system and adrenal cortex. The phenotype of X-ALD ranges from the rapidly progressive cerebral form to milder adrenomyeloneuropathy. However, cerebellar manifestations are rare. We report a case of adrenoleukodystrophy presenting as progressive cerebellar dysfunction resembling olivopontocerebellar degeneration, with a review of the literature

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