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Case Report
A KMT2B Frameshift Variant Causing Focal Dystonia Restricted to the Oromandibular Region After Long-Term Follow-up
Alfand Marl F. Dy Closas, Katja Lohmann, Ai Huey Tan, Norlinah Mohamed Ibrahim, Jia Lun Lim, Yi Wen Tay, Kalai Arasu Muthusamy, Azlina Binti Ahmad-Annuar, Christine Klein, Shen-Yang Lim
J Mov Disord. 2023;16(1):91-94.   Published online December 20, 2022
DOI: https://doi.org/10.14802/jmd.22109
  • 396 View
  • 40 Download
AbstractAbstract PDFSupplementary Material
KMT2B-linked dystonia (DYT-KMT2B) is a childhood-onset dystonia syndrome typically beginning in the lower limbs and progressing caudocranially to affect the upper limbs with eventual prominent craniocervical involvement. Despite its recent recognition, it now appears to be one of the more common monogenic causes of dystonia syndromes. Here, we present an atypical case of DYT-KMT2B with oromandibular dystonia as the presenting feature, which remained restricted to this region three decades after symptom onset. This appears to be the first reported case of DYT-KMT2B from Southeast Asia and provides further supporting evidence for the pathogenic impact of the KMT2B c.6210_6213delTGAG variant.
Brief communication
Movement Disorders Resulting From Bilateral Basal Ganglia Lesions in End-Stage Kidney Disease: A Systematic Review
Kah Hui Yap, Nurul Husna Baharudin, Abdul Halim Abdul Gafor, Rabani Remli, Shen-Yang Lim, Wan Asyraf Wan Zaidi, Shahrul Azmin, Shahizon Azura Mohamed Mukari, Raihanah Abdul Khalid, Norlinah Mohamed Ibrahim
J Mov Disord. 2022;15(3):258-263.   Published online May 26, 2022
DOI: https://doi.org/10.14802/jmd.21185
  • 1,528 View
  • 69 Download
AbstractAbstract PDFSupplementary Material
Objective
The basal ganglia (BG) are susceptible to fluctuations in blood urea levels, sometimes resulting in movement disorders. We described patients with end-stage kidney disease (ESKD) presenting with movement disorders associated with bilateral BG lesions on imaging.
Methods
We report four patients and systematically reviewed all published cases of ESKD presenting with movement disorders and bilateral BG lesions (EBSCOhost and Ovid).
Results
Of the 72 patients identified, 55 (76.4%) were on regular dialysis. Parkinsonism was the most common movement disorder (n = 39; 54.2%), followed by chorea (n = 24; 33.3%). Diabetes mellitus (n = 51; 70.8%) and hypertension (n = 16; 22.2%) were the most common risk factors. Forty-three (59.7%) were of Asian ethnicity. Complete clinical resolution was reported in 17 (30.9%) patients, while 38 (69.1%) had incomplete clinical resolution with relapse. Complete radiological resolution occurred in 14 (34.1%) patients.
Conclusion
Movement disorders associated with BG lesions should be recognized as a rare and potentially reversible metabolic movement disorder in patients with ESKD.
Original Article
Fecal Calprotectin in Parkinson’s Disease and Multiple System Atrophy
Jia Wei Hor, Shen-Yang Lim, Eng Soon Khor, Kah Kian Chong, Sze Looi Song, Norlinah Mohamed Ibrahim, Cindy Shuan Ju Teh, Chun Wie Chong, Ida Normiha Hilmi, Ai Huey Tan
J Mov Disord. 2022;15(2):106-114.   Published online December 24, 2021
DOI: https://doi.org/10.14802/jmd.21085
  • 3,012 View
  • 314 Download
  • 3 Citations
AbstractAbstract PDFSupplementary Material
Objective
Converging evidence suggests that intestinal inflammation is involved in the pathogenesis of neurodegenerative diseases. Previous studies on fecal calprotectin in Parkinson’s disease (PD) were limited by small sample sizes, and literature regarding intestinal inflammation in multiple system atrophy (MSA) is very scarce. We investigated the levels of fecal calprotectin, a marker of intestinal inflammation, in PD and MSA.
Methods
We recruited 169 subjects (71 PD, 38 MSA, and 60 age-similar nonneurological controls). Clinico-demographic data were collected. PD and MSA were subtyped and the severity assessed using the MDS-UPDRS and UMSARS, respectively. Fecal calprotectin and blood immune markers were analyzed.
Results
Compared to controls (median: 35.7 [IQR: 114.2] μg/g), fecal calprotectin was significantly elevated in PD (median: 95.6 [IQR: 162.1] μg/g, p = 0.003) and even higher in MSA (median: 129.5 [IQR: 373.8] μg/g, p = 0.002). A significant interaction effect with age was observed; between-group differences were significant only in older subjects (i.e., ≥ 61 years) and became more apparent with increasing age. A total of 28.9% of MSA and 18.3% of PD patients had highly abnormal fecal calprotectin levels (≥ 250 μg/g); however, this difference was only significant for MSA compared to controls. Fecal calprotectin correlated moderately with selected blood immune markers in PD, but not with clinical features of PD or MSA.
Conclusions
Elevated fecal calprotectin suggests a role for intestinal inflammation in PD and MSA. A more complete understanding of gut immune alterations could open up new avenues of research and treatment for these debilitating diseases.

Citations

Citations to this article as recorded by  
  • The microbiome–gut–brain axis in Parkinson disease — from basic research to the clinic
    Ai Huey Tan, Shen Yang Lim, Anthony E. Lang
    Nature Reviews Neurology.2022; 18(8): 476.     CrossRef
  • The Gut Microbiome–Brain Crosstalk in Neurodegenerative Diseases
    Laura Ghezzi, Claudia Cantoni, Emanuela Rotondo, Daniela Galimberti
    Biomedicines.2022; 10(7): 1486.     CrossRef
  • Gastrointestinal Involvement in Extra-Digestive Disease: Which Is the Role of Fecal Calprotectin?
    Angela Saviano, Marcello Candelli, Christian Zanza, Andrea Piccioni, Alessio Migneco, Veronica Ojetti
    Medicina.2022; 58(10): 1384.     CrossRef
Letters to the editor
Hyperglycemia-Associated Hemichorea-Hemiballismus with Predominant Ipsilateral Putaminal Abnormality on Neuroimaging
Si Lei Fong, Ai Huey Tan, Kar Foo Lau, Norlisah Ramli, Shen-Yang Lim
J Mov Disord. 2019;12(3):187-189.   Published online August 9, 2019
DOI: https://doi.org/10.14802/jmd.19014
  • 5,773 View
  • 155 Download
  • 3 Citations
PDFSupplementary Material

Citations

Citations to this article as recorded by  
  • Consideration for Hemiballismus in the Differential Diagnosis: A Rare Case of Hyperosmolar Hyperglycemic State
    Iman Isayli, Nicolas Ulloa, John Childress
    Cureus.2022;[Epub]     CrossRef
  • A Case of Diabetic Hemichorea Hemiballismus Exacerbated by Hypoglycemia
    Jessica Rupp, Avrum Gillespie
    AACE Clinical Case Reports.2021;[Epub]     CrossRef
  • Hemicorea inducida por hiperglucemia no cetósica: discordancia clínicorradiológica
    Juan Pablo García Marmolejo, Manuel David Mayoral Valencia, Paola Andrea Tejada Serna
    Universitas Médica.2021;[Epub]     CrossRef
Alternating Hemiplegia of Childhood in a Person of Malay Ethnicity with Diffusion Tensor Imaging Abnormalities
Ai Huey Tan, Tien Lee Ong, Norlisah Ramli, Li Kuo Tan, Jia Lun Lim, Mohamad Addin Azhan, Azlina Ahmad-Annuar, Khairul Azmi Ibrahim, Zariah Abdul-Aziz, Laurie J. Ozelius, Allison Brashear, Shen-Yang Lim
J Mov Disord. 2019;12(2):132-134.   Published online May 30, 2019
DOI: https://doi.org/10.14802/jmd.18063
  • 3,993 View
  • 54 Download
  • 1 Citations
PDFSupplementary Material

Citations

Citations to this article as recorded by  
  • White matter and cerebellar involvement in alternating hemiplegia of childhood
    Mariasavina Severino, Livia Pisciotta, Domenico Tortora, Benedetta Toselli, Michela Stagnaro, Ramona Cordani, Giovanni Morana, Anna Zicca, Svetlana Kotzeva, Clelia Zanaboni, Giovanni Montobbio, Andrea Rossi, Elisa De Grandis
    Journal of Neurology.2020; 267(5): 1300.     CrossRef
Chorea in Sporadic Creutzfeldt-Jakob Disease
Ai Huey Tan, Tsun Haw Toh, Soon Chai Low, Si Lei Fong, Kah Kian Chong, Kee Wei Lee, Khean Jin Goh, Shen-Yang Lim
J Mov Disord. 2018;11(3):149-151.   Published online August 9, 2018
DOI: https://doi.org/10.14802/jmd.18017
  • 5,100 View
  • 146 Download
  • 3 Citations
PDFSupplementary Material

Citations

Citations to this article as recorded by  
  • Atypical and early symptoms of sporadic Creutzfeldt – Jakob disease: case series and review of the literature
    Grammatiki Katsikaki, Ioannis E. Dagklis, Petros Angelopoulos, Dimitrios Ntantos, Angeliki Prevezianou, Sevasti Bostantjopoulou
    International Journal of Neuroscience.2021; 131(9): 927.     CrossRef
  • Review of Hereditary and Acquired Rare Choreas
    Daniel Martinez-Ramirez, Ruth H. Walker, Mayela Rodríguez-Violante, Emilia M. Gatto
    Tremor and Other Hyperkinetic Movements.2020;[Epub]     CrossRef
  • A Case of Creutzfeldt-Jakob Disease Presented as Rapid Progressive Parkinsonism
    Yoonah Park, Chan-Nyeong Lee
    Dementia and Neurocognitive Disorders.2019; 18(4): 152.     CrossRef
Case Reports
Purposeless Groaning in Parkinson’s Disease
Shen-Yang Lim, Ai Huey Tan, Jia Lun Lim, Azlina Ahmad-Annuar
J Mov Disord. 2018;11(2):87-88.   Published online May 30, 2018
DOI: https://doi.org/10.14802/jmd.18004
  • 6,711 View
  • 105 Download
  • 4 Citations
AbstractAbstract PDFSupplementary Material
Purposeless groaning has been reported in advanced progressive supranuclear palsy. We present a case of purposeless groaning occurring as a primary complaint in a patient with advanced Parkinson’s disease. Purposeless groaning is thought to be a manifestation of disinhibition and perseveration due to frontal-subcortical dysfunction. Proper recognition of this phenomenon will help clinicians to avoid unnecessary investigations and treatment (e.g., prescription of opioid medications).

Citations

Citations to this article as recorded by  
  • Involuntary moaning in a Hispanic family with eight affected members
    Maria Gisatulin, Malco Rossi, Claudia Perandones, Christine Klein, Katja Lohmann, Marcelo Merello
    Parkinsonism & Related Disorders.2021; 89: 206.     CrossRef
  • Involuntary Groaning Induced by Levodopa Therapy in a Patient With Progressive Supranuclear Palsy
    Jung E. Park
    JAMA Neurology.2020; 77(12): 1569.     CrossRef
  • Clinical Phenotype of LRRK2 R1441C in 2 Chinese Sisters
    Shen-Yang Lim, Jia Lun Lim, Azlina Ahmad-Annuar, Katja Lohmann, Ai Huey Tan, Kai Bin Lim, Yi Wen Tay, Yee Lee Shing, Kalai Arasu Muthusamy, Peter Bauer, Arndt Rolfs, Christine  Klein
    Neurodegenerative Diseases.2020; 20(1): 39.     CrossRef
  • The spectrum of involuntary vocalizations in humans: A video atlas
    Tina Mainka, Bettina Balint, Felix Gövert, Lille Kurvits, Christoph Riesen, Andrea A. Kühn, Marina A.J. Tijssen, Andrew J. Lees, Kirsten Müller‐Vahl, Kailash P. Bhatia, Christos Ganos
    Movement Disorders.2019; 34(12): 1774.     CrossRef
A Patient with Beta-Propeller Protein-Associated Neurodegeneration: Treatment with Iron Chelation Therapy
Shen-Yang Lim, Ai Huey Tan, Azlina Ahmad-Annuar, Susanne A. Schneider, Ping Chong Bee, Jia Lun Lim, Norlisah Ramli, Mohamad Imran Idris
J Mov Disord. 2018;11(2):89-92.   Published online May 30, 2018
DOI: https://doi.org/10.14802/jmd.17082
  • 24,571 View
  • 146 Download
  • 11 Citations
AbstractAbstract PDFSupplementary Material
We present a case of beta-propeller protein-associated neurodegeneration, a form of neurodegeneration with brain iron accumulation. The patient harbored a novel mutation in the WDR45 gene. A detailed video and description of her clinical condition are provided. Her movement disorder phenomenology was characterized primarily by limb stereotypies and gait dyspraxia. The patient’s disability was advanced by the time iron-chelating therapy with deferiprone was initiated, and no clinical response in terms of cognitive function, behavior, speech, or movements were observed after one year of treatment.

Citations

Citations to this article as recorded by  
  • Quantitative retrospective natural history modeling of WDR45-related developmental and epileptic encephalopathy – a systematic cross-sectional analysis of 160 published cases
    Afshin Saffari, Julian Schröter, Sven F. Garbade, Julian E. Alecu, Darius Ebrahimi-Fakhari, Georg F. Hoffmann, Stefan Kölker, Markus Ries, Steffen Syrbe
    Autophagy.2022; 18(7): 1715.     CrossRef
  • Cerebral Iron Deposition in Neurodegeneration
    Petr Dusek, Tim Hofer, Jan Alexander, Per M. Roos, Jan O. Aaseth
    Biomolecules.2022; 12(5): 714.     CrossRef
  • Interactions of dopamine, iron, and alpha-synuclein linked to dopaminergic neuron vulnerability in Parkinson's disease and Neurodegeneration with Brain Iron Accumulation disorders
    Rachel M. Wise, Annika Wagener, Urban M. Fietzek, Thomas Klopstock, Eugene V. Mosharov, Fabio A. Zucca, David Sulzer, Luigi Zecca, Lena F. Burbulla
    Neurobiology of Disease.2022; 175: 105920.     CrossRef
  • WDR45 variants cause ferrous iron loss due to impaired ferritinophagy associated with nuclear receptor coactivator 4 and WD repeat domain phosphoinositide interacting protein 4 reduction
    Kiwako Tsukida, Shin-ichi Muramatsu, Hitoshi Osaka, Takanori Yamagata, Kazuhiro Muramatsu
    Brain Communications.2022;[Epub]     CrossRef
  • Iron Chelation in Movement Disorders: Logical or Ironical
    Dinkar Kulshreshtha, Jacky Ganguly, Mandar Jog
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.2021; : 1.     CrossRef
  • Emerging Disease-Modifying Therapies in Neurodegeneration With Brain Iron Accumulation (NBIA) Disorders
    Vassilena Iankova, Ivan Karin, Thomas Klopstock, Susanne A. Schneider
    Frontiers in Neurology.2021;[Epub]     CrossRef
  • Consensus clinical management guideline for beta‐propeller protein‐associated neurodegeneration
    Jenny L Wilson, Allison Gregory, Manju A Kurian, Ittai Bushlin, Fanny Mochel, Lisa Emrick, Laura Adang, Penelope Hogarth, Susan J Hayflick, Caleb Rogers, Jae‐Hyeok Lee, Kimberly Burke, Meg Tally Dyer, Donna Stretter
    Developmental Medicine & Child Neurology.2021; 63(12): 1402.     CrossRef
  • WDR45, one gene associated with multiple neurodevelopmental disorders
    Yingying Cong, Vincent So, Marina A. J. Tijssen, Dineke S. Verbeek, Fulvio Reggiori, Mario Mauthe
    Autophagy.2021; 17(12): 3908.     CrossRef
  • Towards Precision Therapies for Inherited Disorders of Neurodegeneration with Brain Iron Accumulation
    Robert V.V. Spaull, Audrey K.S. Soo, Penelope Hogarth, Susan J. Hayflick, Manju A. Kurian
    Tremor and Other Hyperkinetic Movements.2021;[Epub]     CrossRef
  • The roles of iron and HFE genotype in neurological diseases
    Yunsung Kim, James R. Connor
    Molecular Aspects of Medicine.2020; 75: 100867.     CrossRef
  • The Contribution of Iron to Protein Aggregation Disorders in the Central Nervous System
    Karina Joppe, Anna-Elisa Roser, Fabian Maass, Paul Lingor
    Frontiers in Neuroscience.2019;[Epub]     CrossRef

JMD : Journal of Movement Disorders