Journal of Movement Disorders

Letter to the editor

Optimizing Device-Aided Therapies in Advanced Parkinson’s Disease: A Case Series on Continuous Subcutaneous Apomorphine Infusion in Challenging Scenarios: Adrian Paul R De Leon, Roongroj Bhidayasiri, Onanong Phokaewvarangkul; Received February 25, 2025 Accepted May 12, 2025 Published online May 14, 2025; DOI: https://doi.org/10.14802/jmd.25045 [Accepted]

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Original Article

The Impact of LRRK2 G2019S on Parkinson’s Disease: Clinical Phenotype and Treatment in Tunisian Patients: Guedi Ali Barreh, Ikram Sghaier, Youssef Abida, Alya Gharbi, Amina Nasri, Saloua Mrabet, Amira Souissi, Mouna Ben Djebara, Sameh Trabelsi, Imen Kacem, Amina Gargouri-Berrechid, Riadh Gouider; J Mov Disord. 2024;17(3):294-303. Published online April 23, 2024; DOI: https://doi.org/10.14802/jmd.23276

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Objective
LRRK2-G2019S is the most frequent mutation in North African Parkinson’s disease (PD) patients. Data on its impact on disease progression and treatment response remain elusive. Therefore, we investigated the clinical features, treatments, and complications of PD in Tunisian patients according to their LRRK2-G2019S profile.
Methods
This longitudinal retrospective study was performed in the Department of Neurology, Razi University Hospital. We included clinically diagnosed PD patients according to the Movement Disorders Society criteria and reviewed their medical records for clinical, treatment, and neuropsychological assessments. All patients were screened for the LRRK2-G2019S mutation using Sanger sequencing. The correlation between LRRK2-G2019S and clinical PD features was evaluated.
Results
We included 393 PD patients, 41.5% of whom had LRRK2-G2019S mutations. Patients with mutations were younger (p = 0.017), and female PD patients had a greater mutation frequency (p = 0.008). Mutation carriers exhibited distinct clinical features, with a greater frequency of postural instability gait difficulty forms (adjusted-p < 0.001). During disease progression, carriers showed a faster annual progression in the Unified Parkinson’s Disease Rating Scale Section III scores (adjusted-p = 0.009), and significantly higher levodopa equivalent dose values in later stages (1060.81 vs. 877.83 for 6-8 years). Motor complications, such as dyskinesia (adjusted-p < 0.001) and motor fluctuations (31.9% vs. 25.7%, adjusted-p < 0.001), were more prevalent in carriers, particularly in the later stages. LRRK2-G2019S carriers also exhibited a lower prevalence of non-motor symptoms, including episodic memory (adjusted-p < 0.001), attention (adjusted-p < 0.001), and dysexecutive disorders (adjusted-p = 0.038), as well as neuropsychiatric symptoms and dysautonomic signs.
Conclusion
The present study demonstrated that the variability of the clinical profile among Tunisian PD patients was explained by the incomplete penetrance of LRRK2-G2019S, which increased with age. Further studies using biomarker and disease progression data are necessary to improve PD management.

Citations

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Glutathione S-transferase polymorphisms (GSTM1/GSTT1) outcomes in clinical profile and treatment responsiveness among Tunisian cohort of Parkinson’s disease
Ali Barreh Guedi, Sghaier Ikram, Abida Youssef, Gharbi Alya, Souissi Amira, Mrabet Saloua, Nasri Amina, Ben Djebara Mouna, Kacem Imen, Gargouri-Berrechid Amina, Gouider Riadh
Journal of Neural Transmission.2025; 132(1): 117. CrossRef
Advanced Parkinson’s disease and eligibility for device-aided therapies in Morocco: a multicenter cross-sectional study
Mohamed Daghi, Zineb Serhier, Abdelhakim Lakhdar, Hicham El Otmani
Neurodegenerative Disease Management.2025; : 1. CrossRef

Review Article

Fighting Against the Clock: Circadian Disruption and Parkinson’s Disease: Yen-Chung Chen, Wei-Sheng Wang, Simon J G Lewis, Shey-Lin Wu; J Mov Disord. 2024;17(1):1-14. Published online November 21, 2023; DOI: https://doi.org/10.14802/jmd.23216

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Abstract PDF

Circadian disruption is being increasingly recognized as a critical factor in the development and progression of Parkinson’s disease (PD). This review aims to provide an in-depth overview of the relationship between circadian disruption and PD by exploring the molecular, cellular, and behavioral aspects of this interaction. This review will include a comprehensive understanding of how the clock gene system and transcription–translation feedback loops function and how they are diminished in PD. The article also discusses the role of clock genes in the regulation of circadian rhythms, as well as the impact of clock gene dysregulation on mitochondrial function, oxidative stress, and neuroinflammation, including the microbiota-gut-brain axis, which have all been proposed as being crucial mechanisms in the pathophysiology of PD. Finally, this review highlights potential therapeutic strategies targeting the clock gene system and circadian rhythm for the treatment of PD.

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Diabetes mellitus and glymphatic dysfunction: Roles for oxidative stress, mitochondria, circadian rhythm, artificial intelligence, and imaging
Kenneth Maiese
World Journal of Diabetes.2025;[Epub] CrossRef
Circadian Rhythm, Clock Genes, and Stroke
Kenneth Maiese
Current Neurovascular Research.2025; 21(4): 343. CrossRef
Exploring Fatigue in Parkinson’s Disease: A Comprehensive Literature Review
Jamir Pitton Rissardo, Maleesha Jayasinghe, Ahmed Farid Gadelmawla, Masoumeh Rashidi, Fatemeh Rashidi, Hania Moharam, Ola D Hag Ali, Mohamed Yousif Elamin Yousif, Ibrahim Khalil, Ana Leticia Fornari Caprara, Omesh Prathiraja, Mallak Bahar
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Ignacio Roura, Jèssica Pardo, Cristina Martín-Barceló, Carles Falcon, Javier Oltra, Anna Campabadal, Nuria Bargalló, Mònica Serradell, Gerard Mayà, Angelica Montini, Claustre Pont-Sunyer, Carles Gaig, Mariateresa Buongiorno, Carme Junqué, Alex Iranzo, Bàr
npj Parkinson's Disease.2025;[Epub] CrossRef

Case Report

Rapid-Onset Dystonia and Parkinsonism in a Patient With Gaucher Disease: Ellen Hertz, Grisel Lopez, Jens Lichtenberg, Dietrich Haubenberger, Nahid Tayebi, Mark Hallett, Ellen Sidransky; J Mov Disord. 2023;16(3):321-324. Published online June 13, 2023; DOI: https://doi.org/10.14802/jmd.23074

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Abstract PDF Supplementary Material

Biallelic mutations in GBA1 cause the lysosomal storage disorder Gaucher disease, and carriers of GBA1 variants have an increased risk of Parkinson’s disease (PD). It is still unknown whether GBA1 variants are also associated with other movement disorders. We present the case of a woman with type 1 Gaucher disease who developed acute dystonia and parkinsonism at 35 years of age during a recombinant enzyme infusion treatment. She developed severe dystonia in all extremities and a bilateral pill-rolling tremor that did not respond to levodopa treatment. Despite the abrupt onset of symptoms, neither Sanger nor whole genome sequencing revealed pathogenic variants in ATP1A3 associated with rapid-onset dystonia-parkinsonism (RDP). Further examination showed hyposmia and presynaptic dopaminergic deficits in [18F]-DOPA PET, which are commonly seen in PD but not in RDP. This case extends the spectrum of movement disorders reported in patients with GBA1 mutations, suggesting an intertwined phenotype.

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Emerging Molecular‐Genetic Families in Dystonia: Endosome‐Autophagosome‐Lysosome and Integrated Stress Response Pathways
Nicole Calakos, Michael Zech
Movement Disorders.2025; 40(1): 7. CrossRef
Long‐Read Sequencing: The Third Generation of Diagnostic Testing for Dystonia
Thomas Wirth, Kishore R. Kumar, Michael Zech
Movement Disorders.2025;[Epub] CrossRef
Phenotypic consequences of GBA1 pathological variant R463C (p.R502C)
Emory Ryan, Samantha Nishimura, Grisel Lopez, Nahid Tayebi, Ellen Sidransky
American Journal of Medical Genetics Part A.2024;[Epub] CrossRef
In vitro study of ATP1A3 p.Ala275Pro mutant causing alternating hemiplegia of childhood and rapid-onset dystonia-parkinsonism
Dan-dan Ruan, Jing Zou, Li-sheng Liao, Ming-dong Ji, Ruo-li Wang, Jian-hui Zhang, Li Zhang, Mei-zhu Gao, Qian Chen, Hong-ping Yu, Wen Wei, Yun-fei Li, Hong Li, Fan Lin, Jie-wei Luo, Xin-fu Lin
Frontiers in Neuroscience.2024;[Epub] CrossRef

Original Article

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.

Citations

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Unveiling the Impact of Outpatient Physiotherapy on Specific Motor Symptoms in Parkinson’s Disease: A Prospective Cohort Study
Yuta Terasawa, Koki Ikuno, Shintaro Fujii, Yuki Nishi, Emi Tanizawa, Sachio Nabeshima, Yohei Okada
Brain & Neurorehabilitation.2023;[Epub] CrossRef

Brief communication

Deep Brain Stimulation Battery Exhaustion during the COVID-19 Pandemic: Crisis within a Crisis: Vikram Venkappayya Holla, Koti Neeraja, Bharath Kumar Surisetti, Shweta Prasad, Nitish Kamble, Dwarakanath Srinivas, Ravi Yadav, Pramod Kumar Pal; J Mov Disord. 2020;13(3):218-222. Published online August 31, 2020; DOI: https://doi.org/10.14802/jmd.20073

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Abstract PDF

Objective
The novel coronavirus disease (COVID-19) pandemic and public health measures to control it have resulted in unique challenges in the management of patients with deep brain stimulation (DBS). We report our experience with the management of acute worsening of symptoms due to battery exhaustion in 3 patients with DBS.
Methods
Patients with DBS for movement disorders who visited the emergency room due to battery exhaustion during the nationwide lockdown from April to May 2020 were included.
Results
Two patients with subthalamic nucleus-DBS for Parkinson’s disease (PD) and one with globus pallidus interna-DBS for generalized dystonia presented with acute worsening of symptoms due to battery exhaustion. Urgent battery replacement was performed in both patients with PD. The patient with generalized dystonia was managed with medication adjustment as he chose to defer battery replacement.
Conclusion
DBS battery replacement can be an emergency. Decisions regarding DBS battery replacement should be individualized during this COVID-19 pandemic.

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Review Articles

Update on Current Technologies for Deep Brain Stimulation in Parkinson’s Disease: Michelle Paff, Aaron Loh, Can Sarica, Andres M. Lozano, Alfonso Fasano; J Mov Disord. 2020;13(3):185-198. Published online August 31, 2020; DOI: https://doi.org/10.14802/jmd.20052

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Abstract PDF

Deep brain stimulation (DBS) is becoming increasingly central in the treatment of patients with Parkinson’s disease and other movement disorders. Recent developments in DBS lead and implantable pulse generator design provide increased flexibility for programming, potentially improving the therapeutic benefit of stimulation. Directional DBS leads may increase the therapeutic window of stimulation by providing a means of avoiding current spread to structures that might give rise to stimulation-related side effects. Similarly, control of current to individual contacts on a DBS lead allows for shaping of the electric field produced between multiple active contacts. The following review aims to describe the recent developments in DBS system technology and the features of each commercially available DBS system. The advantages of each system are reviewed, and general considerations for choosing the most appropriate system are discussed.

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Nutrition and Lifestyle Interventions for Managing Parkinson’s Disease: A Narrative Review: Tracy Lister; J Mov Disord. 2020;13(2):97-104. Published online May 29, 2020; DOI: https://doi.org/10.14802/jmd.20006

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Abstract PDF

The etiology of Parkinson’s disease (PD) is not fully understood, but environmental toxin overexposure, increased intestinal permeability, and dysbiosis related to nutrition and lifestyle habits are thought to be contributors. Considering these nutrition and lifestyle implications, there is a lack of practice-based programs utilizing interventions for managing symptoms or slowing the progression of the disease. The purpose of this narrative review was to identify relevant research related to nutrition and lifestyle interventions for PD, evaluate the research utilizing the evidence analysis process of the Academy of Nutrition and Dietetics to assess the quality of each research article, and group the research into categories. A grading of recommendations assessment, development and evaluation (GRADE) of either good, fair, limited, or not assignable was allocated to each category of research, including diet patterns, vitamin D, B-complex, omega-3 fatty acids, coenzyme Q10, probiotics, physical activity, stress, and sleep. An intervention based on the research presented in the review may be utilized for coaching people with PD on symptom management.

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Original Articles

Long-term Effects of Bilateral Subthalamic Deep Brain Stimulation on Postural Instability and Gait Difficulty in Patients with Parkinson’s Disease: Hae-Won Shin, Mi Sun Kim, Sung Reul Kim, Sang Ryong Jeon, Sun Ju Chung; J Mov Disord. 2020;13(2):127-132. Published online May 29, 2020; DOI: https://doi.org/10.14802/jmd.19081

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Abstract PDF

Objective
The long-term effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on postural instability and gait difficulty (PIGD) in patients with Parkinson’s disease (PD) remain unclear. In this study, we aimed to evaluate the longterm effects of STN-DBS surgery on PIGD symptoms in patients with advanced-stage PD. Methods This study included 49 consecutively included patients with PD who underwent bilateral STN-DBS. The Unified Parkinson’s Disease Rating Scale (UPDRS) scores and subscores for PIGD were assessed at baseline and at 1, 3, and 5 years postoperatively. The PIGD subscore was divided into PIGD-motor and PIGD-activities of daily living (ADL) scores according to parts III and II of the UPDRS, respectively. Results The PIGD-motor and PIGD-ADL scores at the “medication-off” state improved at 3 and 5 years, respectively. Overall, the UPDRS III and II scores at “medication-off” improved at 5 years. The UPDRS IV score also significantly improved and the levodopa equivalent daily dosage decreased at all follow-ups. Finally, the PIGD-motor score at baseline was able to predict long-term improvement in the PIGD-motor score at the 5-year follow-up. Conclusion The STN-DBS has both short- and long-term effects on PIGD, as well as overall motor function, in patients with advanced PD. The degree of PIGD at the preoperative evaluation can be used to predict long-term outcomes after STN-DBS surgery.

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Association between Olfactory Deficit and Motor and Cognitive Function in Parkinson’s Disease: Han Soo Yoo, Seok Jong Chung, Yang Hyun Lee, Byoung Seok Ye, Young H. Sohn, Phil Hyu Lee; J Mov Disord. 2020;13(2):133-141. Published online April 6, 2020; DOI: https://doi.org/10.14802/jmd.19082

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Abstract PDF Supplementary Material

Objective
To investigate whether baseline olfactory dysfunction in Parkinson’s disease (PD) patients is associated with baseline and longitudinal motor and cognitive function.
Methods
We recruited 228 drug-naïve PD patients who were followed for a mean of 6 years. Patients underwent the Cross-Cultural Smell Identification Test (CCSIT), a neuropsychological test, and N-(3-[18F]fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl) nortropane positron emission tomography within 6 months of the baseline evaluation. Olfactory dysfunction was categorized as normosmia (CCSIT score ≥ 9), hyposmia (CCSIT score 5–8), and anosmia (CCSIT score ≤ 4). During the follow-up period, we investigated changes in the levodopa-equivalent dose (LED) and the occurrence of wearing-off, levodopa-induced dyskinesia, and dementia.
Results
Among the PD patients, 80.7% were hyposmic at the time of diagnosis, and 26.1% were anosmic. Baseline olfactory dysfunction was not associated with either initial parkinsonian motor symptoms or with the longitudinal LED increment and motor complications. Meanwhile, the anosmic group had lower baseline scores on the Korea version of the Boston Naming Test and Stroop color reading test than the normosmic and hyposmic groups. The anosmic group exhibited a higher rate of conversion to dementia than the normosmic [adjusted hazard ratio (HR) 3.99, 95% confidence interval (CI) 1.08–14.72] and hyposmic (adjusted HR 2.48, 95% CI 1.15–5.32) PD groups, regardless of baseline motor deficits and cognitive status.
Conclusion
Baseline olfactory dysfunction was not associated with motor deficits and complications, but it was associated with cognitive dysfunction and prognosis, suggesting that severe olfactory impairment may reflect early cortical involvement, probably in the frontotemporal region, and rapid spreading of Lewy body pathology.

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Less Pulsatile Levodopa Therapy (6 Doses Daily) Is Associated with a Reduced Incidence of Dyskinesia: Mark M. Lin, Robert Laureno; J Mov Disord. 2019;12(1):37-42. Published online January 30, 2019; DOI: https://doi.org/10.14802/jmd.18046

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Abstract PDF

Objective
To evaluate whether less pulsatile levodopa therapy (LPT) can reduce the development of levodopa-induced dyskinesia (LID).
Methods
This is a retrospective cohort study of patients with Parkinson’s disease at the movement disorders clinic of Medstar Washington Hospital Center. The study was not blinded or randomized. Patients were seen between August 2002 and August 2018. During these years, we treated patients with less pulsatile (6 doses daily) levodopa treatment to reduce LID. Occurrence of LID was recorded.
Results
Ninety-five patients with Parkinson’s disease taking levodopa were divided into two groups: 1) patients who were initially managed on LPT or who switched from traditional therapy (TT) (n = 61) (mean disease duration: 7.7 ± 4.8 years, mean levodopa duration: 5.6 ± 4.5 years and mean observation time: 4.3 ± 3.4 years), and 2) patients on TT throughout the observation period or until they developed dyskinesia (n = 34) (mean disease duration: 8.3 ± 3.8 years, mean levodopa duration: 6.2 ± 4.2 years and mean observation time: 4.1 ± 3.4 years). Three of the 61 LPT patients developed dyskinesia during the observation period. One of the patients developed dyskinesia after being switched to pulsatile doses by another doctor. In the other two, dyskinesia was minimal. In contrast to this 4.9% cumulative incidence, dyskinesia occurred in 50% (17/34) of TT patients, an incidence similar to that in published data (p < 0.001).
Conclusion
Less pulsatile levodopa with 6 daily doses was associated with a low incidence of LID. Further study of this method of treatment is warranted.

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Reduced Plasma Levodopa Fluctuations with More Frequent Administration of a Novel Carbidopa/Levodopa Functionally Scored Tablet
Thomas N. Chase, Ahmad AL‐Sabbagh, Minako Koga, Kathleen Clarence‐Smith
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Effects of Intracerebral Aminophylline Dosing on Catalepsy and Gait in an Animal Model of Parkinson’s Disease
Érica de Moraes Santos Corrêa, Gustavo Christofoletti, Albert Schiaveto de Souza
International Journal of Molecular Sciences.2024; 25(10): 5191. CrossRef
Dopamine D1 Agonists: First Potential Treatment for Late-Stage Parkinson’s Disease
Mechelle M. Lewis, Lauren J. Van Scoy, Sol De Jesus, Jonathan G. Hakun, Paul J. Eslinger, Julio Fernandez-Mendoza, Lan Kong, Yang Yang, Bethany L. Snyder, Natalia Loktionova, Sridhar Duvvuri, David L. Gray, Xuemei Huang, Richard B. Mailman
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Classification of l-DOPA pharmacokinetics shapes and creating a predictive model
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Personalized Medicine Approach in Treating Parkinson’s Disease, Using Oral Administration of Levodopa/Carbidopa Microtablets in Clinical Practice
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Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review
Michał Hutny, Jagoda Hofman, Aleksandra Klimkowicz-Mrowiec, Agnieszka Gorzkowska
Journal of Clinical Medicine.2021; 10(19): 4377. CrossRef
Pallidal versus subthalamic nucleus deep brain stimulation for levodopa‐induced dyskinesia
Shi‐Ying Fan, Kai‐Liang Wang, Wei Hu, Robert S. Eisinger, Alexander Han, Chun‐Lei Han, Qiao Wang, Shimabukuro Michitomo, Jian‐Guo Zhang, Feng Wang, Adolfo Ramirez‐Zamora, Fan‐Gang Meng
Annals of Clinical and Translational Neurology.2020; 7(1): 59. CrossRef
A Stage-Based Approach to Therapy in Parkinson’s Disease
Claudia Carrarini, Mirella Russo, Fedele Dono, Martina Di Pietro, Marianna G. Rispoli, Vincenzo Di Stefano, Laura Ferri, Filomena Barbone, Michela Vitale, Astrid Thomas, Stefano Luca Sensi, Marco Onofrj, Laura Bonanni
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The Gut Microbiome: A Therapeutically Targetable Site of Peripheral Levodopa Metabolism
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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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Xiaoying Chen, Huangliang Wen, Jinni Wang, Yayan Yi, Jialan Wu, Xiaoyan Liao
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Մ.Ա. Իսայան, Հ.Ա. Հովակիմյան, Լ.Վ. Վարդանյան, Ս.Գ. Խաչատրյան, Զ.Դ. Թավադյան
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Concordance of Mini-Mental State Examination, Montreal Cognitive Assessment and Parkinson Neuropsychometric Dementia Assessment in the classification of cognitive performance in Parkinson's disease
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Rapid Eye Movement Sleep Behavior Disorder in Parkinson’s Disease: A Preliminary Study: Chang Soo Kim, Young Hee Sung, Min Ju Kang, Kee Hyung Park; J Mov Disord. 2016;9(2):114-119. Published online March 2, 2016; DOI: https://doi.org/10.14802/jmd.15039

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Abstract PDF

Objective
Rapid eye movement sleep behavior disorder (RBD) is associated with α-synucleinopathies, such as Parkinson’s disease (PD). We aimed to assess the differences in the clinical characteristics of PD with and without RBD.
Methods
Forty-two patients previously diagnosed with PD were evaluated for clinical history, motor and cognitive functioning using the Unified Parkinson’s Disease Rating Scale (UPDRS) and Mini-Mental State Examination (MMSE), autonomic symptoms, sleep characteristics using the Pittsburg Sleep Quality Index (PSQI), and the presence of RBD using the Korean version of the RBD screening questionnaire (RBDSQ). The prevalence of RBD and the patients’ demographic features were evaluated. The patients were classified into two groups, PD with RBD and PD without RBD, based on the RBDSQ scores. The motor and cognitive functions, as well as other clinical features of the two groups were compared.
Results
A total of 42 PD patients were enrolled. Eighteen patients were classified as PD with RBD. Compared to PD without RBD, PD with RBD showed higher scores of rigidity in the UPDRS subscale. Regarding sleep problems, PD with RBD revealed higher sleep disturbance, lower sleep efficiency, and lower overall sleep quality in the PSQI. There was no difference in cognitive dysfunction between the two groups according to the Korean version of the MMSE.
Conclusions
PD with RBD was associated with poorer sleep and motor symptoms. Therefore, RBD symptoms in PD are possibly poor prognostic markers.

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Review Article

The Current Status of Deep Brain Stimulation for the Treatment of Parkinson Disease in the Republic of Korea: Jung-Il Lee; J Mov Disord. 2015;8(3):115-121. Published online September 10, 2015; DOI: https://doi.org/10.14802/jmd.15043

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Abstract PDF

Parkinson disease (PD) is a common neurodegenerative disease with an increasing prevalence in Korea. Deep brain stimulation (DBS) is a safe and effective surgical treatment option for this disease. The aim of this review was to provide an update regarding current DBS practices with respect to the treatment of PD in the Republic of Korea. The first DBS in Korea was performed in 2000; approximately 2,000 patients have undergone DBS for a variety of neurological disorders, the majority of whom were patients with PD. Approximately 150 new patients with PD receive DBS annually, and more than 20 centers perform DBS. However, DBS remains underutilized for many reasons, and the clinical case burden at many institutions is below the level presumed adequate for qualified practice. With a rapidly aging population and an evolving socioeconomic environment, the need for surgical intervention for PD is likely to increase significantly in the future. Many issues such as finances, education, and quality assurance must be resolved to cope with this need.

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Problems in organizing neurosurgical care for patients with Parkinson’s disease in the Russian Federation
A.A. Tomskiy, E.V. Bril, A.A. Gamaleya, A.A. Poddubskaya, N.V. Fedorova, O.S. Levin, S.N. Illarioshkin
Burdenko's Journal of Neurosurgery.2024; 88(3): 5. CrossRef
Deep Learning and fMRI-Based Pipeline for Optimization of Deep Brain Stimulation During Parkinson’s Disease Treatment: Toward Rapid Semi-Automated Stimulation Optimization
Jianwei Qiu, Afis Ajala, John Karigiannis, Jürgen Germann, Brendan Santyr, Aaron Loh, Luca Marinelli, Thomas Foo, Radhika Madhavan, Desmond Yeo, Alexandre Boutet, Andres Lozano
IEEE Journal of Translational Engineering in Health and Medicine.2024; 12: 589. CrossRef
The treatment gap for deep brain stimulation in Parkinson’s disease: a comparative analysis of cost and utilisation in high-income countries
Athena Stein, Nathan Higgins, Mehul Gajwani, Christian A. Gericke
Australian Health Review.2024; 48(5): 497. CrossRef
Minimising the rate of vascular complications in Deep Brain Stimulation surgery for the management of Parkinson’s disease: a single-centre 600-patient case series
Raymond Cook, Nyssa Chennell Dutton, Peter A Silburn, Linton J Meagher, George Fracchia, Nathan Anderson, Glen Cooper, Hoang-Mai Dinh, Stuart J Cook, Paul Silberstein
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Neuromodulation: Technology at the Neural Interface.2021;[Epub] CrossRef
An International Survey of Deep Brain Stimulation Utilization in Asia and Oceania: The DBS Think Tank East
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Canadian Assessment of Deep Brain Stimulation Access: The Canada Study
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Original Article

Effect of Rivastigmine on Behavioral and Psychiatric Symptoms of Parkinson’s Disease Dementia: Yoon-Sang Oh, Joong-Seok Kim, Phil Hyu Lee; J Mov Disord. 2015;8(2):98-102. Published online May 31, 2015; DOI: https://doi.org/10.14802/jmd.15041

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Objective A recent study showed that rivastigmine and memantin improved behavioral and psychiatric symptoms of dementia (BPSD) in Alzheimer’s dementia. Furthermore, according to recent guidelines presented by the Movement Disorder Society, rivastigmine is efficacious for the treatment of dementia in Parkinson’s disease (PD). We investigated the efficacy of rivastigmine for BPSD in patients with Parkinson’s disease dementia (PDD).
Methods Twenty-three patients in whom cognitive impairment occurred at least one year after a diagnosis of PD participated in this open-label trial. Cognitive, psychiatric, and motor symptoms were assessed before and after 24 weeks of treatment with rivastigmine using unstructured clinical assessments and rating scales including the Unified Parkinson’s Disease Rating Scale, Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory.
Results Age (± standard deviation) was 74.7 ± 5.9 years, average duration of PD was 3.5 ± 3.7 years, Hoehn and Yahr scores were 2.2 ± 0.8, and baseline MMSE scores were 19.1 ± 4.2. Improvements in global mental symptoms and neuropsychiatric symptoms were significant; among them, hallucination, depression and appetite changes improved. Caregiver distress significantly decreased, including distress resulting from hallucinations, depression, apathy, and appetite changes.
Conclusions Although controlled trials are required, the findings suggest that rivastigmine is useful for control of several neuropsychiatric symptoms and beneficial for caregiver distress in patients with PDD.

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