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JMD : Journal of Movement Disorders


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Volume 7(1); April 2014
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Review Article
Cell Therapy Strategies vs. Paracrine Effect in Huntington’s Disease
Wooseok Im, Manho Kim
J Mov Disord. 2014;7(1):1-6.   Published online April 30, 2014
  • 12,514 View
  • 86 Download
  • 5 Citations
AbstractAbstract PDF
Huntington’s disease (HD) is a genetic neurodegenerative disorder. The most common symptom of HD is abnormal involuntary writhing movements, called chorea. Antipsychotics and tetrabenazine are used to alleviate the signs and symptoms of HD. Stem cells have been investigated for use in neurodegenerative disorders to develop cell therapy strategies. Recent evidence indicates that the beneficial effects of stem cell therapies are actually mediated by secretory molecules, as well as cell replacement. Although stem cell studies show that cell transplantation provides cellular improvement around lesions in in vivo models, further work is required to elucidate some issues before the clinical application of stem cells. These issues include the precise mechanism of action, delivery method, toxicity and safety. With a focus on HD, this review summarizes cell therapy strategies and the paracrine effect of stem cells.
Original Articles
The Frequency and Severity of Gastrointestinal Symptoms in Patients with Early Parkinson’s Disease
Hye-Young Sung, Jeong-Wook Park, Joong-Seok Kim
J Mov Disord. 2014;7(1):7-12.   Published online April 30, 2014
  • 15,783 View
  • 156 Download
  • 40 Citations
AbstractAbstract PDF
Objective: Although gastrointestinal dysfunctions occur in the majority of patients with Parkinson’s disease (PD), they are often unrecognized because many patients remain relatively asymptomatic in the early stage. We investigated the frequency of gastrointestinal symptoms in patients with PD using newly developed gastrointestinal symptom questionnaires.
Methods: Early PD patients with a symptom duration not exceeding 3 years were included in this study. All PD patients were evaluated using a questionnaire, which consisted of three relevant domains: oropharyngoesophageal (10 items); gastric (3 items); and intestinal-anorectal (7 items). The frequency of symptoms was calculated as a proportion with an item score ≥ 2.
Results: Of the 54 patients enrolled, 48 patients (88.9%) responded that bowel symptoms developed before the onset of Parkinsonian motor symptoms, and four patients reported that the onset of two types of symptoms (i.e., bowel and neurological) occurred approximately simultaneously, with only months between them. The frequencies of gastrointestinal symptoms are as follows: speech disturbance (40.7%), drooling (24.1%), sense of getting stuck (31.5%), choking (27.8%), globus pharyngis (16.7%), repetitive deglutition (29.6%), pain during swallowing (5.6%), food regurgitation (3.7%), acid reflux (7.4%), nausea/ vomiting (11.1%), early satiety (16.7%), postprandial fullness (14.8%), epigastric soreness (9.3%), abdominal pain (3.7%), constipation (46.3%), excessive strain during defecation (33.3%), fecal incontinence (7.4%), tenesmus (20.4%), loose stool or diarrhea (3.7%), and difficulty in relaxing anal sphincter (11.1%). Two patients were scored at zero.
Conclusions: Our findings confirm that gastrointestinal dysfunction occurs in early PD in relatively high frequency.
Correlation of Sleep Disturbance and Cognitive Impairment in Patients with Parkinson’s Disease
Eun Ja Kim, Joon Hyun Baek, Dong Jin Shin, Hyeon-Mi Park, Yeong-Bae Lee, Kee-Hyung Park, Dong Hoon Shin, Young Noh, Young Hee Sung
J Mov Disord. 2014;7(1):13-18.   Published online April 30, 2014
  • 11,627 View
  • 103 Download
  • 9 Citations
AbstractAbstract PDF
Objective: Cognitive impairment is a common nonmotor symptom of Parkinson’s disease (PD) and is associated with high mortality, caregiver distress, and nursing home placement. The risk factors for cognitive decline in PD patients include advanced age, longer disease duration, rapid eye movement sleep behavior disorder, hallucinations, excessive daytime sleepiness, and nontremor symptoms including bradykinesia, rigidity, postural instability, and gait disturbance. We conducted a cross-sectional study to determine which types of sleep disturbances are related to cognitive function in PD patients.
Methods: A total of 71 PD patients (29 males, mean age 66.46 ± 8.87 years) were recruited. All patients underwent the Mini- Mental State Examination (MMSE) and the Korean Version of the Montreal Cognitive Assessments (MoCA-K) to assess global cognitive function. Sleep disorders were evaluated with the Stanford Sleepiness Scale, Epworth Sleepiness Scale, Insomnia Severity Index (ISI), Pittsburg Sleep Quality Index, and Parkinson’s Disease Sleep Scale in Korea (PDSS).
Results: The ISI was correlated with the MMSE, and total PDSS scores were correlated with the MMSE and the MoCA-K. In each item of the PDSS, nocturnal restlessness, vivid dreams, hallucinations, and nocturnal motor symptoms were positively correlated with the MMSE, and nocturnal restlessness and vivid dreams were significantly related to the MoCA-K. Vivid dreams and nocturnal restlessness are considered the most powerful correlation factors with global cognitive function, because they commonly had significant correlation to cognition assessed with both the MMSE and the MoCA-K.

Conclusions: We found a correlation between global cognitive function and sleep disturbances, including vivid dreams and nocturnal restlessness, in PD patients.
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
  • 12,047 View
  • 1,361 Download
  • 4 Citations
AbstractAbstract 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.
Giant Middle Fossa Epidermoid Presenting as Holmes’ Tremor Syndrome
Bindu Menon, P Sasikala, Amit Agrawal
J Mov Disord. 2014;7(1):22-24.   Published online April 30, 2014
  • 8,501 View
  • 63 Download
  • 2 Citations
AbstractAbstract PDF
Intracranial dermoids may gradually reach an enormous size before the onset of symptoms. Common clinical presentations of intracranial epidermoid include headache and seizures. We present a case of a 35-year female patient with giant middle fossa epidermoid that presented with Holmes’ tremor syndrome, and we review the relevant literature. To the best of our knowledge, such a presentation has not previously been described in the literature.
Rhabdomyolysis Related to Dyskinesia in Parkinson’s Disease
Hesna Bekta, Orhan Deniz, adiye Temel, Hava Dnmez Keklikolu, ener Akyol
J Mov Disord. 2014;7(1):25-27.   Published online April 30, 2014
  • 18,191 View
  • 79 Download
  • 4 Citations
AbstractAbstract PDF
Rhabdomyolysis is a life threatening syndrome. It accounts for an estimated 8% to 15% of cases of acute renal failure and is associated with a mortality rate of 5%. In movement disorders, various causes of rhabdomyolysis have been reported including status dystonicus, myoclonus, generalized chorea and parkinsonism-hyperprexia syndrome in Parkinson’s disease (PD). Levodopa-induced dyskinesia leading to rhabdomyolysis is a very rare phenomenon in PD. We report a case of 76 years old PD patient with dyskinesia and rhabdomyolysis.
Suppression of Myoclonus in Corticobasal Degeneration by Levetiracetam
Jae Wook Cho, Jae Hyeok Lee
J Mov Disord. 2014;7(1):28-30.   Published online April 30, 2014
  • 8,844 View
  • 95 Download
  • 10 Citations
AbstractAbstract PDF
Myoclonus in corticobasal degeneration (CBD) has often been associated with severe and difficult to treat disabilities. Levetiracetam is a new antiepileptic agent with antimyoclonic effects. Herein, we present a 72-year-old woman with clinically probable CBD and with spontaneous rhythmic myoclonus in the right foot, which was markedly ameliorated through treatment with levetiracetam. The effect of levetiracetam was associated with the decreased amplitude of enlarged cortical somatosensory evoked potentials. This result suggests that the antimyoclonic effect of levetiracetam might be mediated through the suppression of increased cortical excitability.

JMD : Journal of Movement Disorders