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JMD : Journal of Movement Disorders

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Volume 7(2); October 2014
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Review Articles
Electrophysiological Evaluation of Oropharyngeal Dysphagia in Parkinson’s Disease
Cumhur Ertekin
J Mov Disord. 2014;7(2):31-56.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14008
  • 26,489 View
  • 237 Download
  • 28 Citations
AbstractAbstract PDF
Parkinson’s disease (PD) is a chronic, neurodegenerative movement disorder that typically affects elderly patients. Swallowing disorders are highly prevalent in PD and can have grave consequences, including pneumonia, malnutrition, dehydration and mortality. Neurogenic dysphagia in PD can manifest with both overt clinical symptoms or silent dysphagia. Regardless, early diagnosis and objective follow- up of dysphagia in PD is crucial for timely and appropriate care for these patients. In this review, we provide a comprehensive summary of the electrophysiological methods that can be used to objectively evaluate dysphagia in PD. We discuss the electrophysiological abnormalities that can be observed in PD, their clinical correlates and the pathophysiology underlying these findings.
Complementary & Alternative Management of Parkinson’s Disease: An Evidence-Based Review of Eastern Influenced Practices
Danny Bega, Cindy Zadikoff
J Mov Disord. 2014;7(2):57-66.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14009
  • 31,446 View
  • 173 Download
  • 17 Citations
AbstractAbstract PDF
The prevalence of Parkinson’s disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative medicine (CAM) modalities in countries like Korea may be as high as 76%. Among patients with PD, herbal medicines, health supplement foods, and acupuncture are interventions which are increasingly used throughout the world. Countries like Korea, China, India, and Japan have long embraced and incorporated traditional medicine into modern management of conditions such as PD, but research into various CAM modalities remains in its infancy limiting evidence-based recommendations for many treatments. We reviewed the literature on CAM treatments for PD, focusing on mind-body interventions and natural products. Based on evidence limited to randomized-controlled trials we found that mind-body interventions are generally effective forms of physical activity that are likely to foster good adherence and may reduce disability associated with PD. Based on the current data, modalities like Tai Chi and dance are safe and beneficial in PD, but better studies are needed to assess the effects of other frequently used modalities such as yoga and acupuncture. Furthermore, despite centuries of experience using medicinal herbs and plants in Eastern countries, and despite substantial preclinical data on the beneficial effects of nutritional antioxidants as neuroprotective agents in PD, there is insufficient clinical evidence that any vitamin, food additive, or supplement, can improve motor function or delay disease progression in PD.
Maladaptive Reward-Learning and Impulse Control Disorders in Patients with Parkinson’s Disease: A Clinical Overview and Pathophysiology Update
Jee-Young Lee, Beom Seok Jeon
J Mov Disord. 2014;7(2):67-76.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14010
  • 36,509 View
  • 120 Download
  • 8 Citations
AbstractAbstract PDF
Impulse control disorders (ICD) in Parkinson’s disease (PD) are a disabling non-motor symptom with frequencies of 13–35% among patients receiving dopamine replacement therapy. ICD in PD is strongly associated with dopaminergic drug use, especially non-ergot dopamine agonists (DA). However, individual susceptibility and disease-related neural changes are also important contributors to the development of ICD. Discrepancies between nigrostriatal and mesolimbic dopaminergic degeneration and non-physiological administration of dopaminergic drugs may induce abnormal ’hyperstimulation’ of the mesolimbic system, which alters reward-learning behaviors in PD patients. In addition, DA can make patients more impulsive during decision-making and seek risk-taking behaviors. DA intake is also related to the biased representation of rewards. Ultimately, loss of negative feedback control due to dysfunctional frontostriatal connections is necessary for the establishment of ICD in PD. The subsequent behavioral and neural changes are affected by PD treatment and disease progression; thus, proper treatment guidelines for physicians are needed to prevent the development of ICD. Future studies aimed at producing novel therapeutics to control the risk factors for ICD or treat ICD behaviors in PD are warranted. This review summarizes recent advances from epidemiological and pathophysiological studies on ICD in PD. Management principles and limitations of current therapeutics are briefly discussed.
Original Articles
Dopamine Does Not Appear to Affect Mental Rotation in Parkinson’s Disease
Gregory P. Crucian, Sheyan Armaghani, Avan Armaghani, Paul S. Foster, David W. Burks, Barry Skoblar, Valeria Drago, Kenneth M. Heilman
J Mov Disord. 2014;7(2):77-83.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14011
  • 13,086 View
  • 43 Download
  • 1 Citations
AbstractAbstract PDF
Objective Patients with Parkinson’s disease (PD) often have deficits with mental rotation (MR). The neuropathological factors underlying these deficits, however, remain to be elucidated. One hypothesis suggests that dopamine depletion in nigro-striatal systems adversely influences MR. Another hypothesis suggests that deterioration of cortical (fronto-temporo-parietal basal ganglia) networks that mediate this function are responsible for this deficit. The goal of this study was to test the dopamine hypothesis by determining if dopamine abstinence negatively influences MR performance.
Methods Thirty three non-demented right-handed individuals with PD were assess for their ability to perform a pencil and paper MR test while “on” and “off” dopaminergic medications. Dopamine abstinence followed the typical overnight withdrawal procedures.
Results No differences in mental rotation abilities were found between “on” and “off” dopaminergic medications.
Conclusions These results suggest that other neuropathological factors, such as cortical-basal ganglia neurodegeneration, or dysfunction of other neurotransmitters systems, might account for these cognitive deficits and future research will have to test these alternative hypotheses.
Nationwide Survey of Patient Knowledge and Attitudes towards Human Experimentation Using Stem Cells or Bee Venom Acupuncture for Parkinson’s Disease
Sun Ju Chung, Seong Beom Koh, Young-Su Ju, Jae Woo Kim
J Mov Disord. 2014;7(2):84-91.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14012
  • 15,479 View
  • 78 Download
  • 8 Citations
AbstractAbstract PDFSupplementary Material
Objective Stem cell treatment is a well-recognized experimental treatment among patients with Parkinson’s disease (PD), for which there are high expectations of a positive impact. Acupuncture with bee venom is one of the most popular complementary and alternative treatments for PD. Patient knowledge and attitudes towards these experimental treatments are unknown.
Methods Using a 12-item questionnaire, a nationwide survey was conducted of 963 PD patients and 267 caregivers in 44 Korean Movement Disorders Society member hospitals from April 2013 to June 2013. The survey was performed by trained interviewers using conventional methods.
Results Regarding questions on experimental treatments using stem cells or bee venom acupuncture, 5.1–17.7% of PD patients answered questions on safety, efficacy, and evidence-based practice incorrectly; however, more than half responded that they did not know the correct answer. Although safety and efficacy have not been established, 55.5% of PD patients responded that they were willing to receive stem cell treatment. With regard to participating in experimental treatments, there was a strong correlation between stem cell treatment and bee venom acupuncture (p < 0.0001, odds ratio = 5.226, 95% confidence interval 3.919–6.969). Younger age, higher education, and a longer duration of PD were all associated with a correct understanding of experimental treatments.
Conclusions Our data suggest that relatively few PD patients correctly understand the safety and efficacy of experimental treatments and that PD patients are greatly interested in new treatments. We hope that our data will be used to educate or to plan educational programs for PD patients and caregivers.
Case Reports
Globus Pallidus Interna Deep Brain Stimulation in a Patient with Medically Intractable Meige Syndrome
Dae-Woong Bae, Byung-chul Son, Joong-Seok Kim
J Mov Disord. 2014;7(2):92-94.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14013
  • 11,963 View
  • 95 Download
  • 6 Citations
AbstractAbstract PDF
Medical therapies in patients with Meige syndrome, including botulinum toxin injection, have been limited because of incomplete response or adverse side effects. We evaluated a patient with Meige syndrome who was successfully treated with deep brain stimulation (DBS) in the globus pallidus interna (GPi). This case report and other previous reports suggest that bilateral GPi DBS may be an effective treatment for medically refractory Meige syndrome, without significant adverse effects.
Treatment of Gait Ignition Failure with Ropinirole
Alexis N. Cohen-Oram, Jonathan T. Stewart, Kim Bero, Michael W. Hoffmann
J Mov Disord. 2014;7(2):95-98.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14014
  • 11,418 View
  • 34 Download
  • 1 Citations
AbstractAbstract PDF
Gait ignition failure (GIF) is a syndrome characterized by hesitation or inability to initiate gait from a static position. It may occur in a variety of conditions, including normal pressure hydrocephalus, subcortical vascular disease, parkinsonian syndromes and a variety of focal lesions. Previous information on the treatment of GIF has been primarily anecdotal, but there have been a few reports of response to dopamine agonists. We report a 63-year-old man with anoxic encephalopathy who developed GIF nine years after the initial anoxic insult. The patient’s GIF responded robustly, albeit transiently, to ropinirole. MRI was unrevealing, but a positron emission tomography scan showed hypometabolism in the deep frontal ACA/MCA watershed area; this may have disconnected the basal ganglia from the motor cortex and/or interrupted dopaminergic mesocortical transmission. Our understanding of the pathophysiology and the treatment of GIF remains limited, but there may be at least a limited therapeutic role for dopamine agonists.
Letters to the editor
Normal Cerebellar Metabolism in a Patient with Superficial Siderosis
Dae-Woong Bae, Seung-Hee Na, In-Seok Park, Joong-Seok Kim
J Mov Disord. 2014;7(2):99-101.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14015
  • 11,346 View
  • 50 Download
  • 2 Citations
PDF
Orthostatic Hypotension and Cognitive Impairment in De Novo Patients with Parkinson’s Disease
Hyo-Jin Bae, Jun-Ho Lim, Sang-Myung Cheon
J Mov Disord. 2014;7(2):102-104.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14016
  • 13,417 View
  • 60 Download
  • 9 Citations
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JMD : Journal of Movement Disorders