Journal of Movement Disorders

Original Article

Longitudinal implications of BDNF rs6265 polymorphism on motor and non-motor features of Parkinson’s disease in Korean population: Sang-Won Yoo, Yun Joong Kim, Dong-Woo Ryu, Yoonsang Oh, Seunggyun Ha, Joong-Seok Kim; Received November 7, 2025 Accepted January 16, 2026 Published online January 20, 2026; DOI: https://doi.org/10.14802/jmd.25300 [Accepted]

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Abstract PDF: Background
Brain-derived neurotrophic factor (BDNF) has been suggested to support dopaminergic neuron’s endurance and dopamine release. Its Val66Met polymorphism might modify Parkinson’s disease (PD) evolution, although evidence in Asian populations remains limited. This study aimed to explore how the BDNF rs6265 genotypes are associated with the clinical characteristics and longitudinal progression patterns of PD patients in a Korean population.
Methods
A total of 247 patients were enrolled and followed for a mean duration of 50.9 ± 23.9 months. Baseline and/or periodic assessments captured motor severity, non-motor burden, cognition, orthostatic stress, cardiac denervation, and presynaptic dopamine transporter availability. The repeated measures were manipulated to infer any genotypic differences in the trajectories of each clinical domain.
Results
Genotype frequencies were 31.2% (77/247) for Val/Val and 68.8% (170/247) for Met-allele carriers. Baseline clinical characteristics and presynaptic dopamine transporter availability were comparable between genotypes; however, Val homozygotes showed more preserved myocardial innervation and poorer non-frontal cognitive performance. Longitudinal analyses demonstrated genotype-specific increases in motor and cognitive severity. Compared to Met-allele carriers, the homozygous Val group exhibited accelerated motor progression and more rapid decline in frontal domain after three years of follow-up.
Conclusions
The differences in myocardial denervation at diagnosis, cognitive profiles, and motor progression might suggest a potential modulatory role of BDNF polymorphism in PD progression in the Korean population.

Review Article

Cardiac ¹²³I-Meta-Iodobenzylguanidine Imaging as a Biomarker for Body-First Parkinson’s Disease: Linking Peripheral α-Synuclein to Clinical Subtyping: Dong-Woo Ryu, Sang-Won Yoo, Yoonsang Oh, Joong-Seok Kim; J Mov Disord. 2026;19(1):1-10. Published online August 4, 2025; DOI: https://doi.org/10.14802/jmd.25137

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Recent neuropathological and imaging studies support the concept of “brain-first vs. body-first” Parkinson’s disease (PD), which is based on the α-synuclein origin site and connectome model. The body-first phenotype is characterized by early involvement of the peripheral autonomic nervous system, particularly the cardiac sympathetic nerves and enteric nerves. ¹²³I-meta-iodobenzylguanidine (¹²³I-MIBG) myocardial scintigraphy is a well-established method for evaluating cardiac sympathetic innervation. This review explores the potential of ¹²³I-MIBG scintigraphy as a biomarker to differentiate the body-first phenotype from the brain-first phenotype. Reduced ¹²³I-MIBG uptake has been observed in idiopathic rapid eye movement (REM) sleep behavior disorder, pure autonomic failure, and incidental Lewy body disease—conditions strongly associated with prodromal or early-stage PD. Postmortem and biopsy evidence indicates α-synuclein accumulation in cardiac nerves and other peripheral sites, which is consistent with bottom-up progression. α-Synuclein seed amplification assays further corroborate the association between the peripheral α-synuclein burden and reduced ¹²³I-MIBG uptake. While ¹²³I-MIBG myocardial scintigraphy is a promising tool, its limitations include cost, limited availability, and potential confounding from underlying cardiac conditions. Nonetheless, early detection of cardiac sympathetic denervation via ¹²³I-MIBG imaging may enhance diagnosis, support subtype classification, and improve the understanding of PD pathogenesis.

Citations

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Letter to the editor: B-type natriuretic peptide in Parkinson's disease: a novel biomarker of dysautonomia
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Letter to the editor

Task-Specific Dystonia in a Professional Billiard Player: Hyukje Lee, Sang-Won Yoo, Joong-Seok Kim; J Mov Disord. 2022;15(1):86-88. Published online September 8, 2021; DOI: https://doi.org/10.14802/jmd.21055

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PDF Supplementary Material

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Erratum

The Impact of Impulsivity on Quality of Life in Early Drug-Naïve Parkinson’s Disease Patients: Dong-Woo Ryu, Joong-Seok Kim, Sang-Won Yoo, Yoon-Sang Oh, Kwang-Soo Lee; J Mov Disord. 2021;14(2):176-176. Published online May 26, 2021; DOI: https://doi.org/10.14802/jmd.19004.e; Corrects: J Mov Disord 2019;12(3):172

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Letters to the editor

Asymmetric Periodic Leg Movements during Sleep after Unilateral Supratentorial Infarction: Two Legs with One Lesion: Sang-Won Yoo, Ko Eun Choi, Joong-Seok Kim; J Mov Disord. 2020;13(3):232-234. Published online June 3, 2020; DOI: https://doi.org/10.14802/jmd.20004

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Unilateral Pseudo-Orthostatic Tremor Provoked by a Remote Limb Movement in Parkinson’s Disease: Sang-Won Yoo, Youngje Heo, Joong-Seok Kim, Kwang-Soo Lee; J Mov Disord. 2020;13(1):69-71. Published online November 8, 2019; DOI: https://doi.org/10.14802/jmd.19056

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Original Article

The Impact of Impulsivity on Quality of Life in Early Drug-Naïve Parkinson’s Disease Patients: Dong-Woo Ryu, Joong-Seok Kim, Sang-Won Yoo, Yoon-Sang Oh, Kwang-Soo Lee; J Mov Disord. 2019;12(3):172-176. Published online August 9, 2019; DOI: https://doi.org/10.14802/jmd.19004; Correction in: J Mov Disord 2021;14(2):176

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Abstract PDF

Objective
Impulse control disorders (ICDs) in Parkinson’s disease (PD) are mostly related to dopamine replacement therapy (DRT); however, drug-naïve PD patients have also frequently experienced impulsivity. This phenomenon makes clinicians hesitate treating patients with DRT. In this study, we assessed the effect of impulsivity on quality of life (QOL) in drug-naïve PD patients.
Methods
Two hundred three newly diagnosed, nonmedicated PD patients were enrolled, and they received structured clinical interviews, physical examinations and validated questionnaires to evaluate motor and nonmotor symptoms and QOL. Impulsivity was evaluated using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS).
Results
Thirty-eight patients (18.7%) had impulsivity with QUIP-RS scores ≥ 1 and 4 patients (2.0%) were diagnosed with combined ICDs. Motor and nonmotor symptoms were significantly correlated with the Parkinson’s Disease Questionnaire-39 summary index. Female sex and QUIP-RS scores were also correlated with QOL in drug-naïve PD patients.
Conclusion
The results of the present study showed that impulsivity negatively influences QOL in early drug-naïve PD patients. In addition, more severe motor and nonmotor symptoms were also associated with lower QOL. Such findings complicate treatment but provide valuable information for managing early PD.

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Letter to the editor

Transient Hypersomnolence Provoked by Metoclopramide in a Patient with Degenerative Parkinsonism: Sang-Won Yoo, Ko Eun Choi, Joong-Seok Kim; J Mov Disord. 2019;12(1):60-62. Published online January 15, 2019; DOI: https://doi.org/10.14802/jmd.18042

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