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Original Articles
Comparing Montreal Cognitive Assessment Performance in Parkinson’s Disease Patients: Age- and Education-Adjusted Cutoffs vs. Machine Learning
Kyeongmin Baek, Young Min Kim, Han Kyu Na, Junki Lee, Dong Ho Shin, Seok-Jae Heo, Seok Jong Chung, Kiyong Kim, Phil Hyu Lee, Young H. Sohn, Jeehee Yoon, Yun Joong Kim
J Mov Disord. 2024;17(2):171-180.   Published online February 13, 2024
DOI: https://doi.org/10.14802/jmd.23271
  • 771 View
  • 65 Download
AbstractAbstract PDFSupplementary Material
Objective
The Montreal Cognitive Assessment (MoCA) is recommended for general cognitive evaluation in Parkinson’s disease (PD) patients. However, age- and education-adjusted cutoffs specifically for PD have not been developed or systematically validated across PD cohorts with diverse education levels.
Methods
In this retrospective analysis, we utilized data from 1,293 Korean patients with PD whose cognitive diagnoses were determined through comprehensive neuropsychological assessments. Age- and education-adjusted cutoffs were formulated based on 1,202 patients with PD. To identify the optimal machine learning model, clinical parameters and MoCA domain scores from 416 patients with PD were used. Comparative analyses between machine learning methods and different cutoff criteria were conducted on an additional 91 consecutive patients with PD.
Results
The cutoffs for cognitive impairment decrease with increasing age within the same education level. Similarly, lower education levels within the same age group correspond to lower cutoffs. For individuals aged 60–80 years, cutoffs were set as follows: 25 or 24 years for those with more than 12 years of education, 23 or 22 years for 10–12 years, and 21 or 20 years for 7–9 years. Comparisons between age- and education-adjusted cutoffs and the machine learning method showed comparable accuracies. The cutoff method resulted in a higher sensitivity (0.8627), whereas machine learning yielded higher specificity (0.8250).
Conclusion
Both the age- and education-adjusted cutoff methods and machine learning methods demonstrated high effectiveness in detecting cognitive impairment in PD patients. This study highlights the necessity of tailored cutoffs and suggests the potential of machine learning to improve cognitive assessment in PD patients.
Potential Link Between Cognition and Motor Reserve in Patients With Parkinson’s Disease
Seok Jong Chung, Yae Ji Kim, Yun Joong Kim, Hye Sun Lee, Mijin Yun, Phil Hyu Lee, Yong Jeong, Young H. Sohn
J Mov Disord. 2022;15(3):249-257.   Published online September 7, 2022
DOI: https://doi.org/10.14802/jmd.22063
  • 2,830 View
  • 150 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary Material
Objective
To investigate whether there is a link between cognitive function and motor reserve (i.e., individual capacity to cope with nigrostriatal dopamine depletion) in patients with newly diagnosed Parkinson’s disease (PD).
Methods
A total of 163 patients with drug-naïve PD who underwent 18F-FP-CIT PET, brain MRI, and a detailed neuropsychological test were enrolled. We estimated individual motor reserve based on initial motor deficits and striatal dopamine depletion using a residual model. We performed correlation analyses between motor reserve estimates and cognitive composite scores. Diffusion connectometry analysis was performed to map the white matter fiber tracts, of which fractional anisotropy (FA) values were well correlated with motor reserve estimates. Additionally, Cox regression analysis was used to assess the effect of initial motor reserve on the risk of dementia conversion.
Results
The motor reserve estimate was positively correlated with the composite score of the verbal memory function domain (γ = 0.246) and with the years of education (γ = 0.251). Connectometry analysis showed that FA values in the left fornix were positively correlated with the motor reserve estimate, while no fiber tracts were negatively correlated with the motor reserve estimate. Cox regression analysis demonstrated that higher motor reserve estimates tended to be associated with a lower risk of dementia conversion (hazard ratio, 0.781; 95% confidence interval, 0.576–1.058).
Conclusion
The present study demonstrated that the motor reserve estimate was well correlated with verbal memory function and with white matter integrity in the left fornix, suggesting a possible link between cognition and motor reserve in patients with PD.

Citations

Citations to this article as recorded by  
  • Hippocampal Perfusion Affects Motor and Cognitive Functions in Parkinson Disease: An Early Phase 18F‐FP‐CIT Positron Emission Tomography Study
    Min Young Chun, Seok Jong Chung, Su Hong Kim, Chan Wook Park, Seong Ho Jeong, Hye Sun Lee, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Yun Joong Kim
    Annals of Neurology.2024; 95(2): 388.     CrossRef
  • Imaging Procedure and Clinical Studies of [18F]FP-CIT PET
    Changhwan Sung, Seung Jun Oh, Jae Seung Kim
    Nuclear Medicine and Molecular Imaging.2024;[Epub]     CrossRef
  • Influence of cognitive reserve on cognitive and motor function in α-synucleinopathies: A systematic review and multilevel meta-analysis
    Isaac Saywell, Lauren Foreman, Brittany Child, Alexander L. Phillips-Hughes, Lyndsey Collins-Praino, Irina Baetu
    Neuroscience & Biobehavioral Reviews.2024; 161: 105672.     CrossRef
  • Structural underpinnings and long-term effects of resilience in Parkinson’s disease
    Verena Dzialas, Merle C. Hoenig, Stéphane Prange, Gérard N. Bischof, Alexander Drzezga, Thilo van Eimeren
    npj Parkinson's Disease.2024;[Epub]     CrossRef
  • Considering the response in addition to the challenge – a narrative review in appraisal of a motor reserve framework
    Daniel Zeller, Shawn Hiew, Thorsten Odorfer, Carine Nguemeni
    Aging.2024; 16(6): 5772.     CrossRef
  • Defining the concept of reserve in the motor domain: a systematic review
    Andreina Giustiniani, Angelo Quartarone
    Frontiers in Neuroscience.2024;[Epub]     CrossRef
  • Extra-Basal Ganglia Brain Structures Are Related to Motor Reserve in Parkinson’s Disease
    Jinyoung Youn, Ji Hye Won, Mansu Kim, Junmo Kwon, Seung Hwan Moon, Minkyeong Kim, Jong Hyun Ahn, Jun Kyu Mun, Hyunjin Park, Jin Whan Cho
    Journal of Parkinson's Disease.2023; 13(1): 39.     CrossRef
Accuracy of Machine Learning Using the Montreal Cognitive Assessment for the Diagnosis of Cognitive Impairment in Parkinson’s Disease
Junbeom Jeon, Kiyong Kim, Kyeongmin Baek, Seok Jong Chung, Jeehee Yoon, Yun Joong Kim
J Mov Disord. 2022;15(2):132-139.   Published online May 26, 2022
DOI: https://doi.org/10.14802/jmd.22012
  • 3,190 View
  • 137 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Objective
The Montreal Cognitive Assessment (MoCA) is recommended for assessing general cognition in Parkinson’s disease (PD). Several cutoffs of MoCA scores for diagnosing PD with cognitive impairment (PD-CI) have been proposed, with varying sensitivity and specificity. This study investigated the utility of machine learning algorithms using MoCA cognitive domain scores for improving diagnostic performance for PD-CI.
Methods
In total, 2,069 MoCA results were obtained from 397 patients with PD enrolled in the Parkinson’s Progression Markers Initiative database with a diagnosis of cognitive status based on comprehensive neuropsychological assessments. Using the same number of MoCA results randomly sampled from patients with PD with normal cognition or PD-CI, discriminant validity was compared between machine learning (logistic regression, support vector machine, or random forest) with domain scores and a cutoff method.
Results
Based on cognitive status classification using a dataset that permitted sampling of MoCA results from the same individual (n = 221 per group), no difference was observed in accuracy between the cutoff value method (0.74 ± 0.03) and machine learning (0.78 ± 0.03). Using a more stringent dataset that excluded MoCA results (n = 101 per group) from the same patients, the accuracy of the cutoff method (0.66 ± 0.05), but not that of machine learning (0.74 ± 0.07), was significantly reduced. Inclusion of cognitive complaints as an additional variable improved the accuracy of classification using the machine learning method (0.87–0.89).
Conclusion
Machine learning analysis using MoCA domain scores is a valid method for screening cognitive impairment in PD.

Citations

Citations to this article as recorded by  
  • Comparing Montreal Cognitive Assessment Performance in Parkinson’s Disease Patients: Age- and Education-Adjusted Cutoffs vs. Machine Learning
    Kyeongmin Baek, Young Min Kim, Han Kyu Na, Junki Lee, Dong Ho Shin, Seok-Jae Heo, Seok Jong Chung, Kiyong Kim, Phil Hyu Lee, Young H. Sohn, Jeehee Yoon, Yun Joong Kim
    Journal of Movement Disorders.2024; 17(2): 171.     CrossRef
Review Article
Emerging Concepts of Motor Reserve in Parkinson’s Disease
Seok Jong Chung, Jae Jung Lee, Phil Hyu Lee, Young H. Sohn
J Mov Disord. 2020;13(3):171-184.   Published online August 31, 2020
DOI: https://doi.org/10.14802/jmd.20029
  • 10,078 View
  • 308 Download
  • 30 Web of Science
  • 33 Crossref
AbstractAbstract PDF
The concept of cognitive reserve (CR) in Alzheimer’s disease (AD) explains the differences between individuals in their susceptibility to AD-related pathologies. An enhanced CR may lead to less cognitive deficits despite severe pathological lesions. Parkinson’s disease (PD) is also a common neurodegenerative disease and is mainly characterized by motor dysfunction related to striatal dopaminergic depletion. The degree of motor deficits in PD is closely correlated to the degree of dopamine depletion; however, significant individual variations still exist. Therefore, we hypothesized that the presence of motor reserve (MR) in PD explains the individual differences in motor deficits despite similar levels of striatal dopamine depletion. Since 2015, we have performed a series of studies investigating MR in de novo patients with PD using the data of initial clinical presentation and dopamine transporter PET scan. In this review, we summarized the results of these published studies. In particular, some premorbid experiences (i.e., physical activity and education) and modifiable factors (i.e., body mass index and white matter hyperintensity on brain image studies) could modulate an individual’s capacity to tolerate PD pathology, which can be maintained throughout disease progression.

Citations

Citations to this article as recorded by  
  • How long have you exercised in your life? The effect of motor reserve and current physical activity on cognitive performance
    Veronica Pucci, Carolina Guerra, Amanda Barsi, Massimo Nucci, Sara Mondini
    Journal of the International Neuropsychological Society.2024; 30(1): 11.     CrossRef
  • Hippocampal Perfusion Affects Motor and Cognitive Functions in Parkinson Disease: An Early Phase 18F‐FP‐CIT Positron Emission Tomography Study
    Min Young Chun, Seok Jong Chung, Su Hong Kim, Chan Wook Park, Seong Ho Jeong, Hye Sun Lee, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Yun Joong Kim
    Annals of Neurology.2024; 95(2): 388.     CrossRef
  • Clinical severity in Parkinson’s disease is determined by decline in cortical compensation
    Martin E Johansson, Ivan Toni, Roy P C Kessels, Bastiaan R Bloem, Rick C Helmich
    Brain.2024; 147(3): 871.     CrossRef
  • Differences in [123I]Ioflupane Striatal Binding Between African American and White Patients
    Juebin Huang, Kevin J. Sullivan, Vani Vijayakumar
    Journal of Nuclear Medicine Technology.2024; : jnmt.123.265806.     CrossRef
  • Plasma extracellular vesicle synaptic proteins as biomarkers of clinical progression in patients with Parkinson’s disease
    Chien-Tai Hong, Chen-Chih Chung, Ruan-Ching Yu, Lung Chan
    eLife.2024;[Epub]     CrossRef
  • Plasma extracellular vesicle synaptic proteins as biomarkers of clinical progression in patients with Parkinson’s disease
    Chien-Tai Hong, Chen-Chih Chung, Ruan-Ching Yu, Lung Chan
    eLife.2024;[Epub]     CrossRef
  • Considering the response in addition to the challenge – a narrative review in appraisal of a motor reserve framework
    Daniel Zeller, Shawn Hiew, Thorsten Odorfer, Carine Nguemeni
    Aging.2024; 16(6): 5772.     CrossRef
  • The greatest loss of unpleasant smells may be related to the risk of more severe PD symptoms
    Shih-Chi Chiu, Ting-Chun Fang, Hsin-Bei Lei, Yu-Hsuan Lin, Ming-Hong Chang, Yi-Jen Guo
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • Lifestyle Modulators of Neuroplasticity in Parkinson’s Disease: Evidence in Human Neuroimaging Studies
    Silvia Paola Caminiti, Silvia Gallo, Federico Menegon, Andrea Naldi, Cristoforo Comi, Giacomo Tondo
    CNS & Neurological Disorders - Drug Targets.2024; 23(5): 602.     CrossRef
  • Defining the concept of reserve in the motor domain: a systematic review
    Andreina Giustiniani, Angelo Quartarone
    Frontiers in Neuroscience.2024;[Epub]     CrossRef
  • Structural underpinnings and long-term effects of resilience in Parkinson’s disease
    Verena Dzialas, Merle C. Hoenig, Stéphane Prange, Gérard N. Bischof, Alexander Drzezga, Thilo van Eimeren
    npj Parkinson's Disease.2024;[Epub]     CrossRef
  • Motor progression marker for newly diagnosed drug‐naïve patients with Parkinson's disease: A resting‐state functional MRI study
    Yanbing Hou, Lingyu Zhang, Ruwei Ou, Qianqian Wei, Xiaojing Gu, Kuncheng Liu, Junyu Lin, Tianmi Yang, Yi Xiao, Qiyong Gong, Huifang Shang
    Human Brain Mapping.2023; 44(3): 901.     CrossRef
  • The Concept of Motor Reserve in Parkinson's Disease: New Wine in Old Bottles?
    Merle C. Hoenig, Verena Dzialas, Alexander Drzezga, Thilo van Eimeren
    Movement Disorders.2023; 38(1): 16.     CrossRef
  • Patterns of striatal dopamine depletion and motor deficits in de novo Parkinson’s disease
    Seong Ho Jeong, Chan Wook Park, Hye Sun Lee, Yun Joong Kim, Mijin Yun, Phil Hyu Lee, Young H. Sohn, Seok Jong Chung
    Journal of Neural Transmission.2023; 130(1): 19.     CrossRef
  • Sex Differences in Brain Structure in de novo Parkinson’s Disease: A Cross-Sectional and Longitudinal Neuroimaging Study
    Hui Li, Xuejia Jia, Min Chen, Xiuqin Jia, Qi Yang
    Journal of Parkinson's Disease.2023; 13(5): 785.     CrossRef
  • Exploring the Complex Phenotypes of Impaired Finger Dexterity in Mild-to-moderate Stage Parkinson’s Disease: A Time-Series Analysis
    Pattamon Panyakaew, Kotchakorn Duangjino, Apiwoot Kerddonfag, Teerit Ploensin, Krerk Piromsopa, Chanon Kongkamol, Roongroj Bhidayasiri
    Journal of Parkinson's Disease.2023; 13(6): 975.     CrossRef
  • Prevention of Falls in Parkinson's Disease: Guidelines and Gaps
    Richard Camicioli, Meg E. Morris, Frederico Pieruccini‐Faria, Manuel Montero‐Odasso, Surim Son, David Buzaglo, Jeffrey M. Hausdorff, Alice Nieuwboer
    Movement Disorders Clinical Practice.2023; 10(10): 1459.     CrossRef
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    Emine Afsin, Zeliha Coşgun, Ramazan Kurul, Şule Aydın Türkoğlu
    Neurological Research.2023; 45(11): 1050.     CrossRef
  • Premorbid Educational Attainment and Long-Term Motor Prognosis in Parkinson’s Disease
    Seong Ho Jeong, Seok Jong Chung, Han Soo Yoo, Jin Ho Jung, Kyoungwon Baik, Yang Hyun Lee, Phil Hyu Lee, Young H. Sohn
    Journal of Parkinson's Disease.2022; 12(1): 129.     CrossRef
  • Parkinsonism and cerebrovascular disease
    Manisha Narasimhan, Raymond Schwartz, Glenda Halliday
    Journal of the Neurological Sciences.2022; 433: 120011.     CrossRef
  • Impact of α‐synuclein spreading on the nigrostriatal dopaminergic pathway depends on the onset of the pathology
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    Brain Pathology.2022;[Epub]     CrossRef
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    Scientific Reports.2022;[Epub]     CrossRef
  • Behavioral Reserve in Behavioral Variant Frontotemporal Dementia
    Su Hong Kim, Yae Ji Kim, Byung Hwa Lee, Peter Lee, Ji Hyung Park, Sang Won Seo, Yong Jeong
    Frontiers in Aging Neuroscience.2022;[Epub]     CrossRef
  • Identifying the white matter structural network of motor reserve in early Parkinson's disease
    Yae Ji Kim, Chan Wook Park, Hye Won Shin, Hye Sun Lee, Yun Joong Kim, Mijin Yun, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Seok Jong Chung
    Parkinsonism & Related Disorders.2022; 102: 108.     CrossRef
  • Comparison of disease progression between brain-predominant Parkinson's disease versus Parkinson's disease with body-involvement phenotypes
    Dong-Woo Ryu, Sang-Won Yoo, Yoon-Sang Oh, Kwang-Soo Lee, Seunggyun Ha, Joong-Seok Kim
    Neurobiology of Disease.2022; 174: 105883.     CrossRef
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    Hossein J. Sadaei, Aldo Cordova-Palomera, Jonghun Lee, Jaya Padmanabhan, Shang-Fu Chen, Nathan E. Wineinger, Raquel Dias, Daria Prilutsky, Sandor Szalma, Ali Torkamani
    npj Parkinson's Disease.2022;[Epub]     CrossRef
  • Potential Link Between Cognition and Motor Reserve in Patients With Parkinson’s Disease
    Seok Jong Chung, Yae Ji Kim, Yun Joong Kim, Hye Sun Lee, Mijin Yun, Phil Hyu Lee, Yong Jeong, Young H. Sohn
    Journal of Movement Disorders.2022; 15(3): 249.     CrossRef
  • Local striatal volume and motor reserve in drug-naïve Parkinson’s disease
    Seong Ho Jeong, Eun-Chong Lee, Seok Jong Chung, Hye Sun Lee, Jin Ho Jung, Young H. Sohn, Joon-Kyung Seong, Phil Hyu Lee
    npj Parkinson's Disease.2022;[Epub]     CrossRef
  • Effectiveness and safety of electroacupuncture in treating Parkinson disease
    Wei Xu, Sha OuYang, Zhenhai Chi, ZhiQin Wang, DaoCheng Zhu, RiXin Chen, GenPing Zhong, FengTing Zhang, GuiQin Zhou, SiWei Duan, Lin Jiao
    Medicine.2021; 100(10): e25095.     CrossRef
  • Differences in cause and 12-month follow-up outcome of parkinsonian symptoms in depressed older adults treated with antipsychotics: a case series
    Anastasios Politis, Nikolaos Kokras, Michael Souvatzoglou, Kostas Siarkos, Panagiotis Toulas, Constantin Potagas, Theodoros Hatzipanagiotou, Georgios Limouris, Panagiotis Alexopoulos
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    Yonghui Hou, Baile Ning, Yamin Liu, Ying Liu, Wenbin Fu, Zehuai Wen
    Medicine.2021; 100(23): e26256.     CrossRef
  • Glucocerebrosidase Mutations and Motor Reserve in Parkinson’s Disease
    Seok Jong Chung, Phil Hyu Lee, Young H. Sohn, Yun Joong Kim
    Journal of Parkinson's Disease.2021; 11(4): 1715.     CrossRef
  • Analysis of pupillometer results according to disease stage in patients with Parkinson’s disease
    Sooyeoun You, Jeong-Ho Hong, Joonsang Yoo
    Scientific Reports.2021;[Epub]     CrossRef
Original Article
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
  • 10,187 View
  • 282 Download
  • 21 Web of Science
  • 21 Crossref
AbstractAbstract PDFSupplementary 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.

Citations

Citations to this article as recorded by  
  • Correlation of olfactory function factors with cardiac sympathetic denervation in Parkinson’s disease
    Dong-Woo Ryu, Sang-Won Yoo, Ko-Eun Choi, Yoon-Sang Oh, Joong-Seok Kim
    Journal of Neurology.2024; 271(3): 1397.     CrossRef
  • Estimating motor progression trajectory pursuant to temporal dynamic status of cardiac denervation in Parkinson’s disease
    Sang-Won Yoo, Dong-Woo Ryu, Yoon-Sang Oh, Seunggyun Ha, Chul Hyoung Lyoo, Yuna Kim, Ji-Yeon Yoo, Joong-Seok Kim
    Journal of Neurology.2024; 271(4): 2019.     CrossRef
  • Olfactory Dysfunction in Parkinson’s Disease, Its Functional and Neuroanatomical Correlates
    Gabriel Torres-Pasillas, Donají Chi-Castañeda, Porfirio Carrillo-Castilla, Gerardo Marín, María Elena Hernández-Aguilar, Gonzalo Emiliano Aranda-Abreu, Jorge Manzo, Luis I. García
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  • Impact of deep brain stimulation (DBS) on olfaction in Parkinson's disease: Clinical features and functional hypotheses
    G. Brand, C. Bontempi, L. Jacquot
    Revue Neurologique.2023; 179(9): 947.     CrossRef
  • Sequential change in olfaction and (non) motor symptoms: the difference between anosmia and non-anosmia in Parkinson’s disease
    Ting-Chun Fang, Yu-Shan Tsai, Ming-Hong Chang
    Frontiers in Aging Neuroscience.2023;[Epub]     CrossRef
  • Traumatic brain injury-induced inflammatory changes in the olfactory bulb disrupt neuronal networks leading to olfactory dysfunction
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    Brain, Behavior, and Immunity.2023; 114: 22.     CrossRef
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    Vasudeva Murthy Challakere Ramaswamy, Peter William Schofield
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    Gabriel A. de Erausquin, Heather Snyder, Traolach S. Brugha, Sudha Seshadri, Maria Carrillo, Rajesh Sagar, Yueqin Huang, Charles Newton, Carmela Tartaglia, Charlotte Teunissen, Krister Håkanson, Rufus Akinyemi, Kameshwar Prasad, Giovanni D'Avossa, Gabriel
    Alzheimer's & Dementia: Translational Research & Clinical Interventions.2022;[Epub]     CrossRef
  • Machine learning-based prediction of cognitive outcomes in de novo Parkinson’s disease
    Joshua Harvey, Rick A. Reijnders, Rachel Cavill, Annelien Duits, Sebastian Köhler, Lars Eijssen, Bart P. F. Rutten, Gemma Shireby, Ali Torkamani, Byron Creese, Albert F. G. Leentjens, Katie Lunnon, Ehsan Pishva
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  • Impact of Subthalamic Deep Brain Stimulation on Hyposmia in Patients With Parkinson's Disease Is Influenced by Constipation and Dysbiosis of Microbiota
    Chao Li, Ying Hou, Xu Wang, Yue-xuan Li, Feng Li, Chao Zhang, Wei-guo Li
    Frontiers in Neurology.2021;[Epub]     CrossRef
  • Hyposmia may predict development of freezing of gait in Parkinson’s disease
    Jae Jung Lee, Jin Yong Hong, Jong Sam Baik
    Journal of Neural Transmission.2021; 128(6): 763.     CrossRef
  • Clinical and Dopamine Depletion Patterns in Hyposmia- and Dysautonomia-Dominant Parkinson’s Disease
    Han Soo Yoo, Sangwon Lee, Seong Ho Jeong, Byoung Seok Ye, Young H. Sohn, Mijin Yun, Phil Hyu Lee
    Journal of Parkinson's Disease.2021; 11(4): 1703.     CrossRef
Case Report
A Case of Abnormal Postures in the Left Extremities after Pontine Hemorrhage: Dystonia or Pseudodystonia?
Chan Wook Park, Seok Jong Chung, Young H. Sohn, Phil Hyu Lee
J Mov Disord. 2020;13(1):62-65.   Published online January 31, 2020
DOI: https://doi.org/10.14802/jmd.19074
  • 5,023 View
  • 130 Download
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
It is difficult to determine the pathoanatomical correlates of dystonia because of its complex pathophysiology, and most cases with secondary dystonia are associated with basal ganglia lesions. Moreover, it is a challenging issue that patients with abnormal postures accompanied by other neurological findings in the affected body part (e.g., sensory loss) can be diagnosed with true dystonia or pseudodystonia. Here, we report a case of abnormal postures with loss of proprioception in the left extremities after right dorsal pontine hemorrhage.

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Original Article
Heterogeneous Patterns of Striatal Dopamine Loss in Patients with Young- versus Old-Onset Parkinson’s Disease: Impact on Clinical Features
Seok Jong Chung, Han Soo Yoo, Yang Hyun Lee, Phil Hyu Lee, Young H. Sohn
J Mov Disord. 2019;12(2):113-119.   Published online May 30, 2019
DOI: https://doi.org/10.14802/jmd.18064
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AbstractAbstract PDFSupplementary Material
Objective
Ample evidence has suggested that age at onset of Parkinson’s disease (PD) is associated with heterogeneous clinical features in individuals. We hypothesized that this may be attributed to different patterns of nigrostriatal dopamine loss.
Methods
A total of 205 consecutive patients with de novo PD who underwent 18F-FP-CIT PET scans (mean follow-up duration, 6.31 years) were divided into three tertile groups according to their age at onset of parkinsonian motor symptoms. Striatal dopamine transporter (DAT) availability was compared between the old- (n = 73) and young-onset (n = 66) groups. In addition, the risk of developing freezing of gait (FOG) and longitudinal requirements for dopaminergic medications were examined.
Results
The old-onset PD group (mean age at onset, 72.66 years) exhibited more severe parkinsonian motor signs than the young-onset group (52.58 years), despite comparable DAT availability in the posterior putamen; moreover, the old-onset group exhibited more severely decreased DAT availability in the caudate than the young-onset group. A Cox regression model revealed that the old-onset PD group had a higher risk for developing FOG than the young-onset group [hazard ratio 2.523, 95% confidence interval (1.239–5.140)]. The old-onset group required higher doses of dopaminergic medications for symptom control than the young-onset group over time.
Conclusion
The present study demonstrated that the old-onset PD group exhibited more severe dopamine loss in the caudate and were more likely to develop gait freezing, suggesting that age at onset may be one of the major determinants of the pattern of striatal dopamine depletion and progression of gait disturbance in PD.

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Case Report
A Case of Isolated Middle Cerebral Artery Stenosis with Hemichorea and Moyamoya Pattern Collateralization
Seok Jong Chung, Hyung Seok Lee, Han Soo Yoo, Kyung Min Kim, Ki Jeong Lee, Jong-Soo Kim, Jae-Wook Lee, Jong Hun Kim, Jeong Hee Cho, Gyu Sik Kim, Jun Hong Lee, Sun-Ah Choi
J Mov Disord. 2013;6(1):13-16.
DOI: https://doi.org/10.14802/jmd.13003
  • 11,550 View
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AbstractAbstract PDF

Isolated middle cerebral artery (MCA) stenosis in young patients with no other medical condition may be a unique pathologic entity with a benign long-term course. Generally, moyamoya disease shows a progression of stenosis from internal cerebral artery (ICA) to other intracranial vessel. A 26-year-old woman was admitted for choreic movements of the right arm and leg. Brain magnetic resonance imaging showed no stroke. Conventional angiography revealed 48% stenosis of the left M1 without ICA stenosis. Single photon emission computed tomography revealed perfusion asymmetry after acetazolamide injection, suggesting decreased uptake in the left basal ganglia and the cerebral cortex. Her hemichorea was mildly decreased with risperidone. One year later, follow-up angiography showed complete occlusion of the left M1 with neovascularization suggestive of moyamoya disease. The patient underwent bypass surgery and her hemichorea disappeared. This may be an atypical presentation of moyamoya disease. The bypass surgery was an effective measure for restoring the vascular insufficiency and, resultantly, controlling her hemichorea.

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