Journal of Movement Disorders

Original Articles

Effects of MAO-B and COMT Inhibitors on Sleep Disturbances in Patients With Parkinson’s Disease: A Network Meta-Analysis: Seon-Min Lee, Sung Ryul Shim, Kyum-Yil Kwon, Taeho Greg Rhee, Yu Jin Jung; J Mov Disord. 2026;19(1):67-75. Published online November 7, 2025; DOI: https://doi.org/10.14802/jmd.25253

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Abstract PDF Supplementary Material: Objective
Sleep disturbances are common and debilitating nonmotor symptoms (NMS) in Parkinson’s disease (PD) patients and profoundly affect quality of life. Despite emerging evidence suggesting that monoamine oxidase B (MAO-B) and catechol-O-methyltransferase (COMT) inhibitors may alleviate NMS, their specific effects on sleep remain unclear. The aim of this network meta-analysis (NMA) was to compare the efficacy of these inhibitors related to sleep problems in PD patients.
Methods
Following a systematic search of PubMed, Cochrane, and Embase, studies comparing MAO-B or COMT inhibitors and assessing sleep outcomes in PD patients were identified. An NMA was conducted using data from the seven studies that met our inclusion criteria. The outcomes included subjective sleep quality, daytime sleepiness, and objective polysomnography (PSG) parameters.
Results
No statistically significant differences were found between the effects of the MAO-B and COMT inhibitors on improving subjective sleep quality or daytime sleepiness. However, analyses of objective PSG data revealed that, compared with rasagiline and placebo, safinamide significantly increased rapid eye movement sleep duration (mean difference, 5.70 min [95% CI, 2.26 to 9.14]) and decreased wake time after sleep onset (mean difference, -10.20 min [-19.38 to -1.02]).
Conclusion
These findings suggest that safinamide may offer additional value for managing sleep disruptions beyond its known motor benefits in patients with PD. Given the limited number and small scale of available trials, the overall evidence should be interpreted cautiously. Nonetheless, this analysis highlights the need for future high-quality trials focused on sleep outcomes to guide the personalized use of MAO-B and COMT inhibitors for sleep disturbances in PD patients.

Association Between Gait and Dysautonomia in Patients With De Novo Parkinson’s Disease: Forward Gait Versus Backward Gait: Seon-Min Lee, Mina Lee, Eun Ji Lee, Rae On Kim, Yongduk Kim, Kyum-Yil Kwon; J Mov Disord. 2023;16(1):59-67. Published online September 7, 2022; DOI: https://doi.org/10.14802/jmd.22045

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Objective
Studies on gait and autonomic dysfunction have been insufficient so far, particularly de novo Parkinson’s disease (PD). The aim of this study was to identify the association between gait dynamics and autonomic dysfunction in patients with de novo PD.
Methods
A total 38 patients with de novo PD were retrospectively included in this study. Details of patients’ dysautonomia were assessed using the Scales for Outcomes in Parkinson’s Disease-Autonomic Dysfunction (SCOPA-AUT). For assessment of gait, a computerized gait analysis was performed using the GAITRite system for forward gait and backward gait. High SCOPA-AUT score (PD-HSAS) group and low SCOPA-AUT score (PD-LSAS) group were identified according to their SCOPA-AUT scores.
Results
Nineteen (50%) patients with high SCOPA-AUT scores above median value (12.5) were assigned into the PD-HSAS group and others were assigned to the PD-LSAS group. Compared with the PD-LSAS group, the PD-HSAS group exhibited slower gait, shorter stride, decreased cadence, increased double support phase, decreased swing phase, and increased variability in swing time. Total SCOPA-AUT score showed significantly positive correlations with gait variability and instability but a negative correlation with gait hypokinesia. In subdomain analysis, urinary dysautonomia was highly associated with impairment of gait dynamics. All significant results were found to be more remarkable in backward gait than in forward gait.
Conclusion
Our findings suggest that alteration in gait dynamics, especially backward gait, is highly associated with autonomic dysfunction in patients with de novo PD.

Citations

Citations to this article as recorded by

Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review
Michael VanNostrand, Patrick G. Monaghan, Wendy Wu, Nora E. Fritz
Gait & Posture.2026; 124: 110048. CrossRef
Balance and gait disorders in de novo Parkinson’s disease: support for early rehabilitation
Beata Lindholm, Peter Hagell, Per Odin, Oskar Hansson, Arkadiusz Siennicki-Lantz, Sölve Elmståhl, Lars B. Dahlin, Erika Franzén
Journal of Neurology.2025;[Epub] CrossRef
Impact of motor features on non‐motor symptoms in patients with de novo Parkinson's disease: Cognition, depression, anxiety, fatigue, and dysautonomia
Kyum‐Yil Kwon, Byung‐Euk Joo, Jihwan You, Rae On Kim
Geriatrics & Gerontology International.2025; 25(3): 392. CrossRef
Advances in autonomic dysfunction research in Parkinson’s disease
Hongjia Xu, Xiaolei Zheng, Xinyue Xing, Zhichao Bi, Dewei Wang, Cheng Zhang, Lifei Wei, Yulin Jin, Shunliang Xu
Frontiers in Aging Neuroscience.2025;[Epub] CrossRef
Exploring the relationship between orthostatic hypotension and gait in people with Parkinson’s disease
Tuhin Virmani, Rebecca D. Jones, Lakshmi Pillai
Clinical Autonomic Research.2025; 35(6): 817. CrossRef
Epidemiology of autonomic dysfunction in Parkinson's disease (Review)
Jamir Rissardo, Ahmed Gadelmawla, Ibrahim Khalil, Ayah Abdulgadir, Karandeep Bhatti, Ana Fornari Caprara
Medicine International.2025; 5(6): 1. CrossRef
Association between autonomic dysfunction with motor and non-motor symptoms in patients with Parkinson's disease
Yi Qin, De-Tao Meng, Zhao-Hui Jin, Wen-Jun Du, Bo-Yan Fang
Journal of Neural Transmission.2024; 131(4): 323. CrossRef
Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson’s Disease
André Ivaniski-Mello, Vivian Torres Müller, Lucas de Liz Alves, Marcela Zimmermann Casal, Aline Nogueira Haas, Luca Correale, Ana Carolina Kanitz, Valéria Feijó Martins, Andréa Kruger Gonçalves, Flávia Gomes Martinez, Leonardo Alexandre Peyré-Tartaruga
International Journal of Sports Medicine.2023; 44(10): 744. CrossRef

Clinical Characteristics of Involuntary Movement in Hospitalized Patients: Kyum-Yil Kwon, Hye Mi Lee, Seon-Min Lee, Seong-Beom Koh; J Mov Disord. 2019;12(1):31-36. Published online December 20, 2018; DOI: https://doi.org/10.14802/jmd.18040

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2 Web of Science
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Abstract PDF

Objective
Neurological symptoms in hospitalized patients are not rare, and neurological consultation for movement disorders is especially important in evaluating or managing those with various movement disorders. Therefore, we investigated a clinical pattern of in-hospital consultations for various movement disorders in a tertiary care university hospital.
Methods
Over two years, a total of 202 patients (70.7 ± 11.8 years of age) presenting with movement disorders referred to movement disorder specialists were investigated.
Results
The main symptoms referred by nonneurologists were tremor (56.9%), parkinsonism (16.8%), and gait disturbance (8.9%). The most frequent diagnostic category was toxic/metabolic-caused movement disorder (T/MCMD) (35%) with regard to medications, followed by Parkinson’s disease (PD) (16%). Regarding the mode of onset, T/MCMD was the leading cause for acute (68%) and subacute onset (46%), while PD was the leading disorder (31%) for chronic onset.
Conclusion
The current study showed a characteristic pattern of inpatients presenting with movement disorders. Furthermore, our findings highlighted the clinical significance of drug use or metabolic problems for treating this patient population.

Citations

Citations to this article as recorded by

Pattern and frequency of involuntary movements: hospital-based study
H. N. El Tallawy, A. S. Shalash, M. A. Abdelhamed, R. E. Elsabrout
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.2023;[Epub] CrossRef
Clinical Spectrum of Movement Disorders in Neurology Inpatients in a Tertiary Care Centre
Shabeer Ahmad Paul, Gouranga Prasad Mondal, Ramesh Bhattacharyya, Kartik Chandra Ghosh, Sarbajit Das, Suman Das, Hema Krishna, Chandrakanta Patra
Journal of Neurosciences in Rural Practice.2021; 12: 581. CrossRef

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