Journal of Movement Disorders

Original Articles

Distinct Patterns of Perivascular Diffusivity and Choroid Plexus Volume in De Novo Parkinson’s Disease and Type 2 Diabetes: Yun Jung Bae, Chaewon Shin, Hyunjae Jeong, Se Jin Cho, Sung Hyun Baik, So Yeong Jeong, Da Hyun Lee, Younbeom Jeong, Jong-Min Kim; Received April 27, 2026 Accepted August 12, 2026 Published online August 18, 2026; DOI: https://doi.org/10.14802/jmd.26131 [Accepted]

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Abstract PDF: Background
Alterations in perivascular fluid dynamics have been implicated in Parkinson’s disease (PD) and metabolic disorders such as type 2 diabetes mellitus (T2DM). However, the relative contributions of neurodegenerative and metabolic conditions to functional perivascular water diffusivity versus structural neurofluid markers remain to be elucidated.
Objectives
To investigate the differences in perivascular water diffusivity and structural neurofluid markers using diffusion tensor image-analysis along the perivascular space (DTI-ALPS), perivascular space (PVS) burden, and choroid plexus volume (CPV) in PD and T2DM.
Methods
Consecutive patients with de novo PD and disease controls were included. Subjects were classified into four groups according to PD and T2DM status and matched for age and sex. The ALPS-index was derived from DTI, whereas PVS burden and CPV were quantified on three-dimensional T1-weighted images and normalized to intracranial volume.
Results
A total of 127 subjects were included. The ALPS-index differed significantly among the four groups (P < 0.001), with both PD groups demonstrating significantly lower values than control groups, irrespective of T2DM status. Within the PD cohort, longer disease duration and older age were independently associated with lower ALPS-index values. CPV also differed significantly across groups (P = 0.006) with higher values observed only in controls with T2DM, while PVS burden did not differ significantly.
Conclusions
In early-stage PD, impaired perivascular diffusivity was associated primarily with neurodegeneration, and no significant additive effect of T2DM was detected. Conversely, the increase in normalized CPV associated with T2DM was observed only in controls and not in PD, suggesting that metabolic and neurodegenerative conditions may differentially influence neurofluid markers.

The Association between the Triglyceride-Glucose Index and the Incidence Risk of Parkinson’s Disease: A Nationwide Cohort Study: Yoonkyung Chang, Ju-young Park, Ji Young Yun, Tae-Jin Song; J Mov Disord. 2025;18(2):138-148. Published online February 27, 2025; DOI: https://doi.org/10.14802/jmd.24131

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Objective
We aimed to investigate the associations of the triglyceride-glucose index, which measures insulin resistance, and the incidence of Parkinson’s disease.
Methods
Our study used the Health Screening Cohort database of the National Health Insurance Service of South Korea (2002–2019). We included 310,021 participants who had no previous history of Parkinson’s disease and for whom more than 3 triglyceride-glucose index measurements were available. A diagnosis of Parkinson’s disease was determined via the International Classification of Diseases Tenth edition (G20) with a specific reimbursement code for rare intractable diseases and a history of prescriptions for anti-Parkinsonism drugs.
Results
During a median of 9.64 years (interquartile range 8.72–10.53), 4,587 individuals (1.5%) had Parkinson’s disease. Based on a multivariable time-dependent Cox proportional hazards model, a per-unit increase in triglyceride-glucose index score was associated with a significantly increased risk of Parkinson’s disease (hazard ratio [HR]: 1.062; 95% confidence interval [CI] 1.007–1.119). In a sensitivity analysis, the triglyceride-glucose index was associated with the incidence of Parkinson’s disease in a non–diabetes mellitus cohort (HR: 1.093; 95% CI 1.025–1.165), but not in the diabetes mellitus cohort (HR: 0.990; 95% CI 0.902–1.087). In a restricted cubic spline analysis, the association between the triglyceride-glucose index and the incidence risk of Parkinson’s disease showed a nonlinear increasing (J-shaped) trend.
Conclusion
Our study demonstrated that higher triglyceride-glucose index scores were associated with the incidence of Parkinson’s disease in the general population, particularly in a nondiabetic mellitus cohort.

Citations

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Association between the triglyceride-glucose frailty index and Parkinson's disease in middle-aged and older adults: a comparative cross-national analysis of NHANES and CHARLS
Changze Ou, Binbin Chen, Haidong Yu, Jun Deng, Huajun Long
Parkinsonism & Related Disorders.2026; 145: 108240. CrossRef
Insulin Resistance Surrogates and Cognitive Impairment in Parkinson’s Disease: A Cross-Sectional Study with Interpretable Machine Learning
Hongming Liang, Yuru Jia, Hui Zhang, Danlei Wang, Haoheng Yu, Yongwen Yan, Jingyi Li, Liangkai Chen, Zheng Xue
Biomedicines.2026; 14(3): 493. CrossRef
Association between the triglyceride-glucose index and disease severity in non-diabetic Parkinson’s disease patients
Deyan Zeng, Min Luo, Baojun Zhang, Yan Zhang, Ailan Pang, Xinglong Yang
Frontiers in Aging Neuroscience.2026;[Epub] CrossRef
Metabolic dysfunction and insulin resistance across major dementias: A comprehensive narrative review of the TyG index as a predictive marker
Moein Mirzai, Seyed Parsa Marouf, MohammadPooyan Eslami, Mohammad Hossein Nabian
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Association between the C-Reactive Protein-Triglyceride-Glucose Index and Parkinsonism: A Weighted Cross-Sectional Study Based on the NHANES Database
梦露范
Advances in Clinical Medicine.2026; 16(08): 1459. CrossRef
The interplay between obesity and triglyceride-glucose index in modulating Parkinson's disease risk: A cross-sectional NHANES study of middle-aged and young adults
Jincheng Ma, Mimi Li, Zhendong Lei
Parkinsonism & Related Disorders.2025; 140: 108070. CrossRef
Revisiting the Triglyceride–Glucose Index in Parkinson’s Disease: Risk Ractor or Disease Marker?
Shweta Prasad, Tarunya Nagaraj, Shubha GS Bhat, Mahima Bhardwaj, Pooja Mailankody, Rohan R Mahale, Nitish Kamble, Vikram Venkappayya Holla, Ravi Yadav, Pramod Kumar Pal
Journal of Movement Disorders.2025; 18(4): 389. CrossRef
Association of triglyceride glucose-waist to height ratio index with Parkinson’s disease and the mediating role of systemic inflammatory response index: A cross-sectional study
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Medicine.2025; 104(52): e46737. CrossRef

The Effect of Blood Lipids, Type 2 Diabetes, and Body Mass Index on Parkinson’s Disease: A Korean Mendelian Randomization Study: Kye Won Park, Yun Su Hwang, Seung Hyun Lee, Sungyang Jo, Sun Ju Chung; J Mov Disord. 2023;16(1):79-85. Published online January 12, 2023; DOI: https://doi.org/10.14802/jmd.22175

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Abstract PDF Supplementary Material

Objective
Associations between various metabolic conditions and Parkinson’s disease (PD) have been previously identified in epidemiological studies. We aimed to investigate the causal effect of lipid levels, type 2 diabetes mellitus (T2DM), and body mass index (BMI) on PD in a Korean population via Mendelian randomization (MR).
Methods
Two-sample MR analyses were performed with inverse-variance weighted (IVW), weighted median, and MR-Egger regression approaches. We identified genetic variants associated with lipid concentrations, T2DM, and BMI in publicly available summary statistics, which were either collected from genome-wide association studies (GWASs) or from meta-analyses of GWAS that targeted only Korean individuals or East Asian individuals, including Korean individuals. The outcome dataset was a GWAS on PD performed in a Korean population.
Results
From previous GWASs and meta-analyses, we selected single nucleotide polymorphisms as the instrumental variables. Variants associated with serum levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides, as well as with T2DM and BMI, were selected (n = 11, 19, 17, 89, and 9, respectively). There were no statistically significant causal associations observed between the five exposures and PD using either the IVW, weighted median, or MR-Egger methods (p-values of the IVW method: 0.332, 0.610, 0.634, 0.275, and 0.860, respectively).
Conclusion
This study does not support a clinically relevant causal effect of lipid levels, T2DM, and BMI on PD risk in a Korean population.

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Genetic evidence for the liver-brain axis: lipid metabolism and neurodegenerative disease risk
Zeyu Wang, Zixiao Yin, Guangyong Sun, Dong Zhang, Jianguo Zhang
Lipids in Health and Disease.2025;[Epub] CrossRef
Exploring the Causal Link Between Systemic Lupus Erythematosus and Stroke Risk Through Mendelian Randomization Study
Lingwen Zhang, Yaxin Li, Wenhui Fan, Hua Xue
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Body mass index, metabolically abnormal status, and incident Parkinson's disease: Data from the UK Biobank
Hae-Ryong Yun, Nak-Hoon Son, Hee Byung Koh, Seok Jong Chung
Journal of Parkinson’s Disease.2025; 15(7): 1275. CrossRef
Metabolic Parkinson’s disease
Federica Invernizzi, Lorenzo Ciocca, Elena Contaldi, Donato Inverso, Daniela Calandrella, Francesco Mignone, Michela Barichella, Ioannis Ugo Isaias, Gianni Pezzoli
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Association of Body Mass Index and Parkinson Disease
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Glycated hemoglobin A1c, cerebral small vessel disease burden, and disease severity in Parkinson's disease
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Case Report

Woodhouse-Sakati Syndrome: Report of the First Tunisian Family with the C2orf37 Gene Mutation: Olfa Hdiji, Emna Turki, Nouha Bouzidi, Imen Bouchhima, Mariem Damak, Saeed Bohlega, Chokri Mhiri; J Mov Disord. 2016;9(2):120-123. Published online May 25, 2016; DOI: https://doi.org/10.14802/jmd.16003

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Abstract PDF

Woodhouse-Sakati syndrome (WSS) is an infrequent autosomal recessive condition characterized by progressive extrapyramidal signs, mental retardation, hypogonadism, alopecia, and diabetes mellitus. This syndrome belongs to a heterogeneous group of inherited neurodegenerative disorders characterized iron accumulation in the brain, and it is caused by mutations of the C2orf37 gene. We report the first Tunisian family with two affected sisters presenting with a phenotype suggestive of WSS. We examined the index patient presenting with movement disorders and mental retardation and then searched for similar cases in her family, which identified a sister with similar signs. We performed a genetic study that confirmed the diagnosis and revealed a c.436delC mutation of the C2orf37 gene. Therefore, WSS is an important consideration in patients presenting with movement disorders and intellectual disability. A high consanguinity contributes to the clustering of such rare autosomal recessive syndromes.

Citations

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Long‐Term Outcomes of Deep Brain Stimulation in Woodhouse–Sakati Syndrome
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Genetic epidemiology of Woodhouse-Sakati Syndrome in the Greater Middle East region and beyond: a systematic review
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The Successful Management of Primary Amenorrhea in Woodhouse–Sakati Syndrome: A Case Report and a Literature Review
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Mohammed A Aljaffer, Ahmad H Almadani, Mohammad AlMutlaq, Abdulaziz Alhammad , Ahmed S Alyahya
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Case Report: A Deletion Variant in the DCAF17 Gene Underlying Woodhouse-Sakati Syndrome in a Chinese Consanguineous Family
Guangmin Chen, Ling Zhou, Qimou Chen, Juan Wang, Peng Jiang, Rufei Shen, Min Long, Houdi Zhou
Frontiers in Genetics.2021;[Epub] CrossRef
Woodhouse–Sakati syndrome in a family is associated with a homozygous start loss mutation in the DCAF 17 gene
K. Shah, A. Jan, F. Ahmad, S. Basit, K. Ramzan, W. Ahmad
Clinical and Experimental Dermatology.2020; 45(2): 159. CrossRef
A novel DCAF17 homozygous mutation in a girl with Woodhouse-Sakati syndrome and review of the current literature
Erdal Kurnaz, Ayberk Türkyılmaz, Oğuzhan Yaralı, Berrin Demir, Atilla Çayır
Journal of Pediatric Endocrinology and Metabolism.2019; 32(11): 1287. CrossRef
Brain MR Imaging Findings in Woodhouse-Sakati Syndrome
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