• Therapeutic Science for Rehabilitation
• /
• v.8 no.1
• /
• pp.73-84
• /
• 2019

Objective: The purpose of this study is to compare the effect of Lee Silverman Voice Treatment-BIG(LSVT-BIG) intervention which consisted of standardized exercise programs and occupation-based activities for people with Parkinson Disease(PD) on motor functions and quality of life Methods: This study applied a one group pretest-posttest design. The experiment was divided into two parts: pre intervention and post intervention period. Before and after LSVT-BIG intervention, Unified Parkinson's Disease Rating Scale(UPDRS), Time up and go(TUG), Parkinson's Disease Questionnaire-39(PDQ-39) were used to measure the participants' motor functions and quality of life. Based on the LSVT-BIG protocol, three participants received 16 one-hour sessions over 4 weeks by a certified occupational therapist. The results were analyzed by using SPSS. Results: There were improvements in UPDRS and TUG. Additionally, PDQ-39 scores decreased in all participants, which means that their quality of life was improved. Conclusions: The study demonstrated positive effects of LSVT-BIG intervention on motor functions and quality of life of patients with PD.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.2
• /
• pp.118-124
• /
• 2013

Objective : Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes. Methods : Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinson's Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups. Results : Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor. Conclusion : The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

• The Journal of Korean Medicine
• /
• v.41 no.2
• /
• pp.23-33
• /
• 2020

Objectives: To investigate the prevalence of pain, clinical characteristics of pain, association between clinical features and pain of patients with Parkinson's Disease(PD). Methods: We undertook a retrospective review of the medical records of patients diagnosed with PD between 2012 and 2019 at Kyung Hee University Korean Medicine Hospital at Gangdong in South Korea. Results: A total of 172 PD patients met entry criteria and 147 out of 172 patients(85.5%) reported pain. In comparison with general population, PD patients has high prevalence of pain. Female PD patients more frequently reported pain than male (P=0.03). 102 out of 147patients(69.3) complained of musculoskeletal pain, and musculoskeletal pain show significant difference depending on the PD motor subtypes (P=0.039). Pain was mainly locatedin the leg (57.8%) in all PD motor subtypes. Tremor-dominant PD more frequently felt pain in upper limb than postural instability-gait difficulty dominant(PIGD) PD, but it was not statistically significant. Conclusions: These findings showed high prevalence of pain in PD patients, the correlation between female and pain, and the relationship between PD motor subtype and pain type. Our study can contribute to the clinical approach based on a more in-depth understanding of PD patients with pain.

• BMB Reports
• /
• v.50 no.5
• /
• pp.237-246
• /
• 2017

Synapse is the basic structural and functional component for neural communication in the brain. The presynaptic terminal is the structural and functionally essential area that initiates communication and maintains the continuous functional neural information flow. It contains synaptic vesicles (SV) filled with neurotransmitters, an active zone for release, and numerous proteins for SV fusion and retrieval. The structural and functional synaptic plasticity is a representative characteristic; however, it is highly vulnerable to various pathological conditions. In fact, synaptic alteration is thought to be central to neural disease processes. In particular, the alteration of the structural and functional phenotype of the presynaptic terminal is a highly significant evidence for neural diseases. In this review, we specifically describe structural and functional alteration of nerve terminals in several neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic lateral sclerosis (ALS), and Huntington's disease (HD).

• Animal cells and systems
• /
• v.10 no.3
• /
• pp.115-120
• /
• 2006

Parkinson's disease (PD) is a neurodegenerative disease caused by selective degeneration of dopaminergic neurons in the substantia nigra. Mutations in ${\alpha}$-synuclein have been causally linked to the pathogenesis of hereditary PD. In addition, it is a major component of Lewy body found in the brains of sporadic cases as well. In the present study, we examined whether overexpression of wild type or PD-related mutant ${\alpha}$-synuclein induces unfolded protein response (UPR) and triggers the known signaling pathway of the resulting endoplasmic reticulum (ER) stress in SH-SY5Y cells. Overexpression of wild type, A30P, and A53T ${\alpha}$-synuclein all induced XBP-1 mRNA splicing, one of the late stage UPR events. However, activation of ER membrane kinases and upregulation of ER or cytoplsmic chaperones were not detected when ${\alpha}$-synuclein was overexpressed. However, basal level of cytoplsmic calcium was elevated in ${\alpha}$-synuclein-expressing cells. Our observation suggests that overexpression of ${\alpha}$-synuclein induces UPR independent of the known ER membrane kinase-mediated signaling pathway and induces ER stress by disturbing calcium homeostasis.

• Bulletin of the Korean Chemical Society
• /
• v.28 no.1
• /
• pp.77-80
• /
• 2007

As neurofilament proteins are major cytoskeletal components of neuron, abnormality of neurofilament is proposed in brain with neurodegenerative disorders such as Parkinson's disease (PD). Since oxidative stress might play a critical role in altering normal brain proteins, we investigated the oxidative modification of neurofilament-L (NF-L) induced by the reaction of cytochrome c with H2O2. When NF-L was incubated with cytochrome c and H2O2, the protein aggregation was increased in cytochrome c and H2O2 concentrationsdependent manner. Radical scavengers, azide, formate and N-acetyl cysteine, prevented the aggregation of NFL induced by the cytochrome c/H2O2 system. The formations of carbonyl group and dityrosine were obtained in cytochrome c/H2O2-mediated NF-L aggregates. Iron specific chelator, desferoxamine, prevented the cytochrome c/H2O2 system-mediated NF-L aggregation. These results suggest that the cytochrome c/H2O2 system may be related to abnormal aggregation of NF-L which may be involved in the pathogenesis of PD and related disorders.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.11
• /
• pp.1415-1420
• /
• 2000

Essential tremor(ET) is the most common movement disorder however there has been little agreement in the neurologic literature regarding diagnostic criteria for ET. Familial ET is an autosomal dominant disorder presenting as an isolated postural tremor. The main feature of ET is postural tremor of the arms with later involvement of the head, voice, or legs. In previous studies, it was reported that ET susceptibility was inherited in an autosomal dominant inheritance. As with previous results, it would suggest that ET might be associated with defect of mitochondrial or nuclear DNA. Recent studies are focusing molecular genetic detection of movement disorders, such as essential tremor and restless legs syndrome. Parkinson's disease(PD) is a neurodegenerative disease involving mainly the loss of dopaminergic neurons in substantia nigra by several factors. The cause of dopaminergic cell death is unknown. Recently, it has been suggested that Parkinson's disease many result from mitochondrial dysfunction. The authors have analysed mitochondrial DNA(mtDNA) from the blood cell of PD and ET patients via long and accurate polymerase chain reaction(LA PCR). Blood samples were collected from 9 PD and 9 ET patients. Total DNA was extracted twice with phenol followed by chloroform : isoamylalcohol. For the analysis of mtDNA, LA PCR was performed by mitochondrial specific primers. With LA PCR, 1/3 16s rRNA~1/3 ATPase 6/8 and COI~3/4 ND5 regions were observed in different patterns. But, in the COI~1/3 ATPase 6/8 region, the data of PCR were observed in same pattern. This study supports the data that ET and PD are genentic disorders with deficiency of mitochondrial DNA multicomplexes.

• Korean Journal of Radiology
• /
• v.22 no.11
• /
• pp.1841-1849
• /
• 2021

Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson's disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young's modulus-ankle angle curve was constructed. The GM slack angle and baseline Young's modulus (E₀) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion: The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

• Journal of the Korean Society of Radiology
• /
• v.8 no.5
• /
• pp.231-240
• /
• 2014

The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.

• Journal of the Korean Society of Physical Medicine
• /
• v.8 no.1
• /
• pp.49-58
• /
• 2013

PURPOSE: The purpose of this study was to determine if auditory cues velocity has a greater effect on the gait pattern of patients with Parkinson's disease (PD) than the cues applied individually. METHODS: The subjects were 15 elderly patients diagnosed with PD, 15 healthy elderly persons. Patients were measured of three conditions performed in random order: slow, general, fast. The auditory cue velocity consisted of a metronome beat ${\pm}20%$ than the subject's general gait speed. Using a motion analysis and a force platform measurement system, changes in spatiotemporal variables, kinetic and kinematic variables were compared to gait analysis. RESULTS: Comparison between the auditory cues velocity, there was a significant difference in the spatiotemporal variables with regard to the cadence, stride length, support time, step length, double support time (p<.05). Comparison between the auditory cues velocity, there was a significant increase general and fast velocity gait than slow velocity gait in the maximum flexion in swing phase of knee joint (p<.05). There appears to be the aspect of an increasing ground reaction force (GRF) on the first peak in the vertical axis (p<.05). CONCLUSION: Auditory cues velocity improved of spatio-temporal factors, kinematic and kinetic factors depending on the velocity of the faster. Therefore at the rehabilitation training of PD patients auditory cues velocity would be used for recovery and gait reeducation, may arise through the patients functional ability.