• 말소리와 음성과학
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• 제10권4호
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• pp.163-171
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• 2018

A mixed dysarthria with combinations of hypokinetic, ataxic, and spastic components is a common clinical feature of multiple system atrophy (MSA). Due to the rapid progress of dysarthria after diagnosis, people with MSA experience difficulty with verbal communication, which eventually affects their quality of life negatively. In this study, SPEAK $OUT!^{(R)}$, an intensive 1:1 treatment of dysarthria for improving functional communicative ability, was provided to twelve people with MSA. To evaluate the efficacy of SPEAK $OUT!^{(R)}$ in people with MSA, aerodynamic, acoustic, and perceptual analyses were conducted. Pre-and post-therapy data included maximum phonation time, vocal intensity, and fundamental frequency during /a/ sustained phonation and passage reading; frequency range between high /a/ and low /a/ phonation; jitter, shimmer, and HNR for vocal quality; speech rate during passage reading; and perceptual evaluation scores for articulation precision and intonation. The participants achieved statistically significant improvement in vocal intensity, pitch range, vocal quality, speech rate, and speech intelligibility. In conclusion, SPEAK $OUT!^{(R)}$ is a feasible treatment for people with MSA to efficaciously improve their speech ability.

• 대한한의학회지
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• 제32권2호
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• pp.118-125
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• 2011

난치성 질환인 다발성 뇌신경계 위축증으로 진단 받은 환자를 신음허, 비기허, 중풍으로 변증하고 한약 치료, 침구 치료 및 재활 치료를 시행한 결과 근력 및 연하기능이 호전된 경과를 관찰하였기에 보고하는 바이다. 향후 다발성 뇌신경계 위축증에 대한 한방치료 효과를 증명하기 위해 추가적인 증례 보고와 다양한 실험 및 임상연구가 필요할 것으로 사료된다.

• 대한한방내과학회지
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• 제40권5호
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• pp.851-864
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• 2019

Multiple system atrophy is a neurodegenerative disease that causes diverse bodily dysfunctions (cerebellar, pyramidal, automatic, and urological, in any combination), as well as Parkinsonism. Patients with multiple system atrophy commonly display antecollis, a condition where the patient's head tilts forward more than 45 degrees. Despite its common occurrence in these patients, no current standardized therapies are effective for treating antecollis. In this study, Korean medicinal treatments, including Chuna manual therapy, pharmaco-acupuncture, bee venom acupuncture, acupuncture, herbal medicine, and moxibustion therapy, were administered to the patient over a 27-day period. After the treatment, assessments of the head position on the EPIS-PD scale (Part I) and at a standing position from the side (Part II) both revealed improvements. As the head flexion angle decreased, the patient's head posture improved, as determined by a decrease in angle from 80 degrees to 30 degrees in the upright, standing position. As a result, patients who previously were unable to walk without the support of walking frames could now roam freely and independently, with significant increases in both walking speed and distance. In essence, this study suggests that Korean medicine is an effective treatment for patients with multiple system atrophy who suffer from antecollis and gait disorders.

• 대한한방내과학회지
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• 제41권4호
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• pp.612-623
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• 2020

Objectives: The aim of this research was to investigate and review the trends in recent clinical studies of multiple system atrophy (MSA) in China. Methods: We searched for clinical studies discussing Oriental medicine-based treatments for MSA in the China National Knowledge Infrastructure (CNKI) database. The search focused on the authors; publication year; type of study; method and duration of treatment; evaluation criteria; and results of the selected articles. Results: Among the articles retrieved from the database, eight case series, two randomized controlled trials (RCTs), and one non-randomized controlled trial (nRCT) were analyzed. Eight articles used acupuncture; ten used herbal medicine. The most frequently used acupoints were GV20, GV24, GB20, PC6, Hyeopcheok Acupoint, CV4, EX-HN3, and GV17. Jihwangeumja was the most commonly used herbal prescription. All 13 studies confirmed the efficacy of Oriental medicine treatments. Conclusions: More varied and scientifically designed clinical studies are required to develop treatments for MSA. The results of this study may provide guidance for further studies of MSA.

• 대한한방내과학회지
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• 제40권5호
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• pp.743-751
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• 2019

This case report suggests the potential effects of Korean medicine for the gait disturbance and posture instability of Multiple System Atrophy-Parkinsonism (MSA-P). A patient with MSA-P who had gait disturbance and posture instability was given a series of Korean medicine, including acupuncture, pharmacopuncture, electro-acupuncture, moxibustion, and herbal medicine, for 15 days of hospitalization. During the hospitalization period, the severity and progression of the disease was measured with the Unified Multiple System Atrophy Rating Scale (UMSARS) and a video recording of a 20-meter round timed walking test. The UMSARS Part I and II scores decreased from 14 to 5 and 9 to 5, respectively. An improvement was also noted in standing and walking posture, and the walking time was shortened from 30 to 25 seconds in the 20-meter round-trip walking test. Dysarthria, dysphagia, and non-motoring symptoms like sleep behavioral disorders and constipation were also improved. The findings of this case study suggest that this series of Korean medicine has potential therapeutic effects for patients with MSA-P with motor and non-motor symptoms.

• 사상체질의학회지
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• 제26권2호
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• pp.194-204
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• 2014

Objectives The aim of this study was to examine significant improvement of gait ataxia, vertigo and tremor after treatment with Sipyimigwanjung-tang, Hyangsayangwi-tang in a Soeumin Greater Yin Symptomatology patient Diagnosed as Cerebellar ataxia. Methods The patient was diagnosed with Soeumin Greater Yin Symptomatology and treated with Soeumin's constitutional medications and acupuncture. The primary outcome measures for this study were the Unified Multiple System Atrophy Rating Scale(UMSARS) and Cerebellar function test to assess the overall function of patient. Secondary outcome assessment included Global Assessment Scale(GAS), change of patient's sleep, stool and digestion. Results The symptoms of gait ataxia, vertigo and tremor decreased from GAS 100 to GAS 0~40 after treatment, and the UMSARS score decreased in Part I, II. Conclusions This case showed that Sasang Constitutional medicine treatment can be effective treatment method for cerebellar ataxia. We consider that consistent treatment can contribute to improve the patient's quality of life.

• 대한중풍순환신경학회지
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• 제24권1호
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• pp.41-54
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• 2023

■Objectives This study is to report the effectiveness of Korean medicine on the treatment for multiple system atropy(MSA-C) patient complaining of autonomic dysfunction. ■Methods The patient was treated with Korean medicine(mainly DokhwalJihwang-tang Gami-bang) for 39 days. The evaluations were performed using UMSARS(Unified Multiple System Atrophy Rating Scale), SCOPA-AUT(The Scale for Outcomes in Parkinson's disease-Autonomic), K-OGS(Korean version of the Orthostatic Grading Scale). ■Results After treatment, the UMSARS score decreased from 25 to 18, the SCOPA-AUT score decreased from 21 to 14, K-OGS score decrease from 15 to 8. ■Conclusion This case suggests that Korean medicine treatment may be effective for MSA-C patients with autonomic dysfuction.

• 대한한의학회지
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• 제21권4호
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• pp.286-291
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• 2000

Behcet's disease is a systemic disease affecting multiple organs including the central nervous system. Neuro-Behcet's disease was regarded as relatively rare, but thanks to the development of diagnostic tools, more and more cases are being reported. We are reporting a case of neuro-Behcet's disease in which the patient displayed paraparesis, dysarthria and involuntary tremor as neurologic symptoms. The patient's brain MRI showed cerebellar atrophy, and a spinal cord MRI failed to reveal any significant lesions. The patient experienced a couple of fever attacks during hospitalization, which were managed adequately by herbal medicines. Her main neurological symptoms such as paraparesis were, however, grossly unchanged at discharge.

• Biomolecules & Therapeutics
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• 제29권1호
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• pp.83-89
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• 2021

Multiple system atrophy (MSA) is a neurodegenerative disease characterized by presence of α-synuclein-positive inclusions in the cytoplasm of oligodendrocytes. These glial cytoplasmic inclusions (GCIs) are considered an integral part of the pathogenesis of MSA, leading to demyelination and neuronal demise. What is most puzzling in the research fields of GCIs is the origin of α-synuclein aggregates in GCIs, since adult oligodendrocytes do not express high levels of α-synuclein. The most recent leading hypothesis is that GCIs form via transfer and accumulation of α-synuclein from neurons to oligodendrocytes. However, studies regarding this subject are limited due to the absence of proper human cell models, to demonstrate the entry and accumulation of neuronal α-synuclein in human oligodendrocytes. Here, we generated mature human oligodendrocytes that can take up neuronderived α-synuclein and form GCI-like inclusions. Mature human oligodendrocytes are derived from neural stem cells via "oligosphere" formation and then into oligodendrocytes, treating the cells with the proper differentiation factors at each step. In the final cell preparations, oligodendrocytes consist of the majority population, while some astrocytes and unidentified stem cell-like cells were present as well. When these cells were exposed to α-synuclein proteins secreted from neuron-like human neuroblastoma cells, oligodendrocytes developed perinuclear inclusion bodies with α-synuclein immunoreactivity, resembling GCIs, while the stem cell-like cells showed α-synuclein-positive, scattered puncta in the cytoplasm. In conclusion, we have established a human oligodendrocyte model for the study of GCI formation, and the characterization and use of this model might pave the way for understanding the pathogenesis of MSA.

• 대한중풍순환신경학회지
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• 제21권1호
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• pp.67-76
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• 2020

■ Objectives The purpose of this case is to report the effectiveness of Korean medicine in the treatment of early stage multiple system atrophy-cerebellar ataxia(MSA-C) ■ Methods The patient was treated with acupuncture, bee venom, and herbal medicine. The clinical symptoms was assessed using unified multiple system atrophy rating scale(UMSARS) and 20M gait time and steps. ■ Results After treatment, UMSARS score and 20M gait time and steps showed improvement. ■ Conclusion This study suggested that Korean medical treatment could be an effective option for treating early stage MSA-C.