• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1303-1310
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• 2019

Objectives: Drug-induced Parkinsonism has similar symptoms to Parkinson's disease, but each has different causes. Drug-induced Parkinsonism accounts for the largest proportion of secondary Parkinsonism We report a outpatient case of drug-induced Parkinsonism after taking Risperidone, an atypical antipsychotic. Method: With discontinuing of antipsychotic drug, modified Yigan-san extract was administered for 12 weeks, and acupuncture and electroacupuncture procedures were performed 20 times. Results: Abnormal Involuntary Movement Scale (AIMS) score decreased from 23 to 3 during 59 days of treatment period without adverse events and worsening of depression. The Patient was highly satisfied. Conclusion: Modified Yigan-san and electroacupuncture (GB34) can be used as an treatment option in patients with drug-induced Parkinsonism.

• Molecules and Cells
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• v.44 no.7
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• pp.493-499
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• 2021

Parkinson's disease (PD) is characterized by a progressive loss of dopamine-producing neurons in the midbrain, which results in decreased dopamine levels accompanied by movement symptoms. Oral administration of l-3,4-dihydroxyphenylalanine (L-dopa), the precursor of dopamine, provides initial symptomatic relief, but abnormal involuntary movements develop later. A deeper understanding of the regulatory mechanisms underlying dopamine homeostasis is thus critically needed for the development of a successful treatment. Here, we show that p21-activated kinase 4 (PAK4) controls dopamine levels. Constitutively active PAK4 (caPAK4) stimulated transcription of tyrosine hydroxylase (TH) via the cAMP response element-binding protein (CREB) transcription factor. Moreover, caPAK4 increased the catalytic activity of TH through its phosphorylation of S⁴⁰, which is essential for TH activation. Consistent with this result, in human midbrain tissues, we observed a strong correlation between phosphorylated PAK4^S474, which represents PAK4 activity, and phosphorylated TH^S40, which reflects their enzymatic activity. Our findings suggest that targeting the PAK4 signaling pathways to restore dopamine levels may provide a new therapeutic approach in PD.

• Journal of Oriental Neuropsychiatry
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• v.30 no.2
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• pp.107-118
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• 2019

Objectives: The objective of this study is to report the effectiveness of Korean medicine therapy on Psychologic tremor patients with MCVT. Methods: Korean medicine therapy including MCVT, herb, acupuncture, and psychotherapy are applied to psychologic tremor patients. Vas and AIMS are used as assessment tools to evaluate the effects of therapy. MCVT is a traditional Korean medicine technique usually for chronic diseases. Similarly, autogenic training by J.H.Schultz and Giungoroen-therapy was conducted as psychotherapy. Results: In case 1, the patient lost all symptoms from vas10 to vas0, while in case 2, symptoms of the patient decreased from vas10 to vas3. Additionally, there was a significant decrease in the AIMS measurement score for both patients. Psychotherapy helped to reduce depression and anxiety. Conclusions: Psychologic tremor can be treated using Korean traditional medicine such as MCVT, Sosiho-tang and psychotherapy.

• Korean Journal of Schizophrenia Research
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• v.23 no.2
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• pp.71-77
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• 2020

Objectives: Tardive dyskinesia (TD) is a movement disorder that is characterized by hyperkinetic movements. Previous studies have suggested that the serotonergic systems are correlated with TD vulnerability. In this study, the association between a single-nucleotide polymorphism (SNP) of the serotonin 1A receptor gene (HTR1A) rs6295 and TD was investigated. Methods: We investigated whether HTR1A rs6295 SNP is associated with antipsychotic-induced TD in 280 Korean patients with schizophrenia. Patients with schizophrenia having TD (n=105) and those without TD (n=175) were matched for their antipsychotic exposures and other relevant variables. The HTR1A rs6295 SNP was analyzed using polymerase chain reaction (PCR)-based methods. Results: There was no significant difference in the distribution of genotypic (χ²=2.70, p=0.26) and allelic (χ²=1.87, p=0.17) frequencies between the patient groups with TD and without TD. There was no significant difference in total abnormal involuntary movement scale score (F=0.39, p=0.68) among the genotype group either. Conclusion: Although there were no differences in genotypic and allelic frequency between patient groups with and without TD, further studies on association of TD with other SNPs of HTRA1 are needed to understand the pathophysiological mechanism of TD.

• Korean Journal of Biological Psychiatry
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• v.10 no.1
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• pp.54-61
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• 2003

Object : This cross-sectional study was performed in order to evaluate the prevalence of tardive dyskinesia among the hospitalized schizophrenic patients. Methods : Four hundred nineteen hospitalized schizophrenic patients(male=263, female=156) were recruited for this study. They were treated with antipsychotics for more than 3 months. The prevalence of tardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale. Results : The prevalence of tardive dyskinesia was 35.6%(Male=36.9%, Female 33.3%). There were no significant differences in the prevalence of tardive dyskinesia among male and female schizophrenic patients. The prevalence of tardive dyskinesia among the patients over 30years old was much higher than those below 30years old. There were no significant correlations between the prevalence of tardive dyskinesia and the duration of hospitalization, the total amount of antipsychotics. The frequently involved parts of the body in the schizophrenic patients who have tardive dyskinesia were tongue, upper extremity, lips and perioral area, jaw, lower extremity, muscles of facial expression trunk, respectively. Conclusions : There was significant correlation between the age and the prevalence of tardive dyskinesia in the antipsychotic-treated schizophrenic patients. There were no correlations between the prevalence of tardive dyskinesia and gender difference, the duration of hospitalization, the total amount of antipsychotics.

• Korean Journal of Biological Psychiatry
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• v.11 no.1
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• pp.54-60
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• 2004

Objectives:Tardive dyskinesia(TD) is a serious side effect associated with long-term antipsychotic treatments. Some candidate genetic polymorphisms were reported to be associated with TD and possible involvement of serotonergic receptors in the pathophysiology of TD has been suggested. In the present study, we investigated the association between $5-HT_6$ receptor gene polymorphism and TD with schizophrenia. Methods:To investigate the relationship between $5-HT_6$ receptor gene polymorphism and TD, 60 patients with TD were compared with 60 patients without TD. The 267C/T allele of $5-HT_6$ receptor gene was genotyped by means of polymerase chain reaction method. TD was evaluated using the Abnormal Involuntary Movement Scale(AIMS). Results:The patients with the three 267C/T genotype showed no significant differences in age, gender, and duration of illness. No significant difference in genotype frequencies was observed between schizophrenic patients with and without TD. In addition, there was no difference in allele frequencies. Further analysis with an measure of AIMS scores showed that these scores were not significantly influenced by the $5-HT_6$ receptor gene polymorphism. Conclusion:These results suggest that 267C/T polymorphism of $5-HT_6$ receptor gene is not significantly associated with susceptibility to TD in schizophrenia.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.853-861
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• 2017

Objectives: The objective of this study was to report a clinical case that suggests potential beneficial effects of Korean medicine therapy for the treatment of levosulpiride-induced acute dyskinesia. Methods: A patient having drug-induced acute dyskinesia was given a series of Korean medicine therapy treatments, including administration of the herbal medicine Chengsimyeonja-tang-gamibang, acupuncture, electroacupuncture, pharmacopuncture, and moxibustion over the 17 days of the hospitalization period. During the therapy, the progression of the disease was measured by the Abnormal Involuntary Movement Scale (AIMS). Results: During the therapy, the remission of orofacial dyskinesia and improvement of AIMS scores were observed. Conclusion: Korean medicine therapy has potential benefits for the treatment of drug-induced acute dyskinesia.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.381-388
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• 2016

Objective: This clinical study reports on the effect of Korean medicine on a patient with drug-induced Parkinsonism.Method: We used herbal medicine (Yigan-san), acupuncture, moxibustion, pharmacopuncture, and bee venom acupuncture to treat a patient with drug-induced Parkinsonism during hospitalization for 11 days. We observed the changes of symptoms using the unified Parkinson’s disease rating scale (UPDRS), the abnormal involuntary movement scale (AIMS), and the Beck depression inventory (BDI).Results: After treatment, the patient’s symptoms showed improvement in tremor, gait disturbance, and general condition. The UPDRS, AIMS, and BDI scores were also improved after treatment.Conclusion: This clinical case study suggests that traditional Korean medicine treatment could be effective in the treatment of drug-induced Parkinsonism.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.523-530
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• 2020

Objectives: This report presents a case of late onset chorea hyperglycemia basal ganglia syndrome treated using traditional Korean medicine therapies. Methods: A patient was treated with Korean medicine therapies, including the herbal medication, Yokukan-san. We evaluated the improvements in the patient's symptoms based on the total score of the Abnormal Involuntary Movement Scale, the activities of daily living portion of the Universidade Federal de Minas Gerais (UFMG) Sydenham's Chorea Rating Scale, the numeric rating scale, and an assessment of the patient's writing. Results: After undergoing Korean medicine treatment for 15 days, there were improvements in the patient's chorea and writing as well as a decrease in the scores for all three scales. Conclusions: This clinical case study suggests that Yokukan-san might be effective for treating dyskinesia in patients with chorea hyperglycemia basal ganglia syndrome.

• Korean Journal of Biological Psychiatry
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• v.25 no.4
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• pp.110-117
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• 2018

Objectives This study aimed to investigate the relationship between depressive and anxiety symptoms and tardive dyskinesia (TD) and reveal the association of cognitive function and TD in patients with schizophrenia. Methods We recruited 30 schizophrenia patients with TD and 31 without TD from a national mental hospital in South Korea. To assess depressive and anxiety symptoms, the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) were conducted. Using the five-factor structure of the BDI-II and BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety were assessed. Computerized neurocognitive function test (CNT) was performed to assess levels of cognitive functions. We compared the clinical characteristics, levels of cognitive functions, and depressive and anxiety symptoms between schizophrenia patients with TD and without TD. Chi-square test, Fisher's exact test, independent t-test and Mann Whitney U test were conducted to compare two groups. Pearson correlation analysis was conducted to evaluate relationships among the abnormal involuntary movement scale (AIMS), BDI-II, BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety. Results The subjects with TD had significantly lower score on the cognitive depression than those without TD (t = -2.087, p = 0.041). There were significant correlations between the AIMS score and the BDI-II score (r = -0.386, p = 0.035) and between the AIMS score and cognitive depression score (r = - 0.385, p = 0.035). Conclusions Our findings suggest the inverse relationship between severities in TD and depression and support the assumption that there is an inverse relationship between the pathophysiology of TD and depression.