• 한국임상약학회지
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• 제28권4호
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• pp.285-292
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• 2018

Background: Long-term levodopa therapy relieves the motor dysfunction associated with Parkinson's disease (PD), but has various effects on non-motor symptoms, including cognitive dysfunction, hallucinations, and affective disorders, and can exacerbate certain aspects of dementia-like cognitive dysfunction. Here, we investigated the relationship between levodopa treatment and development of dementia in patients with PD. Methods: This retrospective study analyzed 76 consecutive patients with PD who had taken levodopa between 2011 and 2015. The participants were initially free of dementia and had initial daily levodopa doses of below 600 mg. Patients who did and did not develop comorbid dementia were compared in terms of potential predictor variables, including PD onset age, sex, levodopa doses, and non-dementia comorbidities. Results: Of the 76 patients, 21 (27.6%) developed dementia, which was followed by hallucinations and insomnia. The independent predictors of incident dementia were PD onset age and second-year and third-year average levodopa doses that were higher than the first-year average levodopa dose. Patients who developed dementia had significantly higher average daily levodopa doses and levodopa dose increases over the 6-year treatment period than those who did not develop dementia. In addition, patients with higher levodopa doses were more likely to experience hallucinations. Conclusion: These results suggest that increases in levodopa doses may be associated with a greater risk of cognitive impairment in patients with PD. Therefore, motor and cognitive functions and levodopa dose increases should be evaluated regularly during long-term levodopa therapy in patients with PD.

• Biomolecules & Therapeutics
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• 제20권2호
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• pp.133-143
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• 2012

Matrix metalloproteinases (MMPs) are a subfamily of zinc-dependent proteases that are re-sponsible for degradation and remodeling of extracellular matrix proteins. The activity of MMPs is tightly regulated at several levels including cleavage of prodomain, allosteric activation, com-partmentalization and complex formation with tissue inhibitor of metalloproteinases (TIMPs). In the central nervous system (CNS), MMPs play a wide variety of roles ranging from brain devel-opment, synaptic plasticity and repair after injury to the pathogenesis of various brain disorders. Following general discussion on the domain structure and the regulation of activity of MMPs, we emphasize their implication in various brain disorder conditions such as Alzheimer's disease, multiple sclerosis, ischemia/reperfusion and Parkinson's disease. We further highlight accumu-lating evidence that MMPs might be the culprit in Parkinson's disease (PD). Among them, MMP-3 appears to be involved in a range of pathogenesis processes in PD including neuroinflamma-tion, apoptosis and degradation of ${\alpha}$-synuclein and DJ-1. MMP inhibitors could represent poten-tial novel therapeutic strategies for treatments of neurodegenerative diseases.

• 한국자기공명학회논문지
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• 제7권1호
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• pp.1-15
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• 2003

PURPOSE - To investigate neurometabolism from the brain destructive lesions and striatal putamen-pallidus regions to the clinically worst side in patients with Parkinson's disease after stereotactic functional neurosurgery. METHODS - Using proton magnetic resonance spectroscopy ($^1$H MRS), fifteen patients (7 males and 8 females; mean age 56.5 years; age range 43-67 years) with Parkinson's disease (PD) were studied to measure N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho) and lactate (Lac) levels on the neurosurgical lesions of thalamus, globus pallidus and striatal putamen-pallidus regions in a brain. RESULTS - Brain destructive lesion and striatal putamen-pallidus region in PD compared with controls were highly and significantly related to NAA/Cho ratios reduction, respectively (P =0.002, P =0.04), but showed no difference from the same regions of PD prior to neurosergery (P =0.06, P =0.77). Increased lactate peaks at 1.3 ppm were present in all the cerebral lesions, and these resonances were confirmed at a long TE =136 ms, indicating that these signals distinguished from lipids. CONCLUSIONS - Our results suggest that NAA/Cho ratios may provide as a neurometabolite marker for neurochemical changes in brain surgical lesion, and the ratios might be related to functional change of neuropathophysiological status in the striatal putamen-pallidus region of PD. Increase of lactate signals, being remarkable in surgical lesions, could be consistent with a common consequence of surgical necrosis. Therefore, MR spectroscopy could be a sensitive diagnostic tool in monitoring neurometabolic changes in PD with neurosurgical treatment.

• 성인간호학회지
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• 제27권2호
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• pp.223-232
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• 2015

Purpose: Parkinson's disease (PD) has a high incidence of psychiatric comorbidity, specifically depression and anxiety. This study examined the effectiveness of group cognitive behavioral therapy (CBT) in treating depression and anxiety. Methods: The study included 42 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression and anxiety. Patients were attending a department of outpatient neurology at D University Schools of Medicine in B Metropolitan city. A structured telephone-administered cognitive behavioral therapy was conducted for eight weeks. A repeated measure ANOVA was used to analyze results at pretest, post-test, and four weeks follow up. Results: According to service method, there were significant differences between the two groups in depression, anxiety and stigma was significant difference between time (p<.05). Analysis of the interaction between time and service method revealed significant differences in depression and anxiety (p<.05). Conclusion: The results suggest that telephone-administered cognitive behavioral therapy may be effective and may provide opportunity to adapt to individual needs for treating depression and anxiety in patients with Parkinson's disease.

• 대한한방내과학회지
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• 제41권6호
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• pp.1141-1161
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• 2020

Objectives: Parkinson's disease (PD) is a neurodegenerative disease of the elderly characterized by impaired behavior from lack of dopamine secretion. However, no accurate quantitative diagnosis method has been established. The purpose of this study was to analyze the patent trends (PTs) of health examination and daily monitoring/healthcare technology for PD. Methods: For analyzing PTs, a search summary for classifying each analysis target technology was set, and a final search formula was constructed by collecting keywords. After constructing a database of related patents through the final search formula, noise was removed to extract valid patents. PTs by major countries were analyzed using the valid patents, and PTs and growth stages were analyzed by the detailed technologies. Results: The survey analysis showed that, despite the existence of unpublished patents between 2018 and 2020, patent activity has increased rapidly in the recent period, and this increasing trend was led by the USA. This technology is considered to be in its early- or mid-stage growth period, which means that the marketability is high and the barriers are low. Korea's market share is only about 25%, but it has a larger number of applications than those of Europe and Japan. Integrated monitoring and diagnosis technologies for PD have a share of 34%. Conclusion: The advances in diagnosis and healthcare technology for PD means that traditional Korean medicine must continue to pay attention to related technologies and to review plans that are applicable to clinical practice.

• 대한의용생체공학회:의공학회지
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• 제31권3호
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• pp.240-244
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• 2010

The purpose of this study is to compare finger tapping (FT) movement of patients with Parkinson's disease (PD) with normal subjects. A gyrosensor system was used for the measurement of FT movement, because it provides angular velocity free from the gravitational artifact and it can be used during clinical FT test listed in unified PD rating scale (UPDRS). Forty PD patients (age: 65.7 ${\pm}$ 11.1 yrs, H&Y stage:2.3 ${\pm}$ 0.5), 14 age-matched elderly subjects (65${\pm}$3.9 yrs) and 17 healthy young subjects (24${\pm}$2.1yrs) participated in this study. Angular velocity of finger tapping movement was measured in both right and left index finger. As quantitative measures, root-mean-squared (RMS) angular velocity, RMS angle, peak power and total power were used. ANOVA showed that all measures were significantly different among three groups (p<0.001) in all quantitative measures. Post-hoc test revealed that all quantitative measures except peak power in patients with PD were significantly smaller than in both healthy elderly and young subjects (p<0.01). This suggests that the measures developed in this study can distinguish patients with PD from normal subjects.

• 한국전문물리치료학회지
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• 제14권4호
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• pp.44-49
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• 2007

The purpose of this study was to investigate the effects of auditory cues in the form of a metronome on gait initiation (GI) in Parkinson's disease (PD). 2 patients (mean age: 54 yrs) with idiopathic PD participated in the study. All patients (Hoehn and Yahr disability score of 2.0) were tested in the "on" state approximately 1.5 hours following the administration and fully responding to their PD medications. Subjects first initiated walking at self-initiated speeds to determine their cadences. Then, subjects were asked to initiate gait along the walkway while keeping pace with a metronome. The metronome rate (in beats/min) was set at a cadence 85% (slow condition), 100% (normal condition) and 115% (fast condition) of gait for each subject. Subjects were able to increase the speed of GI with faster cadence, but the speed of GI for the slow condition was similar to that of the normal condition. Swing toe-off was 578.3 ms for the fast condition, 709.4 ms for the normal condition and 736.2 ms for the slow condition. Respective times for swing heel-strike were 894.3 ms, 1110.2 ms and 1119.1 ms, and stance toe-off were 1105.4 ms, 1338.5 ms, and 1343.1 ms. Except for stance unloading ground reaction forces were greatest for the fast condition and smallest for the slow condition. It appears that PD patients were able to modulate GRFs and temporal events in response to auditory cues to achieve the peak acceleration force of the swing and stance limb. The findings from this study provided preliminary data, which could be used to investigate how PD patients modulate GRFs and temporal events during GI in response to tasks.

• 대한한의학회지
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• 제43권4호
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• pp.8-19
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• 2022

Objectives: Parkinson's disease (PD) patients experience various non-motor symptoms, among which constipation is the second most common after anosmia. However, there are no clear guidelines or effective treatment for constipation in PD. Methods: To investigate the efficacy of Majainhwan (MH) on constipation in patients with PD, we conducted a retrospective chart review study of PD or Parkinsonism patients with constipation who received outpatient or inpatient treatment and whose previous laxatives were replaced by MH from August 2016 to July 2019. Results: In this study, a total of 68 patients' medical records were reviewed. Among the 44 outpatients with MH treatment, "effective" results were observed in 86.4% patients. Similarly, among the 24 inpatients, "effective" results were noted in 95.8% patients. The adverse effect was "diarrhea" reported in five cases. Conclusion: Based on these findings, we could suggest that MH is relatively safe and may be effective in the treatment of constipation in patients with PD.

• 한국음향학회지
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• 제41권6호
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• pp.655-661
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• 2022

파킨슨병 환자에게는 언어 장애가 만연하기 때문에 이러한 환자에게 적합한 음성인식 시스템이 필요하다. 본 논문에서는 파킨슨병 환자의 음성을 효과적으로 인식하는 음성인식 시스템을 제안한다. 음성인식 시스템은 먼저 건강한 사람의 음성 데이터를 사용하여 Globalformer를 사전 학습한 다음 상대적으로 매우 작은 양의 파킨슨병 환자의 음성 데이터를 사용하여 Globalformer를 미세 조정한다. 실험에는 AI 허브에서 구축한 건강한 사람의 음성 데이터셋과 인하대병원에서 수집한 파킨슨병 환자의 음성 데이터셋이 사용되어졌다. 실험 결과 제안된 음성인식 시스템은 22.15 %의 Character Error Rate(CER)으로 파킨슨병 환자의 음성을 인식하였으며, 다른 방법에 비해 우수한 인식률을 보였다.

• Journal of Acupuncture Research
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• 제41권1호
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• pp.29-52
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• 2024

The aim of this review is to consolidate findings from clinical investigations spanning the past decade regarding the impact of acupuncture on Parkinson's disease (PD). The objective is to assess the efficacy of acupuncture as a therapeutic approach to PD, with the intention of informing future clinical practices and advancing the foundation for subsequent research endeavors in this area. A comprehensive literature search was conducted to identify clinical trials exploring the effects of acupuncture on PD between January 2014 and August 2023. Databases search included PubMed, EMBASE, CNKI, OASIS, KISS, KMBASE, RISS, and ScienceON. Quantitative evidence from randomized controlled trials (RCTs) was systematically reviewed, and the methodological quality of the included studies was assessed using Cochrane's risk of bias tool. Meta-analysis was performed using Review Manager (RevMan) 5.4.1 software. The systematic review encompassed a total of 38 RCTs involving 2,786 participants. Meta-analysis of 12 studies revealed that individuals treated with a combination of acupuncture and Western medicine exhibited notable improvements compared to those receiving Western medicine alone or sham acupuncture alongside Western medicine. However, the overall quality of the RCTs was deemed low, and no serious adverse events were reported. Across clinical investigations conducted in the past decade, acupuncture appears to hold promise as a complementary treatment for PD patients when administered alongside Western medicine. Nevertheless, this study identifies certain limitations that warrant consideration in future research endeavors. Enhanced emphasis on conducting high-quality RCTs is imperative to comprehensively evaluate the efficacy of acupuncture in managing PD.