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Parkinson Disease: HELP
Articles by Chae-Won Shin
Based on 20 articles published since 2010
(Why 20 articles?)
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Between 2010 and 2020, Chaewon Shin wrote the following 20 articles about Parkinson Disease.
 
+ Citations + Abstracts
1 Review REM sleep behavior disorder portends poor prognosis in Parkinson's disease: A systematic review. 2018

Kim, Yoon / Kim, Young Eun / Park, Eun Ok / Shin, Chae Won / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, South Korea. · Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea. · Department of Neurology, Kyung Hee University Medical Center, Seoul, South Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: brain@snu.ac.kr. ·J Clin Neurosci · Pubmed #29102236.

ABSTRACT: REM sleep behavior disorder (RBD) is a parasomnia wherein a loss of REM sleep atonia manifests as dream-enactment, often violent. Aside from its significance as a predictor of PD, RBD in PD may imply more than merely screaming at night and experiencing sleep fragmentation. To probe its significance as a prognostic factor in PD, we performed a systematic literature review. Analysis of prospective studies reveals baseline RBD confers a higher risk of developing dementia and hallucinations. In cross-sectional studies, RBD is associated with the non-tremor predominant motor phenotype and autonomic dysfunction. Clinical, imaging, and autopsy studies support the presence of dense and diffuse pathology extending beyond the brainstem in PD with RBD. As RBD in PD is associated with a greater disease burden and an increased risk of mortality, we propose the RBD subtype in PD to highlight that RBD may mark a distinct subtype with relatively poor prognosis.

2 Review Predictors of the placebo response in clinical trials on Parkinson's disease: A meta-analysis. 2016

Shin, Chae Won / Hahn, Seokyung / Park, Byung-Joo / Kim, Jong-Min / Park, Eun Ok / Jeon, Beomseok. ·Departments of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Seoul, Republic of Korea. · Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea. · Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. · Department of Neurology, Seoul National University Bundang Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #27237106.

ABSTRACT: INTRODUCTION: Previous studies have assessed the placebo response in clinical trials on PD using the individual data of participants from the placebo-assigned group. The aim of this study was to examine the group predictors of the placebo response in randomized placebo-controlled trials on PD using a meta-analysis with meta-regression models. METHODS: The placebo response was defined as the mean change in the UPDRS part III score from baseline to the primary efficacy end point in the placebo group. The impacts of the predictors were assessed with meta-regression analyses, and significant predictors were used in a multivariable analysis. Subgroup analyses were conducted in studies that enrolled PD patients with or without motor fluctuations. RESULTS: Forty-eight studies (consisting of 5618 participants on placebo) were included. Motor fluctuation and baseline UPDRS part III score were significant predictors in the univariable analyses. The high baseline UPDRS part III score (β = -0.21, 95% CI -0.34, -0.08; p = 0.005) significantly increased the magnitude of the positive placebo response in the multivariable analysis. In the subgroup analyses, the positive placebo response was significant only in studies that enrolled patients with motor fluctuations; high baseline UPDRS part III score and low baseline daily levodopa dose increased the positive placebo response independently in the subgroup with motor fluctuations. CONCLUSION: Researchers should consider the positive placebo response when they design clinical trials in advanced PD patients with motor fluctuations and severe motor symptoms. Baseline daily levodopa dose may be the independent predictor in studies that enrolled fluctuating patients.

3 Article Asymmetric dynamic center-of-pressure in Parkinson's disease. 2020

Shin, Chaewon / Ahn, Tae-Beom. ·Department of Neurology, Chungnam National University Hospital, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. · Department of Neurology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: taebeom.ahn@khu.ac.kr. ·J Neurol Sci · Pubmed #31710970.

ABSTRACT: BACKGROUND: Gait disturbance gradually worsens as Parkinson's disease (PD) progresses, which significantly affects the quality of life of PD patients. Treadmill-based gait analysis systems can measure gait parameters including the dynamic center-of-pressure (COP) trajectory during ambulation. In this study, we hypothesized that altered dynamic COP changes are new gait characteristics for PD patients. METHODS: Dynamic COP parameters and classic spatiotemporal parameters were obtained for each patient using a treadmill-based system at the maximal comfortable treadmill speed (MCTS). We compared dynamic COP parameters between 44 PD patients and 31 controls, correlated these parameters with clinical and spatiotemporal data, and adjusted for age and MCTS to determine whether the parameters were independent from the treadmill speed. We also evaluated characteristics of COP parameters in relation to the more and less affected sides in PD patients. RESULTS: During treadmill walking the length of the COP trajectory in the stance phase was decreased, an effect that was more prominent on the more affected side in PD patients. COP parameters related to this change were significantly altered in patients when compared to controls. Asymmetry of the COP trajectories compared between both feet was identified as a significant gait characteristic after adjusting for age and MCTS. The overlaid graphical display of dynamic COP trajectory in PD patients showed "distorted butterfly with asymmetric wing" feature. CONCLUSION: Dynamic COP asymmetry provides a new and intuitive way to analyze gait abnormalities of PD patients. Further studies with prospective designs will substantiate the clinical usefulness of this feature of gait.

4 Article Nonmotor and Dopamine Transporter Change in REM Sleep Behavior Disorder by Olfactory Impairment. 2019

Lee, Jee-Young / Yoon, Eun Jin / Kim, Yu Kyeong / Shin, Chae Won / Nam, Hyunwoo / Jeong, Jae Min / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. · Department of Neurology, Seoul National University College of Medicine, Seoul, Korea. · Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. · Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea. · Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea. · Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea. · Department of Neurology and Movement Disorders Center, Seoul National University Hospital, Seoul, Korea. ·J Mov Disord · Pubmed #31158943.

ABSTRACT: OBJECTIVE: It is unclear whether the decline in dopamine transporters (DAT) differs among idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with different levels of olfactory impairment. This study aimed to characterize DAT changes in relation to nonmotor features in iRBD patients by olfactory loss. METHODS: This prospective cohort study consisted of three age-matched groups: 30 polysomnography-confirmed iRBD patients, 30 drug-naïve Parkinson's disease patients, and 19 healthy controls without olfactory impairment. The iRBD group was divided into two groups based on olfactory testing results. Participants were evaluated for reported prodromal markers and then underwent 18F-FP-CIT positron emission tomography and 3T MRI. Tracer uptakes were analyzed in the caudate, anterior and posterior putamen, substantia nigra, and raphe nuclei. RESULTS: Olfactory impairment was defined in 38.5% of iRBD patients. Mild parkinsonian signs and cognitive functions were not different between the two iRBD subgroups; however, additional prodromal features, constipation, and urinary and sexual dysfunctions were found in iRBD patients with olfactory impairment but not in those without. Tracer uptake showed significant group differences in all brain regions, except the raphe nuclei. The iRBD patients with olfactory impairment had uptake reductions in the anterior and posterior putamen, caudate, and substantia nigra (p < 0.016 in all, adjusted for age), which ranged from 0.6 to 0.8 of age-normative values. In contrast, those without olfactory impairment had insignificant changes in all regions ranging above 0.8. CONCLUSION: There was a clear distinction in DAT loss and nonmotor profiles by olfactory status in iRBD.

5 Article Prospective cohort study of patients with early gastric cancer to detect prodromal Parkinson disease (EGC-PPD): A study protocol and baseline characteristics. 2019

Shin, Chaewon / Yang, Han-Kwang / Park, SungHye / Lee, Hyuk-Joon / Kong, Seong-Ho / Suh, Yun-Suhk / Huh, Yeon-Ju / Kim, Yun-Jeong / Park, So-Yong / Ahn, Tae-Beom / Lee, Seok Hwa / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dondaemun-gu, Seoul, Republic of Korea. · Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Pathology, Seoul National University, College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Nursing, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr. ·J Clin Neurosci · Pubmed #31153750.

ABSTRACT: The aim of the current study is to determine the predictive value of alpha-synuclein (AS) aggregation in stomach surgical specimens in combination with selected clinical prodromal markers (CPMs) for development of Parkinson disease (PD) in a normal population. We organized a prospective, long-term, clinicopathologic cohort of patients without neurological diseases who received a radical operation for early gastric cancer (EGC) between ages 50 and 65 years. The participants will be followed for up to 10 years and screened for CPMs and motor symptoms by annual telephone interview. If a participant reports one or more positive answers to screening questions about motor symptoms, they will be regarded as having possible parkinsonism. A movement disorder specialist will then evaluate whether that participant has PD. The primary outcome is the development of PD during the 10-year follow-up. The recruitment period has been completed, and the baseline clinical characteristics are compared between participants with and without possible parkinsonism. A total of 718 participants (mean age: 60.1 ± 5.9) was recruited. The motor symptom screening questionnaire revealed 65 patients with possible parkinsonism (9.0%) at baseline. Patients with possible parkinsonism answered that they had subjective loss of smell more than those without parkinsonism at the time of recruitment (18.5% vs 8.3%) and operation (15.4% vs 6.3%). However, the objective odor discrimination test showed no difference between patients with and without possible parkinsonism. Baseline assessments revealed a sufficient number of patients with possible parkinsonism, which will be confirmed as PD or not in subsequent follow-up visits.

6 Article Clonazepam for probable REM sleep behavior disorder in Parkinson's disease: A randomized placebo-controlled trial. 2019

Shin, Chaewon / Park, Hyeyoung / Lee, Woong-Woo / Kim, Hyun-Jeong / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, Kyung Hee University Hospital, Seoul, Republic of Korea. · Department of Neurology, Seoul Central Clinic, Seoul, Republic of Korea. · Department of Neurology, Eulji General Hospital, 68 Hangeulbiseong-ro, Nowon-gu, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: movement@snu.ac.kr. ·J Neurol Sci · Pubmed #31035190.

ABSTRACT: BACKGROUND: Clonazepam is considered to be a first-line treatment for rapid eye movement sleep-related behavior disorder (RBD) in Parkinson's disease (PD). The purpose of this study was to determine the short-term efficacy and safety of clonazepam for the treatment of probable RBD (pRBD) in patients with PD. METHODS: We conducted a four-week, randomized, double-blind, placebo-controlled trial of clonazepam (0.5 mg/day at bedtime) compared to a placebo for RBD symptoms in patients with PD. Patients aged 30 years or older who had a caregiver that could observe RBD symptoms were recruited between April 2015 and February 2016. The primary outcome was the Clinical Global Impressions-Improvement (CGII) score at week four, and we compared scores between the clonazepam and placebo groups. RESULTS: A total of 40 patients were enrolled, with 20 assigned to receive clonazepam and 20 to receive the placebo. The CGI-I score at four weeks indicated an improvement in RBD symptoms in both the clonazepam (median score [minimum, maximum] = 2 [1,5]) and placebo (3 [1,6]) groups, with no significant difference between the groups (p = .253). The secondary outcomes were not significantly different between the clonazepam and placebo groups. CONCLUSIONS: Both clonazepam and placebo tended toward improvement on pRBD symptoms in patients with PD. No firm conclusion on efficacy of clonazepam was drawn due to limitations in the study design. This study emphasized the importance of conducting future large-scale, randomized trials with better assessment tools and polysomnography to provide evidence for the benefit of clonazepam.

7 Article Long-term effect of subthalamic nucleus deep brain stimulation on freezing of gait in Parkinson's disease. 2019

Kim, Ryul / Kim, Han-Joon / Shin, Chaewon / Park, Hyeyoung / Kim, Aryun / Paek, Sun Ha / Jeon, Beomseok. ·Departments of1Neurology and. · 2Department of Neurology, Aerospace Medical Center, Republic of Korea Air Force, Cheongju, Chungcheongbuk-do, Korea. · 3Department of Neurology, Kyung Hee University Hospital, Seoul; and. · 4Neurosurgery, Seoul National University Hospital, College of Medicine. ·J Neurosurg · Pubmed #30641837.

ABSTRACT: OBJECTIVE: Subthalamic nucleus deep brain stimulation (STN DBS) is effective against freezing of gait (FOG) in Parkinson's disease (PD); however, whether this effect persists over the long term is debated. The aim of the current study was to investigate the long-term effect of STN DBS on FOG in patients with PD. METHODS: Data on 52 cases in which PD patients received bilateral STN DBS were obtained from a prospective registry. The authors blindly analyzed FOG incidence and its severity from the videotapes of a 5-m walking task at the baseline and at the 1-, 2-, and 5- or 7-year follow-up visits. They also compared the axial score from the Unified Parkinson's Disease Rating Scale (UPDRS) part III, UPDRS part II (UPDRS-II) item 14, and the FOG questionnaire (FOG-Q). Postoperatively, video-based FOG analysis and the axial score were evaluated under 4 conditions (off-medication/off-stimulation, off-medication/on-stimulation, on-medication/off-stimulation, and on-medication/on-stimulation), and UPDRS-II item 14 and the FOG-Q score were evaluated under 2 conditions (off-medication/on-stimulation and on-medication/on-stimulation). RESULTS: During the off-medication state, the on-stimulation condition improved FOG outcomes, except for video-based FOG severity, up to the last follow-up compared with the baseline. Video-based FOG outcomes and the axial score during the off-medication state were improved with the on-stimulation condition up to the last follow-up compared with the off-stimulation condition. During the on-medication state, the on-stimulation condition did not improve any FOG outcome compared with the baseline; however, it improved video-based FOG outcomes up to the 2-year follow-up and the axial score up to the last follow-up compared with the off-stimulation condition. CONCLUSIONS: Our findings suggest that STN DBS has a long-term effect on FOG in the off-medication state. However, STN DBS did not show a long-term effect on FOG in the on-medication state, although it had a short-term effect until the 2-year follow-up.

8 Article Submandibular gland is a suitable site for alpha synuclein pathology in Parkinson disease. 2019

Shin, Junghwan / Park, Sung-Hye / Shin, Chaewon / Kim, Ji-Hoon / Yun, Tae Jin / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, Seoul National University Hospital, Seoul National University, Seoul, South Korea. · Department of Pathology, Seoul National University Hospital, Seoul National University, Seoul, South Korea. · Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea. · Department of Radiology, Seoul National University Hospital, Seoul National University, Seoul, South Korea. · Department of Neurology, Seoul National University Hospital, Seoul National University, Seoul, South Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #30340912.

ABSTRACT: OBJECTIVE: To validate the role of α-synuclein (AS) pathology in submandibular gland (SMG) as a biomarker for Parkinson disease (PD). METHODS: We performed ultrasonography (USG) guided core needle biopsy of SMG in PD patients and procured SMG biopsy tissues or surgical excision specimens from non-PD patients as controls. Then, we compared AS deposition in the SMG tissues between the PD patients and the controls. We recruited 16 PD patients in this study. In each individual, two core needle biopsy tissues were obtained from the left submandibular gland under USG guidance. Fourteen sex and age-matched controls who did not have PD and dementia but received a core needle biopsy or surgical resection of the SMG due to SMG diseases were procured from the pathology archive. Biopsy tissues and surgical specimens were immuno-stained with serine 129 phosphorylated AS (pAS) antibody for microscopic examination. pAS deposition in neural structures such as ganglion cells and neurites was considered as positive. RESULTS: No serious complication occurred during and after the SMG biopsy. We found glandular parenchyma and neural structures in all biopsied SMG tissues from the patients and the controls. Nine out of 16 PD patients (56.2%) were positive for pAS staining, while none of the controls were positive (0%). CONCLUSIONS: SMG core needle biopsy can reliably and safely obtain sufficient glandular parenchyma and neural structures to evaluate the α-synuclein pathology. AS pathology in SMG has high specificity and good sensitivity as a biomarker for PD.

9 Article A 7-year observation of the effect of subthalamic deep brain stimulation on impulse control disorder in patients with Parkinson's disease. 2018

Kim, Aryun / Kim, Young Eun / Kim, Han-Joon / Yun, Ji Young / Yang, Hui-Jun / Lee, Woong-Woo / Shin, Chae Won / Park, Hyeyoung / Jung, Yu Jin / Kim, Ahro / Ehm, Gwanhee / Kim, Yoon / Jang, Mihee / Jeon, Beomseok. ·Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. · Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea. · Department of Neurology, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea. · Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. · Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea. · Department of Neurology, Kyung Hee University Medical Center, Seoul, South Korea. · Department of Neurology, Seoul Central Clinic, Seoul, South Korea. · Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea. · Department of Neurology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea. · Department of Neurology, National Medical Center, Seoul, South Korea. · Department of Neurology, Jesus Hospital, Jeonju, South Korea. · Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #30054182.

ABSTRACT: INTRODUCTION: Previous studies have reported improvement of impulse control disorders (ICDs) after subthalamic nucleus (STN) deep brain stimulation (DBS) as well as some de novo ICDs. However, it is not clear how STN DBS changes ICDs in the long-term. METHODS MATERIALS: Eighty-nine patients with Parkinson's disease (PD) who had received a bilateral STN DBS from 2005 to 2009 and were included in our previous study were followed for 7 years with the modified Minnesota Impulsive Disorders Interview (mMIDI). Their mMIDI scores, medication, and frontal function tests measured preoperatively and at 1 and 7 years postoperatively were compared. RESULTS: A total of 61 patients were analyzed after excluding 10 and 18 patients due to death and lost to follow-up, respectively. The numbers of the patients with an ICD at each point were 8, 10, and 7, respectively. All preoperative ICDs disappeared after DBS. De novo ICDs within 1 year after DBS disappeared except for 1 patient. Six of the seven patients, who reported ICDs 7 years after the DBS developed that ICD between 1 and 7 years. Their total levodopa equivalent daily dose (LEDD) and dopamine agonist dose were not higher compared to the other 54 patients without ICDs. There was no correlation with the frontal lobe dysfunction and the electrode position in the subthalamus. CONCLUSION: STN DBS improves baseline ICDs and results in the development of "transient" de novo ICDs in the short-term. In addition, there is a unique group of the patients who develop ICDs a long time after DBS.

10 Article Amantadine and the Risk of Dyskinesia in Patients with Early Parkinson's Disease: An Open-Label, Pragmatic Trial. 2018

Kim, Aryun / Kim, Young Eun / Yun, Ji Young / Kim, Han-Joon / Yang, Hui-Jun / Lee, Woong-Woo / Shin, Chae Won / Park, Hyeyoung / Jung, Yu Jin / Kim, Ahro / Kim, Yoon / Jang, Mihee / Jeon, Beomseok. ·Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. · Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. · Department of Neurology, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea. · Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. · Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea. · Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea. · Department of Neurology, Seoul Central Clinic, Seoul, Korea. · Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea. · Department of Neurology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea. · Department of Neurology, Presbyterian Medical Center, Jeonju, Korea. ·J Mov Disord · Pubmed #29860788.

ABSTRACT: OBJECTIVE: We examined whether amantadine can prevent the development of dyskinesia. METHODS: Patients with drug-naïve Parkinson's disease (PD), younger than 70 years of age and in the early stage of PD (Hoehn and Yahr scale < 3), were recruited from April 2011 to December 2014. The exclusion criteria included the previous use of antiparkinsonian medication, the presence of dyskinesia, significant psychological disorders, and previous history of a hypersensitivity reaction. Patients were consecutively assigned to one of 3 treatment groups in an open label fashion: Group A-1, amantadine first and then levodopa when needed; Group A-2, amantadine first, dopamine agonist when needed, and then levodopa; and Group B, dopamine agonist first and then levodopa when needed. The primary endpoint was the development of dyskinesia, which was analyzed by the Kaplan-Meier survival rate. RESULTS: A total of 80 patients were enrolled: Group A-1 ( CONCLUSION: Amantadine as an initial treatment may decrease the incidence of dyskinesia in patients with drug-naïve PD.

11 Article Emergence of non-motor fluctuations with reference to motor fluctuations in Parkinson's disease. 2018

Kim, Aryun / Kim, Han-Joon / Shin, Chae Won / Kim, Ahro / Kim, Yoon / Jang, Mihee / Jung, Yu Jin / Lee, Woong-Woo / Park, Hyeyoung / Jeon, Beomseok. ·Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, South Korea. · Department of Neurology, Kyung Hee University Medical Center, Seoul, South Korea. · Department of Neurology, Catholic University of Korea, Seoul, South Korea. · Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea. · Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea. · Department of Neurology, Hallym Hospital, Incheon, South Korea. · Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #29724602.

ABSTRACT: INTRODUCTION: Non-motor fluctuations (NMF) and motor fluctuations (MF) are frequent in patients with Parkinson's disease (PD) with long-term medical treatment. We aimed to examine the timing of the emergence of NMF with reference to MF in a prospective cohort of patients with PD without symptom fluctuations. METHODS: A total of 334 patients with PD who had neither MF nor NMF were recruited. The exclusion criteria included a Mini-Mental State Examination score of less than 26 points at baseline and an alternative diagnosis or significant comorbidity during follow-up. The "SNUH-Fluctuation Questionnaire" consisting of 29 items (9 on MF and 20 on NMF) was administered on a semi-annually basis for 3 years. RESULTS: Three hundred seven out of 334 patients were analyzed for symptom fluctuations with the Kaplan-Meier survival analysis. MF were observed in more patients and developed earlier than NMF (cumulative survival of 0.572 for MF and 0.619 for NMF at 36 months of follow-up). In 212 patients who finished the follow-up for 36 months, MF and NMF developed simultaneously in 58 (27.4%), MF developed first in 45 (21.2%), and NMF developed first in only 3 (1.4%). The remaining 106 patients (50.0%) did not develop either MF or NMF. CONCLUSION: NMF developed simultaneously with or later than MF. From these data, we hypothesize that NMF develop in the disease state where the pathology in the brain has been severe enough to develop MF. Hence, pharmacologic management should consider targeting both dopaminergic and non-dopaminergic systems to treat NMF.

12 Article Validation of Freezing-of-Gait Monitoring Using Smartphone. 2018

Kim, Han Byul / Lee, Hong Ji / Lee, Woong Woo / Kim, Sang Kyong / Jeon, Hyo Seon / Park, Hye Young / Shin, Chae Won / Yi, Won Jin / Jeon, Beomseok / Park, Kwang S. ·1 Graduate Program of Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea. · 2 Department of Neurology, Eulji General Hospital , Seoul, Republic of Korea. · 3 Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul, Republic of Korea. · 4 Department of Neurology, Kyung Hee University Medical Center , Seoul, Republic of Korea. · 5 Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University , Seoul, Republic of Korea. · 6 Department of Biomedical Engineering, College of Medicine, Seoul National University , Seoul, Republic of Korea. ·Telemed J E Health · Pubmed #29708870.

ABSTRACT: BACKGROUND: Freezing of gait (FOG) is a commonly observed motor symptom for patients with Parkinson's disease (PD). The symptoms of FOG include reduced step lengths or motor blocks, even with an evident intention of walking. FOG should be monitored carefully because it not only lowers the patient's quality of life, but also significantly increases the risk of injury. INTRODUCTION: In previous studies, patients had to wear several sensors on the body and another computing device was needed to run the FOG detection algorithm. Moreover, the features used in the algorithm were based on low-level and hand-crafted features. In this study, we propose a FOG detection system based on a smartphone, which can be placed in the patient's daily wear, with a novel convolutional neural network (CNN). METHODS: The walking data of 32 PD patients were collected from the accelerometer and gyroscope embedded in the smartphone, located in the trouser pocket. The motion signals measured by the sensors were converted into the frequency domain and stacked into a 2D image for the CNN input. A specialized CNN model for FOG detection was determined through a validation process. RESULTS: We compared our performances with the results acquired by the previously reported settings. The proposed architecture discriminated the freezing events from the normal activities with an average sensitivity of 93.8% and a specificity of 90.1%. CONCLUSIONS: Using our methodology, the precise and continuous monitoring of freezing events with unconstrained sensing can assist patients in managing their chronic disease in daily life effectively.

13 Article Non-Motor Symptom Burdens Are Not Associated with Iron Accumulation in Early Parkinson's Disease: a Quantitative Susceptibility Mapping Study. 2018

Shin, Chaewon / Lee, Seon / Lee, Jee Young / Rhim, Jung Hyo / Park, Sun Won. ·Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea. · Department of Mechanical and Aerospace Engineering, Seoul National University, Seoul, Korea. · Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. · Department of Radiology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. · Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. swpark8802@gmail.com. ·J Korean Med Sci · Pubmed #29573246.

ABSTRACT: BACKGROUND: Quantitative susceptibility mapping (QSM) has been used to measure iron accumulation in the deep nuclei of patients with Parkinson's disease (PD). This study examined the relationship between non-motor symptoms (NMSs) and iron accumulation in the deep nuclei of patients with PD. METHODS: The QSM data were acquired from 3-Tesla magnetic resonance imaging (MRI) in 29 patients with early PD and 19 normal controls. The Korean version of the NMS scale (K-NMSS) was used for evaluation of NMSs in patients. The patients were divided into high NMS and low NMS groups. The region-of-interest analyses were performed in the following deep nuclei: red nucleus, substantia nigra pars compacta, substantia nigra pars reticulata, dentate nucleus, globus pallidus, putamen, and head of the caudate nucleus. RESULTS: Thirteen patients had high NMS scores (total K-NMSS score, mean = 32.1), and 16 had low NMS scores (10.6). The QSM values in the deep were not different among the patients with high NMS scores, low NMS scores, and controls. The QSM values were not correlated linearly with K-NMSS total score after adjusting the age at acquisition of brain MRI. CONCLUSION: The study demonstrated that the NMS burdens are not associated with iron accumulation in the deep nuclei of patients with PD. These results suggest that future neuroimaging studies on the pathology of NMSs in PD should use more specific and detailed clinical tools and recruit PD patients with severe NMSs.

14 Article Fundamental limit of alpha-synuclein pathology in gastrointestinal biopsy as a pathologic biomarker of Parkinson's disease: Comparison with surgical specimens. 2017

Shin, Chaewon / Park, Sung-Hye / Yun, Ji Young / Shin, Jung Hwan / Yang, Han-Kwang / Lee, Hyuk-Joon / Kong, Seong-Ho / Suh, Yun-Suhk / Shen, Guangxun / Kim, Yoon / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea. · Department of Pathology, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, Republic of Korea. · Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Guseong-dong, Yuseong-gu, Daejeon, Republic of Korea. · Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, China-Japan Union Hospital of Jilin University, 126 Xiantai St, Erdao Qu, Changchun Shi, Jilin Sheng, China. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #28923294.

ABSTRACT: OBJECTIVE: Alpha-synuclein (AS) accumulation identified by immunohistochemistry (IHC) of gastrointestinal (GI) tract biopsies is considered as a potential pathologic biomarker for Parkinson's disease (PD). We compared AS IHC findings in biopsy specimens and surgically resected full-depth specimens to examine the reliability of GI tract biopsies. METHODS: We included patients with PD who had undergone operation of the GI tract for treatment of tumors. Controls were matched with age at operation, gender, and surgical resection site. We compared AS accumulation using phosphorylated AS (pAS) IHC between patients and controls, and within individuals between surgical and biopsy specimens. RESULTS: A total of 33 patients with PD were categorized into either the stomach (N = 12) or colorectal group (N = 21). The frequency of pAS positivity in gastric surgical specimens was 58.3% (7/12) and 8.3% (1/12) in the patient and control groups, respectively (p = 0.027). The frequency of pAS positivity in colorectal surgical specimens was identical in the patient and control group (23.8% [5/21] in each). Intriguingly, immunostaining results for biopsy specimens were not concordant with those for surgical specimens. There was no significant difference in the frequency of pAS positivity in biopsy specimens between patients and controls (9.1% [2/22] vs 18.2% [4/22]; p = 0.664). INTERPRETATION: Our results demonstrate that AS accumulation identified via pAS IHC of GI biopsies is unreliable due to its low positive rates and poor concordance with surgical specimens, and that future studies investigating AS accumulation in the GI tract should target the stomach, rather than the colon or rectum.

15 Article Depression may negatively affect the change in freezing of gait following subthalamic nucleus stimulation in Parkinson's disease. 2017

Kim, Ryul / Kim, Han-Joon / Kim, Aryun / Kim, Yoon / Kim, Ah-Ro / Shin, Chae-Won / Paek, Sun Ha / Jeon, Beomseok. ·Department of Neurology, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea; Aerospace Medical Group, Air Force Education and Training Command, Jinju, Republic of Korea. · Department of Neurology, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea. · Department of Neurology, Kyung Hee University Hospital, Seoul, Republic of Korea. · Department of Neurosurgery, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea. · Department of Neurology, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #28830666.

ABSTRACT: OBJECTIVE: To assess the influence of preoperative depression on the change in freezing of gait (FOG) following subthalamic nucleus stimulation (STN-DBS) in patients with Parkinson's disease (PD). METHODS: One hundred and twelve PD patients were included who received bilateral STN-DBS. Of these, 33 had no preoperative depression (PD-ND) and the other 79 had preoperative depression (PD-D). Each PD-ND patient was matched with one PD-D patient by the propensity score for which sex, age at PD onset, disease duration, UPDRS-III score during off-medication state, levodopa-equivalent daily dose, and mini mental state examination were the independent variables. We compared both a FOG-questionnaire (FOG-Q) and the axial score from UPDRS-III between the two groups over 12-month follow-up. RESULTS: During the off-medication state, FOG-Q at 12-month was decreased with STN-DBS in both PD-ND (-52.9%, p < 0.001) and PD-D (-24.2%, p < 0.001) with a significant difference in the change of FOG in favor of PD-ND (p = 0.001). Similarly, there was an improvement in the axial score for both PD-ND (-66.1%, p < 0.001) and PD-D (-45.3%, p < 0.001) at 12-month with a significant difference between the groups. (p = 0.005). During the on-medication state, both the FOG-Q and axial score at 12-month were not improved with STN-DBS in the PD-ND and PD-D with no difference between the groups. CONCLUSIONS: Our findings suggest that preoperative depression negatively affects the outcome of FOG following STN-DBS in the off-medication state but not in the on-medication state.

16 Article Leukocyte glucocerebrosidase and β-hexosaminidase activity in sporadic and genetic Parkinson disease. 2016

Kim, Han-Joon / Jeon, Beomseok / Song, Junghan / Lee, Woong-Woo / Park, Hyeyoung / Shin, Chae-Won. ·Department of Neurology and Movement Disorder Center, Parkinson Study Group, and Neuroscience Research Institute, College of Medicine, Seoul National University, Seoul, South Korea. · Department of Neurology and Movement Disorder Center, Parkinson Study Group, and Neuroscience Research Institute, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: brain@snu.ac.kr. · Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. · Department of Neurology, Eulji General Hospital, Seoul, South Korea. ·Parkinsonism Relat Disord · Pubmed #26705847.

ABSTRACT: BACKGROUND: Recent reports have shown that the activities of lysosomal enzymes are altered in the CNS of sporadic PD (sPD) without GBA mutations. We hypothesized that the activities of lysosomal enzymes are altered in peripheral blood leukocytes (PBLs) of patients with sPD and other genetic parkinsonism. METHODS: Glucocerebrosidase and β-hexosaminidase activities in PBLs were measured in 36 patients with sPD, 5 PD patients with PARK2 mutations, 10 patients with spinocerebellar ataxia (SCA) 17 with parkinsonism, and 20 healthy controls. RESULTS: The glucocerebrosidase and β-hexosaminidase activities were not different in patients with sPD, PD with PARK2 mutations, and SCA17 with parkinsonism from those of the controls. In the patients with sPD, the activity of GCase was positively correlated with disease duration. CONCLUSION: The glucocerebrosidase and β-hexosaminidase activities in PBLs cannot be used as a biomarker in sPD and other genetic parkinsonism.

17 Article Unconstrained detection of freezing of Gait in Parkinson's disease patients using smartphone. 2015

Kim, Hanbyul / Lee, Hong Ji / Lee, Woongwoo / Kwon, Sungjun / Kim, Sang Kyong / Jeon, Hyo Seon / Park, Hyeyoung / Shin, Chae Won / Yi, Won Jin / Jeon, Beom S / Park, Kwang S. · ·Conf Proc IEEE Eng Med Biol Soc · Pubmed #26737109.

ABSTRACT: Freezing of gait (FOG) is a common motor impairment to suffer an inability to walk, experienced by Parkinson's disease (PD) patients. FOG interferes with daily activities and increases fall risk, which can cause severe health problems. We propose a novel smartphone-based system to detect FOG symptoms in an unconstrained way. The feasibility of single device to sense gait characteristic was tested on the various body positions such as ankle, trouser pocket, waist and chest pocket. Using measured data from accelerometer and gyroscope in the smartphone, machine learning algorithm was applied to classify freezing episodes from normal walking. The performance of AdaBoost.M1 classifier showed the best sensitivity of 86% at the waist, 84% and 81% in the trouser pocket and at the ankle respectively, which is comparable to the results of previous studies.

18 Article Putaminal abnormality on 3-T magnetic resonance imaging in early parkinsonism-predominant multiple system atrophy. 2010

Lee, Jee-Young / Yun, Ji Young / Shin, Chae-Won / Kim, Han-Joon / Jeon, Beom S. ·Department of Neurology, Seoul National University Boramae Hospital, Seoul, Korea. ·J Neurol · Pubmed #20652301.

ABSTRACT: To evaluate the diagnostic value of putaminal abnormality on 3-T magnetic resonance imaging (MRI) for differentiating early parkinsonism-predominant multiple system atrophy (MSA-p) from Parkinson disease (PD) based on long-term clinical follow-up data. Totals of 23 clinical MSA-p (6 possible and 17 suspicious) and 50 PD patients were included. Subjects submitted to 3-T MRI at baseline and were followed up to substantiate the initial diagnosis. MRI findings were compared between MSA-p and PD patients based on the final diagnosis. Putaminal abnormalities were recorded as presence of atrophy, signal hypointensity, and abnormal disruption of the hyperintense lateral rim of the putamen. The sum scores for putaminal abnormality were calculated from the presence of each item. During the follow-up over 3 years, the diagnosis of MSA-p was supported in 17 patients (14 probable and 3 possible) and the diagnosis of PD was stable in all 50 patients. Putaminal abnormalities were more frequent in MSA-p (n = 17) than in PD (n = 50). A sum score of >1 on 3-T MRI had sensitivity, specificity, and positive- and negative-predictive values of 70.6, 93, 77.4, and 90.3%, respectively, for differentiating MSA-p from PD. Fourteen of the initial 23 clinical MSA-p patients had a sum score of >1, and in all but two, the diagnosis became supported during the follow-up, whereas the diagnosis of five of the nine patients with a sum score of ≤1 remained uncertain. Putaminal abnormality on 3-T MRI can be a specific diagnostic marker for early stage MSA-p.

19 Minor Alpha-synuclein staining in non-neural structures of the gastrointestinal tract is non-specific in Parkinson disease. 2018

Shin, Chaewon / Park, Sung-Hye / Yun, Ji Young / Shin, Jung Hwan / Yang, Han-Kwang / Lee, Hyuk-Joon / Kong, Seong-Ho / Suh, Yun-Suhk / Kim, Han-Joon / Jeon, Beomseok. ·Department of Neurology, Kyung Hee University Hospital, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea. · Department of Pathology, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, Ewha Woman's University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, Republic of Korea. · Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Guseong-dong, Yuseong-gu, Daejeon, Republic of Korea. · Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. · Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr. ·Parkinsonism Relat Disord · Pubmed #30279061.

ABSTRACT: -- No abstract --

20 Minor Two Parkinson's disease patients with alpha-synuclein gene duplication and rapid cognitive decline. 2010

Shin, Chae Won / Kim, Hee Jin / Park, Sung Sup / Kim, Sung Yeun / Kim, Ji Yeon / Jeon, Beom Seok. · ·Mov Disord · Pubmed #20222138.

ABSTRACT: -- No abstract --