Group differences in nonmotor manifestations based on the KVSS II TDI score (*<i>P</i> = 0.029; **<i>P</i> = 0.046, chi-square test or Fisher's exact test, as appropriate).

<p>(<b>A</b>) all PD patients. (<b>B</b>) <i>de novo</i> PD patients.</p

Demographics and clinical profiles of the PD patients.

<p>Data are shown as means (standard deviation) unless otherwise indicated. <i>P</i>-values are from Student's <i>t</i>-test for continuous measures or Mann-Whitney <i>U</i> test for ordinal data. PD, Parkinson's disease; LEDD, levodopa equivalent daily dose; KVSS, Korean version of the sniffin' stick; TDI, threshold-discrimination-identification.</p

Dendrogram of the hierarchical cluster analysis and multiscale bootstrap resampling results of nonmotor features of Parkinson's disease (PD).

<p>The clusters with an approximately unbiased (AU, red) <i>P</i>-value>95% are highlighted by the red dashed rectangles. (<b>A</b>) all PD patients. (<b>B</b>) <i>de novo</i> PD patients.</p

Data_Sheet_1_Measuring Anxiety in Patients With Early-Stage Parkinson's Disease: Rasch Analysis of the State-Trait Anxiety Inventory.docx

The State-Trait Anxiety Inventory (STAI), composed of two 20-item subscales (STAI-state and STAI-trait), has been increasingly used to assess anxiety symptoms in patients with Parkinson's disease (PD). However, the clinimetric attributes of the STAI under the statistical framework of the item-response theory (IRT) have not been fully elucidated within this population to date. We performed an IRT-based Rasch analysis of the STAI outcomes of patients with de novo PD from the Parkinson's Progression Markers Initiative database. The unidimensionality, Rasch model fit, scale targeting, separation reliability, differential item functioning, and response category utility of the STAI were statistically evaluated. A total of 326 (209 males, 117 females) patients without cognitive dysfunction were enrolled in our study. The original versions of the STAI-state and STAI-trait had acceptable separation reliability but lacked appropriate response category functioning, exhibited scale off-targeting, and several items demonstrated poor fit to the Rasch model. The response categories were reduced from four to three, and the rescored three-point TASI-trait demonstrated a marked improvement in clinimetric properties without a significant impact on unidimensionality and separation reliability. The rescored three-point version of the STAI-state required the additional removal of four misfitting items in order to improve the Rasch model fit. To our knowledge, this is the first study to assess the measurement properties based on the IRT of the STAI in patients with PD. Our Rasch analysis identified the components requiring possible amendments in order to improve the clinimetric attributes of the STAI.</p

Effects of the Arrangement of a Distal Catalytic Residue on Regioselectivity and Reactivity in the Coupled Oxidation of Sperm Whale Myoglobin Mutants

The coupled oxidations of sperm whale myoglobin (Mb) mutants are performed to examine active site residues controlling the regiospecific heme degradation. HPLC analysis of biliverdin isomers shows that L29H/H64L Mb almost exclusively gives biliverdin IXγ, although H64L and wild-type Mb mainly afford the α-isomer. Relocation of the distal histidine at the 43 and 107 positions increases the amount of γ-isomer to 44 and 22%, respectively. Interestingly, the increase in the ratio of γ-isomer is also observed by a single replacement of either His-64 with Asp or Phe-43 with Trp. It appears that the polarity of the active site as well as hydrogen bonding between oxygen molecule bound to the heme iron and His or Trp is important in controlling the regioselectivity. The results of coupled oxidation kinetics, autoxidation kinetics, and redox potential of the Fe3+/Fe2+ couple are discussed with regard to their implications for the active site and mechanism of heme oxygenase

Bilateral Deep Brain Stimulation of the Subthalamic Nucleus under Sedation with Propofol and Fentanyl

<div><p>Awakening during deep brain stimulation (DBS) surgery may be stressful to patients. The aim of the current study was to evaluate the effect on MER signals and their applicability to subthalmic nucleus (STN) DBS surgery for patients with Parkinson’s disease (PD) under sedation with propofol and fentanyl. Sixteen consecutive patients with PD underwent STN-DBS surgery with propofol and fentanyl. Their MER signals were achieved during the surgery. To identify the microelectrodes positions, the preoperative MRI and postoperative CT were used. Clinical profiles were also collected at the baseline and at 6 months after surgery. All the signals were slightly attenuated and contained only bursting patterns, compared with our previous report. All electrodes were mostly located in the middle one third part of the STN on both sides of the brain in the fused images. Six months later, the patients were improved significantly in the medication-off state and they met with less dyskinesia and less off-duration. Our study revealed that the sedation with propofol and fentanyl was applicable to STN-DBS surgery. There were no significant problems in precise positioning of bilateral electrodes. The surgery also improved significantly clinical outcomes in 6-month follow-up.</p></div

Overall movement and disability scales in the patients with <i>DYT</i>-1 dystonia, PKAN, and tardive dystonia.

<p>Patients with <i>DYT</i>-1 dystonia showed an abrupt decrease in motor and disability scores, and a sustained improved state during the follow-up period. Patients with <i>PKAN</i> had relatively higher motor and disability scores preoperatively. But some patients showed substantial improvement in motor score over time; 2 patients acquired improvement which appeared even after postoperative 12 months without resetting (indicated as asterisks). Tardive dystonia patients experienced no considerable improvement in motor and disability scores, except for 1 patient. (PKAN: pantothenate kinase-associated neurodegeneration)</p

Typical bursting patterns from microelectrode recording.

<p>Typical bursting patterns from microelectrode recording.</p

Characteristics of signals on microelectrode recording.

<p>Characteristics of signals on microelectrode recording.</p

Data_Sheet_1_Movement Disorders Associated With Cerebral Artery Stenosis: A Nationwide Study.PDF

BackgroundStudies of secondary movement disorder (MD) caused by cerebrovascular diseases have primarily focused on post-stroke MD. However, MD can also result from cerebral artery stenosis (CAS) without clinical manifestations of stroke. In this study, we aimed to investigate the clinical characteristics of MD associated with CAS.Materials and MethodsA nationwide multicenter retrospective analysis was performed based on the data from patients with CAS-associated MDs from 16 MD specialized clinics in South Korea, available between January 1999 and September 2019. CAS was defined as the >50% luminal stenosis of the major cerebral arteries. The association between MD and CAS was determined by MD specialists using pre-defined clinical criteria. The collected clinical information included baseline demographics, features of MD, characteristics of CAS, treatment, and MD outcomes. Statistical analyses were performed to identify factors associated with the MD outcomes.ResultsThe data from a total of 81 patients with CAS-associated MD were analyzed. The mean age of MD onset was 60.5 ± 19.7 years. Chorea was the most common MD (57%), followed by tremor/limb-shaking, myoclonus, and dystonia. Atherosclerosis was the most common etiology of CAS (78%), with the remaining cases attributed to moyamoya disease (MMD). Relative to patients with atherosclerosis, those with MMD developed MD at a younger age (p ConclusionsThis study highlights the spectrum of CAS-associated with MD across the country. A progressive, age-dependent functional neuronal modulation in the basal ganglia due to CAS may underlie this condition.</p