Myung sik lee’s scientific contributions in neurology and chorea anoxia at birth

[show abstract] [hide abstract] ABSTRACT: background

Rare patients have been reported who developed a mixture of gait disturbances following a focal lesion in the frontal lobe. Thus, the exact location of frontal lesion responsible for a specific gait disturbance is not well defined.

Case presentation

We describe a 47-year-old man who experienced two episodes of paroxysmal freezing of gait of the right leg. During the attacks, he had no motor weakness, sensory change, or disequilibrium. He had past history of panic attacks. Recently, he had been under severe emotional stress. T2 and diffusion brain magnetic resonance imaging scans were normal.


So far, the most likely clinical diagnosis might be functional freezing of gait.Anoxia at birth however, magnetic resonance angiography showed atherosclerosis in the proximal left anterior cerebral artery. Perfusion scans showed a delayed mean transit time in the left mesial frontal lobe. He developed two more attacks during the four months of follow up.

Conclusions

The presented case illustrates that the mesial frontal lobe may be important in the pathophysiology of freezing of gait. We speculate that the supplementary motor area may generate a neuronal command for the initiation of locomotion that in our case may have been inhibited by a transient ischemia.

[show abstract] [hide abstract] ABSTRACT: patients with carbon monoxide (CO) intoxication may develop ongoing neurological and psychiatric symptoms that ebb and flow, a condition often called delayed encephalopathy (DE).Anoxia at birth the association between morphologic changes in the brain and neuropsychological deficits in DE is poorly understood.

Magnetic resonance imaging and neuropsychological tests were conducted on 11 CO patients with DE, 11 patients without DE, and 15 age-, sex-, and education-matched healthy subjects. Differences in gray matter volume (GMV) between the subgroups were assessed and further correlated with diminished cognitive functioning.

As a group, the patients had lower regional GMV compared to controls in the following regions: basal ganglia, left claustrum, right amygdala, left hippocampus, parietal lobes, and left frontal lobe. The reduced GMV in the bilateral basal ganglia, left post-central gyrus, and left hippocampus correlated with decreased perceptual organization and processing speed function.Anoxia at birth those CO patients characterized by DE patients had a lower GMV in the left anterior cingulate and right amygdala, as well as lower levels of cognitive function, than the non-DE patients.

Patients with CO intoxication in the chronic stage showed a worse cognitive and morphologic outcome, especially those with DE. This study provides additional evidence of gray matter structural abnormalities in the pathophysiology of DE in chronic CO intoxicated patients.

[show abstract] [hide abstract] ABSTRACT: introduction: cerebrovascular diseases are one of the most common causes of secondary movement disorders. Hypokinetic or hyperkinetic movement disorders may occur after an ischemic or hemorrhagic stroke, either immediately or thereafter.Anoxia at birth such disorders are also known to be caused by diffuse leukoaraiosis, vascular malformations and dural fistulas in the basal ganglia or other brain regions.

Area covered: the aim of this review was to describe movement disorders secondary to cerebrovascular diseases, and highlight their pivotal pathophysiological aspects, clinical features, diagnostic criteria and therapeutic options.

Expert commentary: movement disorders secondary to cerebrovascular diseases remain a challenge for neurologists. These conditions share some therapeutic options with idiopathic forms, though tailored treatment may be required in certain cases. Innovative neuroimaging techniques may play a pivotal role in the early diagnosis of vascular movement disorders.Anoxia at birth further natural history studies and good-quality clinical trials are warranted to achieve a better management of these complex disorders.

[show abstract] [hide abstract] ABSTRACT: background

PD is a progressive neurodegenerative disorder commonly treated by levodopa. The findings from genetic studies on adverse effects (adrs) and levodopa efficacy are mostly inconclusive. Here, we aim to identify predictive genetic biomarkers for levodopa response (LR) and determine common molecular link with disease susceptibility. A systematic review for LR was conducted for ADR, and drug efficacy, independently. All included articles were assessed for methodological quality on 14 parameters. GWAS of PD were also reviewed.Anoxia at birth protein-protein interaction (PPI) analysis using STRING and functional enrichment using webgestalt was performed to explore the common link between LR and PD.

Results

From 37 candidate studies on levodopa toxicity, 18 genes were found associated, of which, can STR 13, 14 (DRD2) was most significantly associated with dyskinesia, followed by rs1801133 (MTHFR) with hyper-homocysteinemia, and rs474559 (HOMER1) with hallucination. Similarly, 8 studies on efficacy resulted in 4 genes in which rs28363170, rs3836790 (SLC6A3) and rs4680 (COMT), were significant. To establish the molecular connection between LR with PD, we identified 35 genes significantly associated with PD. With 19 proteins associated with LR and 35 with PD, two independent PPI networks were constructed.Anoxia at birth among the 67 nodes (263 edges) in LR, and 62 nodes (190 edges) in PD pathophysiology, UBC, SNCA, FYN, SRC, CAMK2A, and SLC6A3 were identified as common potential candidates.

Conclusion

Our study revealed the genetically significant polymorphism concerning the adrs and levodopa efficacy. The six common genes may be used as predictive markers for therapy optimization and as putative drug target candidates.

Electronic supplementary material

The online version of this article (10.1186/s12920-017-0291-0) contains supplementary material, which is available to authorized users.

[show abstract] [hide abstract] ABSTRACT: published diagnostic criteria for functional (psychogenic) movement disorders (fmds) include psychiatric symptoms and some historical variables to affect the threshold between categories of diagnostic certainty.Anoxia at birth clinically probable and possible categories, however, do not suffice to rule in FMD or rule out complex organic movement disorders and therefore are of little practical help. In contrast, a handful of unequivocal and reliably incongruent or inconsistent clinical features in each functional movement phenotype, when present, allow a clinically definite diagnosis of FMD, regardless of any psychiatric symptom. We suggest that the use of phenotype-specific clinically definite FMD diagnostic criteria will increase inter-rater reliability and minimize false-positive diagnostic errors. This process involves the ascertainment of core (mandatory) examination features instead of supportive but insufficiently sensitive historical, psychiatric, and inconsistent examination features.Anoxia at birth

[show abstract] [hide abstract] ABSTRACT: tension-type headache (TTH) is recognized as the most prevalent type of headache. Despite this, there is a limited understanding of the entity’s physiology, epidemiology, and clinical presentation. Anxiety and depression are recognized comorbidities present among patients with TTH.

To quantify the prevalence of anxiety and depression among patients with episodic and chronic TTH.

Fifty patients with episodic TTH and fifty patients with chronic TTH completed beck’s anxiety and depression surveys. Only patients presenting with moderate to severe scores were considered.

Among the patients with episodic TTH, anxiety and depression were observed in 30 (60%) and 16 (32%) patients respectively.Anoxia at birth among the patients with chronic TTH, anxiety was observed in 22 (44%) patients, and depression was observed in 20 (40%).

Both comorbidities are important among patients with episodic and chronic TTH. Neglecting this association may result in failure of symptomatic and prophylactic treatment ultimately leading to lost quality of life.

[show abstract] [hide abstract] ABSTRACT: the present contribution discusses the clinical use of functional MRI (fmri) and its role in the most common neurological diseases. FMRI was found a reliable and reproducible examination tool resulting in a wide distribution of fmri methods in presurgical evaluation of epilepsy in determining the relationship of eloquent areas and the epileptic focus.Anoxia at birth preliminary data suggest that fmri using memory paradigms can predict the postoperative memory decline in epilepsy surgery by determining whether a reorganization of memory functions took place. Speech-activated fmri became the most used tool in determining hemispheric dominance. Visual and sensory-motor cortex can also be routinely investigated by fmri which helps in decision on epilepsy surgery. FMRI combined with EEG is a new diagnostic tool in epilepsy and sleep disorders. FMRI can identify the penumbra after stroke and can provide an additional information on metabolic state of the threatened brain tissue. FMRI has a predictive role in post-stroke recovery. In relapsing-remitting MS an adaptive reorganization can be demonstrated by fmri affecting the visual, motor, and memory systems, despite preserved functional performance.Anoxia at birth much more extensive reorganization can be demonstrated in secondary progressive MS. These findings suggest that the different stages of MS are related to different stages of the reorganization and MS becomes progressive when there is no more reserve capacity in the brain for reorganization. FMRI offers the capability of detecting early functional hemodynamic alterations in alzheimer’s disease before morphological changes. FMRI can be a valuable tool to test and monitor treatment efficacy in AD. FMRI can also provide information about the mechanisms of different therapeutic approaches in parkinson disorder including drug treatment and deep brain stimulation.

[show abstract] [hide abstract] ABSTRACT: objective:

anoxia at birth

Movement disorders are a rare manifestation of moyamoya angiopathy (MMA). Data on prevalence and clinical presentation are warranted. Possible involuntary movements include focal motor seizures, tremor, limb-shaking transient ischemic attacks, choreiform and spastic or dystonic movement disorders.

Patients and methods:

We developed a questionnaire to systematically assess movement disorders in MMA. Patients’ history of involuntary movements and their clinical presentation were assessed systematically by interview. Additionally, demographic data were assessed as well as localization of movements, possible trigger factors and the presence of other symptoms.

Results:

The questionnaire was administered to 63 european patients with MMA.Anoxia at birth the response rate was high with 93.6% participating patients. Twenty-eight patients (47.4%) reported involuntary movement disorders including periodic tremor, irregular jerks, involuntary movements with loopy or pranced character, stiffness and muscle cramps. From those patients, 16 (57.1%) individuals had the symptoms prior to the diagnosis of MMA. The most common involuntary movements were irregular jerks witnessed by 17 (60.7%) patients, followed by stiffness and muscle cramps in 10 (35.7%). Eight (28.6%) patients suffered from unintended loopy and pranced character, while 4 individuals (14.3%) remembered periodic tremor. Of the 28 patients who witnessed movement disorders, 23 had undergone revascularization surgery (82.1%).Anoxia at birth from the latter subgroup, movement disorders were reversed in 7 out of 12 patients (58.3%) with irregular jerks and 4 out of 7 patients (57.1%) with unintended loopy and pranced character.

Conclusions:

Our study elucidates the high incidence of movement disorders in an unselected consecutively recruited cohort of european MMA patients.