BACKGROUND: Dyskinesia is one of the most common complications of stroke. Acupuncture therapy (AT) and mirror therapy (MT) are promising rehabilitation measures for the treatment of post-stroke dyskinesia. Although some studies suggested that AT and MT are effective and safe for dyskinesia, the effects, and safety remain uncertain due to lacking strong evidence. The purpose of this study is to investigate the efficacy and safety of AT combined with MT in the treatment of post-stroke dyskinesia.
METHODS: We searched the following databases: PubMed, Web of Science, Cochrane Library, EMBASE, Medline, China Knowledge Network, WANFANG, and China Biomedical Literature Database, from inception to 1 January 2023 to identify eligible studies. Total effective rate, the Fugl-Meyer assessment scale (FMA) upper and lower limb scores, modified Barthel index scores, Berg balance scale, modified Ashworth scale, and adverse reactions were adopted as outcome indicators. The Grading of Recommendations Assessment Development and Evaluation system was used by 2 independent reviewers to assess the quality of evidence for the outcome indicators included in the study. The statistical analysis was conducted by RevMan V.5.4 software.
RESULTS: A total of 24 randomized controlled studies included 2133 patients with post-stroke dyskinesia were included. The total effective rate of AT combined with MT was more advantageous in the treatment of post-stroke dyskinesia (relative risk = 1.31, 95% confidence interval [CI] [1.22-1.42], Z = 6.96, P < .0001). AT combined with MT was more advantageous for FMA upper limb score (mean difference [MD] = 6.67, 95% CI [5.21-8.13], Z = 8.97, P < .00001) and FMA lower limb score (MD = 3.72, 95% CI [2.81-4.63], Z = 7.98, P < .00001). Meta-analysis showed that AT combined with MT for post-stroke dyskinesia had a more advantageous modified Barthel index score (MD = 9.51, 95% CI [7.44-11.58], Z = 9.01, P < .00001).
CONCLUSIONS: AT combined with MT is effective in improving motor function and daily living ability of patients, especially in improving muscle spasms. However, these results should be regarded with caution given the low quality of evidence for the evaluation results.

OBJECTIVE: Overactive bladder (OAB) and dyskinesia are frequent complications in patients with Parkinson\'s disease (PD). However, the correlation between OAB and dyskinesia has been insufficiently explored. The purpose of this study was to examine the relationship between dyskinesia, OAB, and clinical characteristics among individuals with PD.
METHODS: 1338 PD patients were included in the present study. Demographic features were compared between patients with or without dyskinesia and OAB symptoms. Logistic regression was conducted on dyskinesia to screen clinically relevant factors. Overactive Bladder Symptom Score (OABSS) was further used to stratify the association between the severity of OAB and the occurrence of dyskinesia.
RESULTS: This study indicates that both dyskinesia and OAB are significantly related to disease severity and cognitive status. PD patients with dyskinesia and OAB having higher UPDRS scores (p < 0.001), H-Y scores (p < 0.001), NMSQ (p < 0.001) and MoCA scores (p < 0.001), and lower MMSE scores (p < 0.001) are identified. The multivariate logistic regression confirms that disease duration (p = 0.041), LEDD (p < 0.001), UPDRSII (p < 0.001), MoCA (p = 0.024), urgency (p < 0.001), frequency (p < 0.001), and nocturia (p = 0.002) are independent risk factors for dyskinesia. Trend analysis indicates that the risk of dyskinesia significantly increases when patients exhibit moderate to severe OAB symptoms (OABSS > 5) (p < 0.001). No significant interactions were found between OABSS and age, gender, disease duration, LEDD, and NMSQ scores in different subgroups, indicating that dyskinesia is more pronounced in patients with OABSS > 5.
CONCLUSIONS: This study provides compelling evidence supporting the strong correlation between OAB and dyskinesia in PD patients, emphasizing the presence of shared pathogenic mechanisms between these two conditions. Our findings underscore the importance of considering both OAB and dyskinesia in the clinical management of PD, investigating the intricate connections between OAB and dyskinesia could unveil valuable insights into the complex pathophysiology of PD and potentially identify novel therapeutic targets for more effective PD treatment strategies.

Fatal familial insomnia,an autosomal dominant prion disease,is rare.We reported the clinical symptoms,examination results,diagnosis,treatment,and prognosis of a patient who was diagnosed with fatal familial insomnia.Furthermore,we described the unique clinical manifestations that involuntary movements and laryngeal stridor were significantly correlated with postural changes,aiming to provide reference for the clinical diagnosis,treatment,and research of the disease in the future.
致死性家族性失眠症是一种罕见的常染色体显性遗传的朊蛋白病,本文报道1例确诊的致死性家族性失眠症患者的临床症状、相关检查、诊断、治疗及预后情况,并对其不自主运动、喉部喘鸣与体位改变显著相关的独特临床表现进行描述,以期为该病今后的临床诊治和研究提供参考。.

Zearalenone (ZEA), one of the usual mycotoxins, has been recognized in many areas and crops, posing a significant threat to the living organisms even to human beings. However, the mechanisms of locomotive defects remain unknown. Herein, zebrafish larvae was employed to investigate ZEA effects on developmental indexes, muscle and neural toxicity, apoptosis, transcriptome and motor behaviors of zebrafish larvae. Zebrafish larvae exposed to ZEA (0, 0.5, 1, 2 and 4 μM) showed no change in survival rate, but the malformation rate of zebrafish larvae increased dramatically manifesting with severe body bending and accomplished with adverse effects on hatching rate and body length. Moreover, the larvae manifested with defective muscle and abnormal neural development, resulting in decreased swimming ability, which probably due to the abnormal overactivation of apoptosis. And this was confirmed by enriched caspase 8-mediated apoptosis signaling pathway in the following transcriptome analysis. Meanwhile, there was a recovery in swimming behaviors in the larvae co-exposed in ZEA and caspase 8 inhibitor. These findings provide an important evidence for risk assessment and potential treatment target of ZEA exposure.

Parkinson\'s disease (PD) is a neurodegenerative condition that results in dyskinesia, with oxidative stress playing a pivotal role in its progression. Antioxidant peptides may thus present therapeutic potential for PD. In this study, a novel cathelicidin peptide (Cath-KP; GCSGRFCNLFNNRRPGRLTLIHRPGGDKRTSTGLIYV) was identified from the skin of the Asiatic painted frog ( Kaloula pulchra). Structural analysis using circular dichroism and homology modeling revealed a unique αββ conformation for Cath-KP. In vitro experiments, including free radical scavenging and ferric-reducing antioxidant analyses, confirmed its antioxidant properties. Using the 1-methyl-4-phenylpyridinium ion (MPP +)-induced dopamine cell line and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD mice, Cath-KP was found to penetrate cells and reach deep brain tissues, resulting in improved MPP +-induced cell viability and reduced oxidative stress-induced damage by promoting antioxidant enzyme expression and alleviating mitochondrial and intracellular reactive oxygen species accumulation through Sirtuin-1 (Sirt1)/Nuclear factor erythroid 2-related factor 2 (Nrf2) pathway activation. Both focal adhesion kinase (FAK) and p38 were also identified as regulatory elements. In the MPTP-induced PD mice, Cath-KP administration increased the number of tyrosine hydroxylase (TH)-positive neurons, restored TH content, and ameliorated dyskinesia. To the best of our knowledge, this study is the first to report on a cathelicidin peptide demonstrating potent antioxidant and neuroprotective properties in a PD model by targeting oxidative stress. These findings expand the known functions of cathelicidins, and hold promise for the development of therapeutic agents for PD.
帕金森病（PD）是一种以运动障碍为主要临床表现的的神经退行性疾病。这种运动障碍通常由氧化应激损伤导致，这表明抗氧化肽可能具有治疗帕金森病的潜力。在该研究中，我们从 Kaloula pulchra青蛙的皮肤中鉴定出一种名为Cath-KP （GCSGRFCNLFNNRRPGRLTLIHRPGGDKRTSTGLIYV）的新型 Cathelicidin 多肽。圆二色谱和同源建模分析表明，Cath-KP 具有独特的 αββ结构；自由基清除实验和铁还原抗氧化分析的体外实验证实了其抗氧化特性。我们使用1-甲基-4-苯基吡啶离子 （MPP +）诱多巴胺神经元细胞系（MN9D）构建PD细胞模型，和使用1-甲基-4-苯基-1,2,3,6-四氢吡啶（MPTP）处理C57小鼠构建PD动物模型。实验表明，Cath -KP可内化至细胞内并递送至深部脑组织，提高MPP +诱导的细胞活力，并通过激活Sirt1/Nrf2抗氧化通路，促进抗氧化酶的表达，减轻线粒体损伤和细胞内活性氧的积累，缓解细胞氧化应激损伤。FAK和p38也在其调节中发挥作用。最终，使用Cath-KP 治疗PD小鼠可以提高黑质区域酪氨酸羟化酶 (TH) 阳性神经元的数量和纹状体TH的表达，并改善小鼠的运动行为障碍。据我们所知，这是第一个通过作用氧化应激在PD模型中展示出有效的抗氧化和神经保护特性的Cathelicidin家族多肽。这些发现扩展了Cathelicidins的已知功能，并为开发新的PD治疗药物带来了希望。.

Diabetic striatopathy (DS) is a rare central nervous system complication of diabetes mellitus, characterized mainly by non-ketotic hyperglycemia and lateralized involuntary movements. Patients with diabetic striatopathy manifested solely by subacute cognitive decline were rarely reported. In this paper, we report a patient with DS who presented solely with subacute cognitive decline without involuntary movements, and cranial CT showed bilateral high density in the basal ganglia. In contrast, SWI showed microhemorrhages in the right caudate nucleus head. After one week of treatment, including glycemic control, the patient showed significant improvement in cognitive function, while a repeat cranial CT showed improved hyperdensity in the right basal ganglia region. 1 month later, at telephone follow-up, the patient\'s symptoms did not recur.

The paper introduces professor ZHUANG Li-xing\'s clinical experience in treatment of dyskinesia of Parkinson\'s disease with acupuncture at triple-acupoint prescription. In pathogenesis, dyskinesia of Parkinson\'s disease refers to yang deficiency and disturbing wind. In treatment, acupuncture focuses on warming yang, promoting the circulation of the governor vessel, regulating the spirit and stopping trembling; and Baihui (GV 20), Suliao (GV 25) and Dingchanxue (Extra) are selected to be \"trembling relief needling\". In combination with Jin\'s three needling, named \"three-trembling needling\" \"three-governor-vessel needling\" and \"three-spasm needling\", the triple-acupoint prescription is composed. To ensure the favorable therapeutic effect, this prescription is modified according to the symptoms and the specific techniques of acupuncture are combined such as conducting qi, harmonizing yin and yang, and manipulating gently for reinforcing and reducing.
介绍庄礼兴教授运用“治异三针”穴组针刺治疗帕金森病异动症的临床经验。庄教授认为帕金森病异动症基础病机是“阳虚风动”，针刺治疗以“温阳通督、调神止颤”为法，选择百会、素髎、定颤穴作为“止颤针”，配合靳三针中的“颤三针”“督三针”“挛三针”，构成“治异三针”穴组，随症加减，配合导气同精、小补小泻的特定针刺手法。.

BACKGROUND: Chorea-acanthocytosis (ChAc) is a rare hereditary autosomal recessive neurodegenerative disorder caused by pathogenic variants of the Vacuolar Protein Sorting 13 homolog A (VPS13A) gene. The variant spectrum of VPS13A has not been completely elucidated. This study reports two novel heterozygous VPS13A pathogenic variants in ChAc that expand the variant spectrum of VPS13A.
METHODS: We described a case of a 29-year-old man with typical clinical manifestations of ChAc, including chorea, orofacial lingual dyskinesia, vocal tics, elevated serum biochemical indicators, increased acanthocytes in peripheral blood, and caudate nucleus atrophy. Next-generation sequencing revealed two heterozygous variants of VPS13A: a nonsense variant (NM_033305.2: c.8215G > T, p. Glu2739Ter) and a deletion variant in the exons 25-31.
CONCLUSIONS: The identified nonsense variant gives rise to premature translation termination, while the deletion variant is expected to cause a significant in-frame deletion of amino acid residues in the encoded protein. Both variants are considered to be pathogenic and result in loss-of-function proteins. These findings have implications for the genetic counseling of patients with VPS13A variants.

Parkinson\'s disease (PD) is the commonest neurodegenerative disorder. It reduces motor and cognitive function in patients. Vinpocetine (Vinp) has the effects of anti-inflammatory and antioxidant, and could improve cognitive function in patients. This study was aimed to investigating the therapeutic effects of Vinp on dyskinesia in a 6-Hydroxydopamine hydrobromide (6-OHDA)-induced PD rat model. We constructed a PD rat model by injecting 6-OHDA, and intervened with Vinp for 7 days. The motor function of the rats was evaluated by an open-field test and rotation test. Besides, H&E staining was applied to observe the changes of dopaminergic neurons in the striatum. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the rat striatum were detected. We assessed the impact of Vinp on α-synuclein (α-Syn) and Wnt/β-catenin signaling pathway-related molecules by western blot and qRT-PCR. Rats in the PD group showed reduced horizontal movement frequency and number of squares crossed, increased contact time and rotation frequency, and reduced number of dopaminergic neurons accompanied by severe morphological damage. Vinp treatment increased the horizontal movement frequency and number of squares crossed, reduced the contact time, and rotation frequency in PD rats. Also, Vinp downregulated α-Syn protein expression and MDA level, while upregulated SOD activity in the striatum of PD rats. Furthermore, Vinp treatment activated the Wnt/β-catenin signaling pathway in the striatum of PD rats. In conclusion, Vinp improved the dyskinesia in 6-OHDA-induced PD rats by alleviating oxidative stress, and these effects may be associated with activating the Wnt/β-catenin signaling pathway.

BACKGROUND: Current research on the prediction of movement complications associated with levodopa therapy in Parkinson\'s disease (PD) is limited. levodopa-induced dyskinesia (LID) is a movement complication that seriously affects the life quality of PD patients. One-third of PD patients develop LID within 1 to 6 years of levodopa treatment. This study aimed to construct models based on radiomics and machine learning to predict early LID in PD.
METHODS: We extracted radiomics features from the T1-weighted MRI obtained in the baseline of 49 PD control and 54 PD with LID in the first 6 years of levodopa therapy. Six brain regions related to the onset of PD were segmented as regions of interest (ROIs). The least absolute shrinkage and selection operator (LASSO) was used for feature selection. Using the machine learning methods of support vector machine (SVM), random forest (RF), and AdaBoost, we constructed radiomics models and hybrid models. The hybrid models combined the radiomics features and the Unified Parkinson\'s Disease Rating Scale part III (UPDRS III) total score. The five-fold cross-validation was performed and repeated 20 times to validate the stability of the classifiers. We used sensitivity, specificity, accuracy, receiver operating characteristic (ROC) curves, and area under the ROC curve (AUC) for model validation.
RESULTS: We selected 33 out of 6138 radiomics features. In the testing set of the radiomics model, the AUC values of the SVM, RF, and AdaBoost classifiers were 0.905, 0.808, and 0.778, respectively, and the accuracies were 0.839, 0.742, and 0.710. The hybrid models had better prediction performance. In the testing set, the AUC values of SVM, RF, and AdaBoost classifiers were 0.958, 0.861, and 0.832, respectively, and the accuracies were 0.903, 0.806, and 0.774.
CONCLUSIONS: Our results indicate that T1-weighted MRI is valuable in predicting early LID in PD. This work demonstrates that the combination of radiomics features and clinical features has good potential and value for identifying early LID in PD.