Movement Disorders Associated With Cerebral Artery Stenosis: A Nationwide Study

Kye Won Park, Nari Choi, Eungseok Oh, Chul Hyoung Lyoo, Min Seok Baek, Han Joon Kim, Dalla Yoo, Jee Young Lee, Ji Hyun Choi, Jae Hyeok Lee, Seong Beom Koh, Young Hee Sung, Jin Whan Cho, Hui Jun Yang, Jinse Park, Hae Won Shin, Tae Beom Ahn, Ho Sung Ryu, Sooyeoun You, Seong Min ChoiBum Joon Kim, Seung Hyun Lee, Sun Ju Chung

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Studies 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 Methods: A 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. Results: The 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 < 0.001) and had a more chronic mode of onset (p = 0.001) and less acute ischemic lesion (p = 0.021). Eight patients who underwent surgical treatment for CAS showed positive outcomes. Patients with acute MD onset had a better outcome than those with subacute-to-chronic MD onset (p = 0.008). Conclusions: This 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.

Original languageEnglish
Article number939823
JournalFrontiers in Neurology
Volume13
DOIs
Publication statusPublished - 2022 Jul 14

Bibliographical note

Funding Information:
This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI19C0256).

Publisher Copyright:
Copyright © 2022 Park, Choi, Oh, Lyoo, Baek, Kim, Yoo, Lee, Choi, Lee, Koh, Sung, Cho, Yang, Park, Shin, Ahn, Ryu, You, Choi, Kim, Lee and Chung.

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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