Publications by authors named "Yung Yee Chang"

Article Synopsis
  • Influenza-associated encephalopathy, particularly acute necrotizing encephalopathy (ANE), is primarily seen in pediatric populations and has been reported in a 44-year-old woman who developed severe neurological symptoms after an influenza A (H3N2) infection.* -
  • Rapid progression of symptoms led to a diagnosis of ANE based on brain MRI, exclusion of other infections, and elevated interleukin-6 levels, following which pulse steroid therapy and tocilizumab treatment significantly stabilized her condition.* -
  • Analysis of adult cases revealed a wide age range with a high mortality rate (32%); thalamic lesions were most common, emphasizing the need for awareness and research into cytokine-directed therapies for this serious
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Parkinson's disease (PD) is a debilitating neurodegenerative disease with a relentlessly progressive course of illness. This study aimed to assess the dyadic dynamics of benefit finding (BF), demoralization, and stigma on the depression severity of PD patients and their caregivers. This study used a cross-sectional design with purposive sampling.

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  • - The study investigates the role of IRF2BPL mutations in a Taiwanese group of dystonia patients, revealing a de novo pathogenic variant in one adolescent that leads to dystonia, developmental regression, and epilepsy.
  • - Researchers analyzed 300 patients with dystonia using whole exome sequencing, finding the identified mutation affects the protein structure significantly and correlates with a higher occurrence of epilepsy and other symptoms.
  • - The findings suggest that IRF2BPL mutations are a rare cause of dystonia, with different mutation locations linked to varying clinical features, highlighting the complexity of genetic contributions to this disorder.
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  • Tardive syndrome (TS), caused by long-term use of dopamine receptor-blocking agents like antipsychotics, affects movement and has few follow-up studies on its outcomes.* -
  • In a study of 123 patients in Taiwan, about 42.4% experienced TS, with tardive dyskinesia being the most common type, and the overall remission rate after 10 years was found to be 74.3% with factors like vitamin B6 influencing recovery.* -
  • The research emphasizes that early detection and treatment, including monitoring for TS symptoms and using antioxidants, can lead to better outcomes for patients on antipsychotics.*
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Background And Purpose: Dystonia is a heterogeneous movement disorder, and it remains unclear whether neurodegeneration is involved. Neurofilament light chain (NfL) is a biosignature of neurodegeneration. We aimed to investigate whether plasma NfL levels were elevated and associated with disease severity in patients with dystonia.

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Background: Tardive sensory syndrome (TSS) is a subtype of tardive syndrome (TS), and its etiology is still uncertain. Lurasidone is an atypical antipsychotic that has high affinity for dopamine D2- and serotonergic 5HT2A- and 5-HT7-receptors.

Case Summary: A 52-year-old woman, previously diagnosed with schizophrenia, and with no history of movement disorders and no sensory paresthesia, had taken lurasidone, initiate dose 40 mg daily then up titration to 120 mg daily, since March 2021, and developed mandibular sensory (pain) paresthesia after 3 mo of administration.

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Genetic leukoencephalopathies (GLEs) are a group of white matter abnormalities with heterogeneous radiological and phenotypic features. Although these conditions have mostly been described in children, adult-onset cases are increasingly recognized owing to the widespread use of neuroimaging and advances in molecular genetic testing. The disease course is often progressive with a varied spectrum of presentations, trapping neurologists in the dilemma of differential diagnosis.

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Article Synopsis
  • - The IMPDH2 gene was identified as a new gene linked to autosomal dominant dystonia.
  • - A study involving 245 Taiwanese patients with isolated or combined dystonia found no pathogenic variants in the IMPDH2 gene.
  • - These results indicate that IMPDH2 is likely not a significant contributor to the development of dystonia.
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Objectives: The classic triad of idiopathic normal pressure hydrocephalus (NPH) encompass gait disturbance, cognitive impairment, and urinary incontinence. These symptoms overlap with parkinsonism but with distinct treatment. Lacking applicable differentiation also hampers the prediction to therapeutic response.

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Background And Purpose: Oral nucleos(t)ide analogs (NAs) are the mainstay treatment for chronic hepatitis B (CHB). Myotoxicity is an important extrahepatic effect related to NA treatment. Telbivudine is the NA for CHB that is frequently associated with muscle-related side effects.

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Hereditary spastic paraplegias (HSPs) are a heterogeneous group of neurodegenerative disorders clinically characterized by progressive lower-limb spasticity. Cerebellar ataxia commonly co-occurs with complicated HSPs. HSP with concurrent cerebellar ataxia has significant clinical and genetic overlaps with hereditary cerebellar ataxia (HCA) and other inherited neurological diseases, adding to the challenge of planning genetic testing for the disease.

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Depression is a common comorbidity in patients with Parkinson's disease (PD) and in their caregivers. This study aimed to compare the prevalence and risk factors of depression between patients with PD and their caregivers. In total, 113 patients with PD and 101 caregivers were enrolled.

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Parkinson's disease (PD) is a progressive, neurodegenerative disorder and is commonly comorbid with depression. The aim of this cross-sectional study was to assess morbidity and associated factors of depression in patients with PD. In total, 181 patients with PD were enrolled and assessed using the Mini-International Neuropsychiatric Interview.

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Article Synopsis
  • Dystonia is a complex movement disorder with unclear genetic causes, particularly in Asian populations.
  • Researchers tested 318 Taiwanese patients using advanced genetic analysis methods and identified causative mutations in about 12.6% of them.
  • Significant associations were found between genetic diagnosis and factors like juvenile onset and combined dystonia features, revealing key genes involved in the disorder.
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Background: Peripheral neuropathy is not an uncommon manifestation in patients with chronic hepatitis. The role of cryoglobulin (CG) in neuropathy in patients with chronic hepatitis remains controversial. There is limited information about the autonomic neuropathy in chronic hepatitis.

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Background: Patients with Parkinson's disease (PD) can develop impulse control disorders (ICDs) while undergoing a pharmacological treatment for motor control dysfunctions with a dopamine agonist (DA). Conventional clinical interviews or questionnaires can be biased and may not accurately diagnose at the early stage. A wearable electroencephalogram (EEG)-sensing headset paired with an examination procedure can be a potential user-friendly method to explore ICD-related signatures that can detect its early signs and progression by reflecting brain activity.

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Background/purpose: A heterozygous three-nucleotide (GAG) in-frame deletion in the TOR1A gene causes the rare disease, dystonia (DYT1), which typically presents as focal limb dystonia during adolescence, then spreads to other limbs. This study investigated the frequency and clinical features of DYT1 in a Taiwanese dystonia cohort.

Methods: We performed targeted next generation sequencing in 318 patients with primary dystonia.

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Aim: To investigate the clinical and genetic features of hereditary spastic paraplegia (HSP) type 3A (SPG3A) in Taiwan.

Methods: Mutational analysis of the ATL1 gene was performed for 274 unrelated Taiwanese HSP patients. The diagnosis of SPG3A was ascertained by the presence of a heterozygous pathogenic mutation in ATL1.

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Background: Microelectrode recording (MER)-guided deep brain stimulation (DBS) remains the standard electrophysiological procedure to place the DBS lead at the optimal target. When single-track MER or test stimulation yields suboptimal results, trajectory adjustments are needed. Intraoperative computed tomography (iCT) can be useful to visualize the microelectrode and verify possible adjustments.

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Background: Primary familial brain calcification (PFBC) is a rare inherited disease characterized by multiple calcified foci in the brain parenchyma. MYORG is the first gene found to be associated with autosomal recessive PFBC. The precise pathogenic mechanism of neurodegeneration in PFBC remains unclear.

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This study is intended to explore the associations between nutritional status and molecular biomarkers and the clinical severity of Parkinson's disease (PD), as well as to examine the differences in related factors between PD patients with normal nutrition and those with at risk for malnutrition. A cross-sectional assessment of 82 consecutive outpatients with PD was conducted using the mini nutritional assessment (MNA), Unified Parkinson's Disease Rating Scale (UPDRS), and the Hoehn and Yahr scale to determine the nutritional status, the clinical severity of PD, and the stage of the disease. Recordings of blood samples collected after 12 h of overnight fasting were also assessed in terms of serum levels of glycated hemoglobin (HbA1c), blood urea nitrogen (BUN), creatinine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), hemoglobin (Hgb), folate, and vitamin B12.

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Introduction: Systemic inflammation with elevated oxidative stress causing neuroinflammation is considered a major factor in the pathogenesis of Parkinson's disease (PD). The interface between systemic circulation and the brain parenchyma is the blood-brain barrier (BBB), which also plays a role in maintaining neurovascular homeostasis. Vascular cell adhesion molecule-1 (VCAM-1) and microRNAs (miRNAs) regulate brain vessel endothelial function, neoangiogenesis, and, in turn, neuronal homeostasis regulation, such that their dysregulation can result in neurodegeneration, such as gray matter atrophy, in PD.

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Objective: Parkinson disease (PD) is a debilitating neurodegenerative disease. Caring for an individual with PD can have a variety of negative physical and psychological effects on caregivers which may challenge their ability to continue in their caretaking role. The aim of this study was to assess the prevalence and associated factors of depressive disorders in caregivers of individuals with PD using standardized instruments.

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Background: Alexander disease (AxD) is an autosomal-dominant leukodystrophy caused by heterozygous mutations in the glial fibrillary acidic protein (GFAP) gene.

Objectives: The objective of this report is to characterize the clinical phenotype and identify the genetic mutation associated with adult-onset AxD.

Methods: A man presented with progressive unsteadiness since age 16.

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