Journal of Clinical Neurology (Seoul, Korea)最新文献

{"title":"Paroxysmal Alien Hand Syndrome: Case Report and Literature Review","authors":"T. Altiparmak, B. Geniş, B. Coşar","doi":"10.3988/jcn.2022.18.2.250","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.2.250","url":null,"abstract":"","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132662754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wide Phenotypic Spectrum of PNMHH Patients With p.R941L Mutation in MYH14","authors":"Hyeonjin Kwon, J. Park, K. Chung, Byung-Ok Choi","doi":"10.3988/jcn.2022.18.2.238","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.2.238","url":null,"abstract":"","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131263020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Spontaneous Pneumocephalus and Subarachnoid Hemorrhage Due to Klebsiella Pneumoniae Meningitis","authors":"Eun Ji Lee, R. O. Kim, Mina Lee, Byung-Euk Joo","doi":"10.3988/jcn.2022.18.2.253","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.2.253","url":null,"abstract":"Dear Editor, Pneumocephalus is the presence of air or gas within the cranial cavity,1 and is usually caused by craniofacial trauma, neurosurgery, or an invasive procedure. Although rare, bacterial meningitis can lead to pneumocephalus without structural defect of the skull or dura.2 In addition, subarachnoid hemorrhage (SAH) is extremely rare, although there are reports of cerebral infarction due to arteritis, thrombophlebitis, or vasospasm being accompanied with bacterial meningitis.3 Here we report an unusual case—which is the first case to the best of our knowledge—presenting concurrent pneumocephalus and SAH due to Klebsiella pneumoniae meningitis in adults. A 51-year-old female was admitted to our hospital with right ear pain and headache that had first appeared 3 days previously. She had a 10-year history of diabetes mellitus (DM) and liver cirrhosis due to hepatitis C. At admission she had no fever and her consciousness was alert, but on the following day her consciousness deteriorated to stupor with a high fever of 38.9°C. A neurologic examination revealed neck stiffness, although her brainstem reflexes including the corneal reflex and vestibulo-ocular reflex were intact. The initial brain CT (computed tomography) showed right chronic otitis media (COM), but the findings were otherwise unremarkable (Fig. 1A). At 3 hours after the initial brain CT, she showed ocular flutter and absence of brainstem reflexes. Blood tests revealed thrombocytopenia (platelet count: 40,000/μL), but no leukocytosis or elevation of CRP. During the cerebrospinal fluid (CSF) study there was a high opening pressure of 510 mm H2O, with the CSF presenting a greenish yellow color with the following extremely serious inflammatory findings: 14,200 white blood cells/μL (97% polymorphonuclear cells), 3,150 red blood cells/μL, elevated protein (1,740 mg/dL), and severe hypoglycorrhachia (glucose ratio in CSF/serum=0.03). Vancomycin, meropenem, and ampicillin along with high doses of steroids were applied immediately after obtaining the CSF findings. Despite the combined antibiotic treatment, the patient deteriorated rapidly to a coma state with anisocoric pupils and no self-respiration. On the 3rd day of hospitalization, SAH in both cerebral sulci and the suprasellar cistern was observed on brain CT (Fig. 1B). Brain magnetic resonance angiography only revealed diffuse luminal irregularity in both middle cerebral arteries, with no aneurysm identified. She progressed to septic shock with high fever and decreased blood pressure. Chest and abdomenpelvic CT produced no other infectious findings. However, Klebsiella pneumoniae was identified in blood and CSF cultures. Based on these results, cefepime (which is more effective against Klebsiella pneumoniae) was replaced as the main antibiotic treatment. However, her condition did not improve despite aggressive treatment. Brain CT of the 10th day (Fig. 1C) revealed pneumocephalus (which had not been seen previously) within subdural","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115590218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Bilateral Vestibulopathy Associated With COVID-19","authors":"Sun-Uk Lee, Tark Kim, Eek-Sung; Eeksung Lee","doi":"10.3988/jcn.2022.18.2.247","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.2.247","url":null,"abstract":"Dear Editor, Coronavirus disease 2019 (COVID-19) patients often experience dizziness and unsteadiness, even after recovering from the main symptoms.1,2 Previous studies were based on patient self-reporting, and hence the exact mechanism of these symptoms is uncertain. We report a case suggestive of bilateral vestibulopathy (BVP) as a cause of dizziness and unsteadiness after COVID-19, and propose virus infection as an etiology of acute simultaneous BVP. A 43-year-old male with COVID-19 who was also experiencing vertigo was referred to the neurology department. The patient had a history of hypertension, end-stage renal disease (ESRD), and congestive heart failure. He had been diagnosed with COVID-19 by realtime reverse-transcription polymerase chain reaction 10 days previously after persistent fever and dysgeusia. The patient denied a history of dizziness/unsteadiness, headache, ear fullness, or hearing loss. His vertigo disappeared 2 days after onset, but he still felt unsteady, particularly in the dark or when standing on an uneven floor. The patient had been referred to our department 1 week previously for right posterior auricular pain after jugular vein catheterization. At that time he did not complain of vertigo or unsteadiness, the Romberg test was negative, and tandem gait was possible without assistance. Neurological examination showed diminished bilateral knee jerks. Limb ataxia and other motor and sensory abnormalities as well as spontaneous nystagmus with or without visual fixation were absent. Nystagmus was not induced by horizontal head-shaking, vibratory stimuli, or positional maneuvers. Head-impulse tests were positive in both directions. Bithermal caloric tests using water irrigation revealed reduced responses in both ears (11.8°/s of summated slow-phase velocities induced by warm and cold stimulation) (Fig. 1A). Cervical and ocular vestibular-evoked myogenic potentials were decreased during stimulation of either ear (Fig. 1B). Pure-tone audiometry was unremarkable (Fig. 1C), and horizontal and vertical saccades and smooth pursuit were normal, as was visual cancellation of the vestibulo-ocular reflex. Findings on diffusionand susceptibility-weighted images, as well as fluid-attenuated inversion-recovery images of the brainstem and cerebellum were unremarkable. Based on these observations, a diagnosis of BVP was established according to the 2017 diagnostic criteria of the Bárány Society.3 The patient was discharged 1 month after fever onset and instructed to undergo vestibular rehabilitation at home. In a telephone interview conducted 5 months later, the patient reported no dizziness, vertigo, or unsteadiness while walking. COVID-19 is known not only for its preferential respiratory invasion, but also for nervous system involvement, including the cranial nerves.4 It can also manifest as hearing impairment or dizziness due to involvement of the eighth cranial nerve.5 Vestibular neuritis can develop during the course of COVID-19,6 an","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128595556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial Embolic Infarction After COVID-19 Vaccination Associated With Antiplatelet Factor 4 Antibody","authors":"Kwan Young Park, D. Jeong, S. Ha, B. Kim","doi":"10.3988/jcn.2022.18.2.230","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.2.230","url":null,"abstract":"Dear Editor, Coronavirus disease 2019 (COVID-19) vaccinations are actively being performed worldwide. Four vaccines are currently administered in South Korea: Ad26.COV2.S (Janssen), mRNA-1273 (Moderna), ChAdOx1 nCoV-19 (AstraZeneca, University of Oxford, and Serum Institute of India), and BNT162b2 (Pfizer-BioNTech). Among them, ChAdOx1 nCoV19 and Ad26.COV2.S vaccines are based on adenoviral vectors. Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) is one of the significant adverse events of COVID-19 vaccines. Clinical features of VIPIT include thrombocytopenia, thromboses, and coagulation abnormalities, and they typically appear at 4 to 28 days after vaccination. The clinical presentation and course are similar to heparin-induced thrombocytopenia (HIT), forming part of the spectrum of platelet-activating antiplatelet factor 4 (PF4)/heparin disorders.1 Venous thrombosis is one of the most common presentations of VIPIT. Cerebral venous thrombosis was found in 13 of 23 patients who were diagnosed as VIPIT after ChAdOx1 nCoV-19 vaccination, while arterial ischemic stroke was only diagnosed in 2 of these patients.1 Here we describe a case of arterial ischemic stroke in a VIPIT patient after ChAdOx1 nCoV-19 vaccination in South Korea. A 69-year-old female visited the emergency department with dysarthria that occurred 13 days after ChAdOx1 nCoV-19 vaccination. She had a previous history of coronary artery disease and dyslipidemia, and was receiving aspirin and rosuvastatin, but she had no history of previous heparin exposure. At 1 day after the vaccination the patient reported experiencing myalgia and mild fever. No other focal neurological deficits were observed, and there was no sign of thromboembolism. Brain magnetic resonance imaging showed small scattered cortical infarctions in both middle cerebral arterial territories without steno-occlusive lesions (Fig. 1). Embolic workups including transthoracic echocardiography and Holter monitoring produced negative results. Chest computed tomography and lower extremity sonography yielded no evidence of pulmonary thromboembolism or deep vein thrombosis, respectively. Serological testing at admission showed marked thrombocytopenia (69,000/μL). The D-dimer level was elevated at 5.06 μg/mL, and the fibrinogen level was 446 mg/dL. A peripheral blood smear showed no blast cells. After admission, the vaccination history prompted the antiheparin/PF4 immunoglobulin G antibody to be checked using an enzyme-linked immunosorbent assay, which showed positivity with an optical density of 0.89 (cutoff criterion <0.4). The patient was finally diagnosed as VIPIT. Rivaroxaban was started at 15 mg per day, while intravenous immunoglobulin was not considered since the patient was stable and showed only mild severity. Serological testing in the outpatient clinic showed normalization of both the platelet (168,000/μL) and D-dimer (0.48 μg/mL) levels. Based on the relevance of VIPIT to HIT, a recently proposed hypothe","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131390436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-Wide Association Study of the Relationship Between Matrix Metalloproteinases and Intracranial Aneurysms","authors":"B. Kim, E. Hong, Dong Hyuk Youn, J. Jeon","doi":"10.3988/jcn.2022.18.e6","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.e6","url":null,"abstract":"Background and Purpose Matrix metalloproteinases (MMPs) are expected to play an important role in extracellular matrix (ECM) remodeling in response to hemodynamic stress. We investigated the association between MMPs and intracranial aneurysms (IAs) via a genome-wide association study (GWAS) of IAs. Methods A GWAS data set of 250 IAs and 294 controls was used to analyze the genetic link between MMPs and IAs via single-nucleotide polymorphisms (SNPs), MMP gene families, and in silico functional analyses of gene ontology (GO) enrichment and protein–protein interaction (PPI). Results Forty-eight SNPs and 1 indel out of 342 markers of MMP genes were related to IAs. The rs2425024 SNP located on MMP24 was the most strongly associated with IAs (OR=0.43, CI=0.30–0.61, p=2.4×10-6), suggesting a protective effect. The 16938619 SNP of MMP26 significantly increased the risk of an IA (OR=3.12, 95% CI=1.76–5.50, p=8.85×10-5). Five MMP genes (MMP24, MMP13, MMP2, MMP17, and MMP1) increased the susceptibility to an IA. MMP24 was the gene most closely related to IAs (p=7.96×10-7). GO analysis showed that collagen catabolism was the most-enhanced biological process. Further, metalloendopeptidase activity and ECM were predominantly detected in the cellular component and molecular function, respectively. PPI provided evidence that MMP2, TIMP2 (tissue inhibitor of metalloproteinase 2), and TIMP3 genes constitute a network for predicting IA formation. Conclusions The present results provide comprehensive insight into the occurrence of IAs associated with MMPs.","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125113923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel RAB3GAP1 Mutation in the First Tunisian Family With Warburg Micro Syndrome","authors":"Nesrine Kerkeni, M. Kharrat, F. Maazoul, H. Boudabous, R. M'rad, M. Trabelsi","doi":"10.3988/jcn.2022.18.e2","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.e2","url":null,"abstract":"Background and Purpose Warburg Micro syndrome (WARBM) is a rare autosomal recessive genetic disease characterized by ocular, neurologic, and endocrine anomalies. WARBM is a phenotypically and genetically heterogeneous syndrome caused by mutations in RAB3GAP1, RAB3GAP2, RAB18, and TBC1D20. Here we present the clinical and genetic characterization of a consanguineous Tunisian family with a WARBM phenotype presenting two pathogenic variations, one of which is on RAB3GAP1. Methods We applied whole-exome sequencing (WES) to two affected young males presenting a WARBM-compatible phenotype. Results We reveal a new variation in RAB3GAP1 (NM_012233.3: c.297del, p.Gln99fs) and another variation in ABCD1 (NM_000033: c.896A>G, p.His299Arg). Each of these mutations, which in silico predictions concluded as being pathogenic variations, affects a critical protein region. Both affected males presented a WARBM-compatible phenotype, with severe intellectual disability, severe developmental delay, postnatal growth delay, postnatal microcephaly, congenital bilateral cataracts, general hypotonia, and a thin corpus callosum without a splenium. However, intrafamilial clinical heterogeneity was present, since only the oldest child had large ears, microphthalmia, foot deformities, and a genital anomaly, and only the youngest child had microcornea. Despite the mutation identified in ABCD1, our patients did not have any X-linked symptoms of adrenoleukodystrophy disorder that are usually caused by ABCD1 mutations, which prompted our interest in clinical monitoring. Conclusions WES analysis of a consanguineous Tunisian family with WARBM revealed a novel variation in RAB3GAP1 (NM_012233.3: c.297del, p.Gln99fs) that is most likely pathogenic and allowed us to confirm the diagnosis of WARBM.","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117092345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and Dynamic Nomogram to Determine the Individual Risk of Malignant Brain Edema After Endovascular Thrombectomy in Acute Ischemic Stroke","authors":"Qianmei Jiang, Shuai Yu, Xiao-Feng Dong, Huai-Shun Wang, Jie Hou, Zhi-Chao Huang, Zhiliang Guo, S. You, G. Xiao","doi":"10.3988/jcn.2022.18.e7","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.e7","url":null,"abstract":"Background and Purpose This study aimed to construct an optimal dynamic nomogram for predicting malignant brain edema (MBE) in acute ischemic stroke (AIS) patients after endovascular thrombectomy (ET). Methods We enrolled AIS patients after ET from May 2017 to April 2021. MBE was defined as a midline shift of >5 mm at the septum pellucidum or pineal gland based on follow-up computed tomography within 5 days after ET. Multivariate logistic regression and LASSO (least absolute shrinkage and selection operator) regression were used to construct the nomogram. The area under the receiver operating characteristic curve (AUC) and decision-curve analysis were used to compare our nomogram with two previous risk models for predicting brain edema after ET. Results MBE developed in 72 (21.9%) of the 329 eligible patients. Our dynamic web-based nomogram (https://successful.shinyapps.io/DynNomapp/) consisted of five parameters: basal cistern effacement, postoperative National Institutes of Health Stroke Scale (NIHSS) score, brain atrophy, hypoattenuation area, and stroke etiology. The nomogram showed good discrimination ability, with a C-index (Harrell’s concordance index) of 0.925 (95% confidence interval=0.890–0.961), and good calibration (Hosmer-Lemeshow test, p=0.386). All variables had variance inflation factors of <1.5 and tolerances of >0.7, suggesting no significant collinearity among them. The AUC of our nomogram (0.925) was superior to those of Xiang-liang Chen and colleagues (0.843) and Ming-yang Du and colleagues (0.728). Conclusions Our web-based dynamic nomogram reliably predicted the risk of MBE in AIS patients after ET, and hence is worthy of further evaluation.","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131260199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localization of Ulnar Neuropathy at the Wrist Using Motor and Sensory Ulnar Nerve Segmental Studies.","authors":"Ki Hoon Kim,&nbsp;Beom Suk Kim,&nbsp;Min Jae Kim,&nbsp;Dong Hwee Kim","doi":"10.3988/jcn.2022.18.1.59","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.1.59","url":null,"abstract":"<p><strong>Background and purpose: </strong>Diagnosing ulnar neuropathy at the wrist (UNW) is often challenging, and performing several short segmental studies have been suggested for achieving this. We aimed to determine the utility of ulnar nerve segmental studies at the wrist (UNSWs) in patients with suspected UNW.</p><p><strong>Methods: </strong>Fourteen patients with typical symptoms of unilateral UNW were evaluated using conventional electrophysiological tests, UNSWs, and ultrasonography (US). In UNSWs, the ulnar nerve was stimulated at three sites (3 cm distal, just lateral, and 2 cm proximal to the pisiform), and recordings were made at the first dorsal interosseous (FDI) muscle and the fifth digit. Four types of UNW were identified by conventional ulnar nerve conduction studies based on motor and sensory fiber involvement. UNW was also categorized as either a proximal or distal lesion relative to the pisiform based on the UNSWs. The relationships between the conventional electrophysiological type, UNSW categorization results, and lesion location as verified by US were analyzed.</p><p><strong>Results: </strong>Proximal UNW lesions were associated with involvement of the entire deep motor and the superficial sensory fibers (type I). Distal lesions were more closely related to deep motor fibers that innervated the FDI (type III). All five proximal and six distal lesions seen in US matched the lesion locations found on UNSWs.</p><p><strong>Conclusions: </strong>Motor and sensory UNSW are considered useful assistive techniques for diagnosing UNW and localizing its lesion sites.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"59-64"},"PeriodicalIF":3.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/87/jcn-18-59.PMC8762509.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39814657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Community Management Rate for Dementia Patients: A Proposed Indicator for Dementia Policies.","authors":"Hyuk Sung Kwon,&nbsp;Jeewon Suh,&nbsp;Mi-Hee Kim,&nbsp;Boyoung Yoo,&nbsp;Minkyung Han,&nbsp;Im-Seok Koh,&nbsp;Hojin Choi","doi":"10.3988/jcn.2022.18.1.24","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.1.24","url":null,"abstract":"<p><strong>Background and purpose: </strong>There is no specific indicator for monitoring dementia management. We propose an auxiliary indicator called the community management rate, defined as the proportion of dementia patients who receive informal care from close caregivers or themselves within their community population. The 5-year community management rate is the percentage of dementia patients who are receiving community management at 5 years after they were diagnosed. The aim of this study was to identify how the community management rate has changed over time and how the 5-year community management rate differs according to age, sex, income, residence area, and comorbidities.</p><p><strong>Methods: </strong>We analyzed customized research database of the Korean National Health Insurance Services from 2003 to 2018. The 5-year community management rate was calculated annually with newly diagnosed dementia patients, and compared among subgroups according to age, sex, income, residence area, and comorbidities.</p><p><strong>Results: </strong>This study analyzed 549,297 patients. Among those newly diagnosed with dementia in 2003, the mean duration of community management during the 15-year follow-up was 5.98 years. The community management rate decreased rapidly from 2003 to 2006, after which it increased. A low 5-year community management rate was associated with older age, higher comorbidity burden, nonmetropolitan residence, and low income.</p><p><strong>Conclusions: </strong>The community management rate seems to reflect diverse patient factors. Efforts are needed to reduce the comorbidity burden and differences in the 5-year community management rate according to residence area and income. This study indicates the need for further investigations into the use of this indicator to monitor the management of dementia patients.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"24-32"},"PeriodicalIF":3.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/90/jcn-18-24.PMC8762494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39814652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}