Kim BK, et al. J Clin Neurol. 2012 Sep;8(3):204-211. http://dx.doi.org/10.3988/jcn.2012.8.3.204

Background: High-sensitivity C-reactive protein (hs-CRP) is a sensitive systemic marker of inflammation, and increased levels of hs-CRP are associated with inflammatory reactions. Microglia-mediated neuroinflammation has been hypothesized to play an important role in the pathogenesis of idiopathic Parkinson’s disease (PD). However, the clinical value of hs-CRP in PD is poorly defined. Therefore, we conducted this study to investigate the clinical value of hs-CRP in patients with PD. Methods: We examined 212 patients with de novo PD, 253 patients with acute ischemic cerebrovascular disease and 119 healthy subjects and investigated the differences in hs-CRP among these 3 groups. The PD group was classified into 4 subgroups according to the Hoehn and Yahr stage to investigate the relationship between hs-CRP and symptom severity. Results: There was no significant difference in the hs-CRP value between the PD and the ischemic cerebrovascular disease groups, but the subjects in the 2 disease groups demonstrated higher hs-CRP levels than those in the normal control group. A post-hoc analysis of the 4 PD subgroups showed no significant differences in hs-CRP values. In addition, this study demonstrated that the odds ratio of the PD group by hs-CRP was 2.037 (95% CI 1.180–3.517; p = 0.011). Conclusion: We suggest that our results could support the hypothesis that neuroinflammation contributed to the pathogenesis of PD and cautiously assume that elevated hs-CRP might have a clinical value as a risk factor for PD.

Cluster headaches (CH) are recurrent severe headaches, which impose a major burden on the life of patients. We investigated the impact of CH on employment status and job burden. The study was a sub-study of the Korean Cluster Headache Registry. Patients with CH were enrolled from September 2016 to February 2018 from 15 headache clinics in Korea. We also enrolled a headache control group with age-sex matched patients with migraine or tension-type headache. Moreover, a control group including individuals without headache complaints was recruited. All participants responded to a questionnaire that included questions on employment status, type of occupation, working time, sick leave, reductions in productivity, and satisfaction with current occupation. The questionnaire was administered to participants who were currently employed or had previous occupational experience. We recruited 143 patients with CH, 38 patients with other types of headache (migraine or tension-type headache), and 52 headache-free controls. The proportion of employees was lower in the CH group compared with the headache and headache-free control groups (CH: 67.6% vs. headache controls: 84.2% vs. headache-free controls: 96.2%; p = 0.001). The CH group more frequently experienced difficulties at work and required sick leave than the other groups (CH: 84.8% vs. headache controls: 63.9% vs. headache-free controls: 36.5%; p < 0.001; CH: 39.4% vs. headache controls: 13.9% vs. headache-free controls: 3.4%; p < 0.001). Among the patients with CH, sick leave was associated with younger age at CH onset (25.8 years vs. 30.6 years, p = 0.014), severity of pain rated on a visual analogue scale (9.3 vs. 8.8, p = 0.008), and diurnal periodicity during the daytime (p = 0.003). There were no significant differences with respect to the sick leave based on sex, age, CH subtypes, and CH recurrence. CH might be associated with employment status. Most patients with CH experienced substantial burdens at work.

Background: Several studies have suggested that the specific stroke subtype may influence the presence of leukoaraiosis in patients with ischemic stroke. We investigated the association between stroke subtype and leukoaraiosis in Korean patients with ischemic stroke by MRI. Methods: There were 594 patients included in this study that were classified as large artery disease, lacune and cardioembolic stroke. For large-artery disease, the analysis focused on the intracranial or extracranial location of the stenosis, and the multiplicity of the stenotic lesions. Leukoaraiosis grading was performed according to the Atherosclerosis Risk in Communities Study. Results: There was a significant association between leukoaraiosis and the stroke subtypes; the large-artery-disease group had a higher prevalence of leukoaraiosis than did the other groups (55.4% in the large-artery-disease group, 30.3% in the lacunar group and 14.3% in the cardioembolic group, P = 0.016 by chi-square test). On the multivariate linear regression analysis, age, the presence of hypertension, previous stroke and stroke subtype were independently associated with the presence of leukoaraiosis. In the sub analysis of the large-artery-disease group, the leukoaraiosis had a tendency to be more prevalent in the mixed and intracranial stenosis group than did the extracranial stenosis group (45.5% in the mixed group, 40.3% in the intracranial group and 26.9% in the extracranial group, P = 0.08 by chi-square test). Conclusion: The association of leukoaraiosis with large-artery disease in this study might be due to the relatively high prevalence of intracranial occlusive lesions in Korean stroke patients compared to other ethnic groups.

Jang J, et al. J Clin Neurol. 2020 Oct;16(4):562-572. https://doi.org/10.3988/jcn.2020.16.4.562

Park JW, et al. J Clin Neurol. 2007 Mar;3(1):24-30. http://dx.doi.org/10.3988/jcn.2007.3.1.24