We aimed to investigate the clinical characteristics of movement disorders (MD) associated with cerebral artery stenosis (CAS). 

Studies of secondary MD caused by cerebrovascular diseases have primarily focused on post-stroke MD. However, MD can also result from CAS without clinical manifestations of stroke. 

A nationwide multi-center retrospective analysis was performed based on the data from patients with CAS-associated MDs from 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 the 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 outcomes of MD. Statistical analyses were performed to identify factors associated with the outcomes of MD.

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. Relative to patients with atherosclerosis, those with moyamoya disease 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 onset of MD had a better outcome than those with subacute-to-chronic onset of MD (p = 0.008). 

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.