>Hmm so whats new :)

The only drug I take for PD so far (5 years) is benztropine, an 
anticholinergic. I lose my balance sometimes when people hug me but 
I've never actually fallen.

>
>-----Original Message-----
>From: Parkinson's Information Exchange Network
>[mailto:[log in to unmask]] On Behalf Of mschild
>Sent: Thursday, December 17, 2009 10:00 AM
>To: [log in to unmask]
>Subject: Falls in PD Correlate with Cholinergic, not Dopaminergic,
>Dysfunction
>
>
>
>Loss of cholinergic function predicts falling in Parkinson's disease,
>according to a new study, independent of dopaminergic denervation.
>
>Seventeen PD patients with a history of falls, 27 PD patients without such
>history, and 15 controls underwent radioimaging with tracers for cholinergic
>
>and dopaminergic activity. Both PD groups had reduced dopaminergic function
>compared to controls, but were not significantly different from each other.
>Compared to controls, combined cortical and thalamic cholinergic function
>was
>reduced in PD non-fallers (-6.6%) and was even worse in fallers (-12.3%).
>The
>same pattern held true for cortical function alone. In contrast, thalamic
>cholinergic function was reduced compared to controls only in fallers.
>
>"Thalamic acetylcholinesterase activity derives mainly from terminals of
>brainstem pedunculopontine nucleus neurons that play a role in the
>generation
>of movement," the authors state, "and loss of AChE is likely to reflect PPN
>neuron dysfunction or degeneration. Our results are consistent with a key
>role
>for the PPN in the maintenance of balance in humans and with PPN
>dysfunction/degeneration as a cause of impaired postural control and gait in
>
>PD." They suggest that cholinergic therapy may have a role to play in
>treatment of gait disorder in PD, but "it is uncertain whether the current
>generation of cholinesterase inhibitors have sufficient brain penetrance to
>produce meaningful clinical benefits."
>
>History of falls in Parkinson disease is associated with reduced cholinergic
>
>activity
>NI Bohnen, MLTM Muller, RA Koeppe, SA studenski, MA Kilbourn, KA Frey, RL
>Albin
>Neurology 2009;73:1670-1676
>
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-- 
Steve in VT

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