CURRENT SCIENCE REVIEWS   By Joe Bruman   November 1997   p. 1 of 4

Tedeschi G et al; Brain 1997;120:1541-1552:
They scanned 12 patients with progressive supranuclear palsy, 10
with Parkinson's disease, 9 with corticobasal degeneration, and 11
healthy controls, by proton magnetic resonance imaging. Mapping the
distribution of certain compounds by that technique can distinguish
PD from PSP or CBGD.

Gerloff C et al; Brain 1997;120:1587-1602:
Transcranial magnetic stimulation of the supplementary motor area
of the frontomesial cortex interferes with preparation for planned
complex movement sequence.

Lancet, 20 Sep 1997;868 (news item):
Debate continues over grafting animal tissue or organs into humans.
Breeding of genetically altered pigs has resolved the hyperacute
rejection problem, but the porcine endogenous retrovirus still might
produce new pathogens transmissible by humans.

Gross C et al; J Neurosurg 1997;87:491-498:
Chronic implanted stimulation of the globus pallidus internus in 7
late-stage PD patients alleviated akinesia, rigidity, and levodopa-
induced dyskinesia, improved gait and speech impairment, and in
some subjects reduced tremor, for follow-up periods up to 3 years.
The "high frequency" was 135 to 185 Hz.

Albanese A et al; Mov Disord 1997;12:764-766:
Local injection of botulinum toxin relieved severe constipation in
a PD patient.

Le Couteur D et al; Mov Disord 1997;12:760-763:
A certain anomaly in the dopamine transporter gene was 10 times more
common among 100 PD patients than in 200 controls. Since the
dopamine transporter mediates susceptibility to MPTP, they suspect
that the genetic anomaly might also cause susceptibility to PD.

Hauser R, Zesiewicz T; Mov Disord 1997;12:756-759:
They tried the serotonin reuptake inhibitor Sertraline in 15 PD
patients with depression. It helped but had adverse effects, worse
for those on selegiline, on 5 of the subjects, 2 of whom quit.

Schuurman P et al; Mov Disord 1997;12:752-755:
Staged bilateral posteroventral pallidotomy in 3 young-onset
patients with advanced (H-Y stage 5) PD. One had visual field
deficit and transient facial paresis, but overall improvement
of response fluctuations, hypokinesia, rigidity, and dystonia
was marked and lasting, up to the longest follow-up of 13 months.

Strafella A et al; Mov Disord 1997;12:727-737:
A single stimulus through an implanted electrode inhibited specific
voluntary movement if the site was the ventrolateral thalamus, but
not the periventricular grey matter, globus pallidus internus, or
subthalamic nucleus, leading to a hypothesis about the pathway
involved in the parkinsonian rest tremor.

Rosin R et al; Mov Disord 1997;12:682-690:
They used an optoelectronic tracking system to study gait kinematics
in 31 PD patients and 20 healthy controls, finding the overall
pattern similar, but preparation phase longer, in the PD group.

CURRENT SCIENCE REVIEWS   By Joe Bruman   November 1997   p. 2 of 4

Pahwa R et al; Mov Disord 1997;12:677-681:
In a short study to compare effects of Sinemet CR against those of
regular Sinemet in 18 PD patients at the fluctuation stage, they
needed more CR to compensate its reduced absorption, but enjoyed
better home management and mobility.

Konczak J et al; Mov Disord 1997;12;665-676:
They studied the effect of external timing signals on repetitive
voluntary movement in 12 PD patients, finding that it might help
initiation, but not temporal or spatial coordination.

Teo C et al; Mov Disord 1997;12:655-664:
They found decreased habituation of auditory evoked responses in
advanced-PD patients, and conclude that PD may cause disregulation
of sensory processing.

Curra A et al; Mov Disord 1997;12:646-654:
In a test having subjects point to sequential targets on a screen,
PD patients were slower, more so in internally determined than in
externally cued movements.

Kosel S et al; Mov Disord 1997;12:639-645:
PD is characterized by defect in the respiratory chain of neural
mitochondria. However, in postmortem analysis they found no
corresponding defect in mitochondrial DNA.

Rajput A et al; Mov Disord 1997;12:634-638:
They report 5 patients who had large cumulative dosage of levodopa
(up to 24 kg in 26 yr). Three had essential tremor, one had dopa-
responsive dystonia, and one had non-progressive parkinsonism. None,
including 2 autopsied, showed evidence of levodopa neurotoxicity.

Jaber M et al; Mov Disord 1997;12:629-633:
They used a strain of genetically altered mice to demonstrate the
central importance of the plasma membrane dopamine transporter in
regulating dopamine level in the brain and as an obligatory target
for the action of amphetamine and cocaine. They suggest further
study of transporter-affecting drugs.

Durr A et al; J Neur N'surg Psych 1997;63:394-395:
They studied DNA of 57 with familial PD, 46 with idiopathic PD, and
387 healthy controls, for genes of variants of apolipoprotein E,
one of which is a feature of Alzheimer's. That one is not significant
in PD, but they found another which distinguishes familial from
sporadic PD.

Komaroff A: JAMA, 8 Oct 97:1179-1185:
Complete detailed case history of a 56-yr woman with severe disabling
chronic fatigue for 11 yr. She reported at times feeling unable to
get out of bed in the morning; profound fatigue, pain, and weakness
after minor exertion. Various soporific and antidepressant drugs were
ineffectual, and at time of review, neither attending physician nor
commentator knew what to do next. At one point, he mentions "she
walked slowly", and "family history remarkable for Parkinson disease"
but, incredibly, fails to mention PD anywhere else in the 7-page
article.



CURRENT SCIENCE REVIEWS   By Joe Bruman   November 1997   p. 3 of 4

Bain P; The Neurologist 1997;3:305-321:
In this rather new journal aimed at neuros in clinical practice, the
most thorough (217 refs) summary and tutorial yet seen on essential
tremor. All the known treatments, with histories and actual trial
results.

Sanberg P et al; Nat Med 1997;3:1129-1132:
Ethical and logistic problems of fetal tissue inspire a search for
other sources of dopaminergic cells. A promising candidate is the
Sertoli cells of the testis, readily obtainable from adult cadavers
or pigs rather than aborted human fetuses, and which have improved
parkinson symptoms in rat experiments.

Eliasson M et al; Nat Med 1997;3:1089-1095*:
The unhappy feature of ischemic stroke is the death of involved
neurons, blamed in part on excess nitric oxide (NO) and glutamate,
which happen also to be suspected villains in PD. Working with mice,
researchers found that inhibiting the mediator poly(ADP-ribose)
polymerase (PARP), or deleting the gene for it, is neuroprotective.
* comment, 1073-1074

Science News; 18 Oct 1997:255 (news item):
Lewy bodies, a hallmark of PD, are found to be clumps of the protein
alpha-synuclein. Although it isn't certain that Lewy bodies cause the
death of brain cells, scientists are looking for ways to prevent
alpha-synuclein from clumping.

Haas H et al; J Neur N'surg Psych 1997;63:421-428:
In formal trial of tolcapone and tolcapone plus levodopa in
late-stage PD patients having "wearing-off" motor fluctuations,
tolcapone prolonged "on" time, shortened "off" time, and reduced
the levodopa dosage requirement.

Oliveira R et al; J Neur N'surg Psych 1997;63:429-433:
Small handwriting common in PD was improved by external cues, either
auditory reminders or guiding marks on the paper. Movements became
generally longer rather than faster.

Graham J et al; J Neur N'surg Psych 1997;63:434-440:
Hallucinations in PD are associated with direct-acting dopamine
agonists, but not with age at onset or levodopa dosage amount.
However the 129-patient survey showed two distinct modes: in early
stages, association with rapid progression and lack of cognitive
impairment; and in late (>5 yr) stages, with cognitive impairment.

Jansek R, Morris M; J Neur N'surg Psych 1997;63:556:
Improvement of gait in PD is better done by attention to stride
length than to faster cadence.

Guttman M et al; Neur 1997;49:1060-1065:
Comparison of pramipexole vs. bromocriptine vs. placebo in 247
late-stage (fluctuating) PD patients showed pramipexole somewhat
better than bromocriptine, and much better than placebo.

Rajput A et al; Neur 1997;49:1066-1071:
Formal trial on 247 fluctuating PD patients showed that tolcapone
improves motor function and reduces levodopa requirement.


CURRENT SCIENCE REVIEWS   By Joe Bruman   November 1997   p.4 of 4

Uitti R et al; Neur 1997;49:1072-1077:
In 20 consecutive pallidotomy recipients about equally divided
between under 65 and over 65, the elderly benefited as well as the
younger group.

Troster A et al; Neur 1997;49:1078-1083:
Although some pallidotomy recipients have had decline in memory and
language, 9 recipients of pallidal stimulation implants had no such
problems.

Kazumata K et al; Neur 1997;49:1083-1090:
Careful clinical, PET, and MRI study of 22 pallidotomy recipients
showed that glucose metabolism in the lentiform nucleus, and
clinical responsiveness to levodopa, may be useful predictors of
subsequent pallidotomy benefits.

Richard I et al; Neur 1997;49:1168-1170:
In a survey, 71 investigators reported that 26% of 23,410 PD
patients were on antidepressants. Although selective serotonin
reuptake inhibitors {e.g., Paxil, Prozac, Zoloft) are popular, there
is some fear that they may aggravate motor impairment, and authors
suggest a controlled trial.

Denson M et al; Ann Neur 1997;42:638-643:
They studied a newly found PD cluster in a family of Mennonites who
migrated together from Germany to Poland to the Crimea, and late in
the 19th century to America. Their PD is distinct, both clinically
and pathologically, from that of previously reported PD kindreds.

Zareparsi S et al; Ann Neur 1997;42:655-658:
Features of PD and AD sometimes overlap. A mutation of the gene for
apolipoprotein E is associated with Alzheimer's, and now in 137 PD
patients, the same mutation is associated with early onset of PD.

Le Tissier P et al; Nature, 16 Oct 97:681-682 and:
Lancet, 18 Oct 97:1148 (news item):
A retrovirus survives by invading and corrupting its host DNA, thus
ensuring its transmission from one generation to the next. Some RVs
cause illness in the host; others are harmless to the host but may
cause illness in humans or other species. Two such dangerous RVs were
found in pigs, and it looks unlikely that they can be bred out; so
the future of pig cell transplants in PD for now seems bleak.

Bandmann O et al; Lancet, 18 Oct 97:1136-1139:
Pursuing the notion of inherited susceptibility to environmental
PD hazards, they looked at 6 genes for enzymes that reduce environ-
mental toxins, in 100 patients with sporadic PD, 100 with familial
PD, and brain tissue of 100 PD-free controls. Of the 6 they found one
having much more frequent mutations in, and therefore associated
with, the familial PD group.

Le Bars P et al; JAMA, 22 Oct 97:1327-1332:
A 52-week double-blind trial of Ginkgo Biloba extract in 202 patients
with dementia from either Alzheimer's or multiple infarcts (applicable
to PD) showed a modest but distinct improvement in cognition.

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