CURRENT SCIENCE REVIEWS   By Joe Bruman  September 98  P. 1 of 4

Young R et al; J N'surg 1998;89:183-193:
The team of gamma knife proponents applied the technique in 28
pallidotomies and 27 thalamotomies, with results comparable to
the more common lesioning by a stereotactic probe. [The gamma
knife is attractive because it is noninvasive, but it doesn't
provide for microelectrode recording or stimulation to find the
optimum lesion site. -JRB]

Desaloms M et al; J N'surg 1998;89:194-199:
Conventional posteroventral pallidotomy yielded good results in
35 PD patients, despite occasional presence of morbid conditions
such as cortical atrophy, enlarged ventricles, deep white-
matter lesions, etc.

Keller T et al; J N'surg 1998;89:314-316:
Detailed case report of a stereotactic thalamotomy (ventral
intermediate nucleus) that completely abolished persistent leg
tremor, with high praise for microelectrode guidance.

Larkin M; Lancet, 18 Jul 98:208:
Natural concentration of adrenal steroid dehydroepiandrosterone
(DHEA) peaks in the 3d decade but declines 90% by age 80. Claims
of various benefits have made it very popular as a nutritional
supplement, alarming some experts. But at least one formal
double-blind trial of DHEA as an antidepressant is underway.

Litvan I et al; Arch Neur 1998;55:969-978:
Presence of Lewy bodies is no longer considered essential to
diagnosis of PD, and there is some question as to whether PD and
dementia with Lewy bodies are two distinct diseases or not. The
authors had 6 neurologists review clinical records of a diverse
cohort, and compared their opinions with autopsy findings.

Thorogood M et al; BMJ, 25 Jul 1988:252-255:
Looking once more for mortality risk of selegiline, they
reviewed computerized PD patient records representing 14,000
person-years of anti-PD drug use, finding nothing significant.

Coyle J et al; J Neur N'surg Psych 1998;65;280-282(letters):
The British team that set off the scare about selegiline
(Eldepryl) mortality 4 years ago didn't give up. They later
claimed that it carries risk of acute postural hypotension (CSR
Oct 97 p.3). That study too is now rebutted by two groups, one
of whom bluntly called it "not scientifically sound".

Perrine K et al; J Neur N'surg Psych 1998;65:150-154:
Neuropsychological test of 28 posteroventral pallidotomy
recipients showed no dramatic cognitive decline.

Scott R; J Neur N'surg Psych 1998;65:148 (editorial):
Comment on article above; although cognition is generally not
affected by pallidotomy, there is considerable individual
variation that remains unexplained.

Asahina M et al; J Neur n'surg Psych 1998;65:155-163:
Looking for source of cognitive impairment in PD, PET studies
of 12 PD patients, 7 with PSP, and 8 healthy controls showed
abnormality of certain cortical acetylcholine receptors in the
PD group.

CURRENT SCIENCE REVIEWS  By Joe Bruman September 1998  P. 2 of 4

Counihan T, Penney J; J Neur N'surg Psych 1998;65:164-169:
Testing the hypothesis that regional difference in expression
of the dopamine transporter DAT might account for selective
vulnerability of substantia nigra neurons in PD, postmortem
study of 5 PD subjects and 5 controls showed no difference.

Churchilles E et al; Mov Disord 1998;13:406-413:
By questionnaires and interviews, they found that health burdens
of PD increase as the disease advances.

Agostino R et al; Mov Disord 1998;13:418-421:
In PD patients, sequential finger movement is harder than gross
hand movement, because finer cortical control is impaired.

Oliveira R et al; Mov Disord 1998;13:422-427:
In PD, movement in a motor task is reduced when another task is
added, due to underactivation of the supplementary motor cortex.

Housdorff J et al; Mov Disord 1998;13:428-437:
Variation of stride timing was greater than normal in PD and HD.

Wenning G et al; Mov Disord 1998;13:438-445:
Combined beta-CIT and IBZM SPECT studies may help monitor
progression of nigrostriatal dysfunction in early-stage PD.

Delalande I et al; Mov Disord 1998;13:446-452;
Tests of PD and MSA patients confirmed that visual evoked
potentials and spatiotemporal contrast sensitivity differ in the
two diseases, suggesting a useful diagnostic tool.

Caviness J et al; Mov Disord 1998;13:540-544:
Two levodopa-responsive PD patients had myoclonic movements in
wrists and fingers, determined by evoked potential measurements
to be of cortical origin.

Anderson D et al; Mov Disord 1998;13:626-632:
Judging from unpublished PD prevalence surveys in 5 different
nations, they are less valuable if the diagnostic criteria vary,
or if only one instead of all family members is interviewed.

Stebbins G, Goetz C; Mov Disord 1998;13:633-636:
Assessment of 294 idiopathic PD patients suggests that the Motor
Examination section of the Unified Parkinson's Disease Rating
Scale (UPDRS) provides a useful measure of PD function as well
as severity measures of six clinical disability domains.

Schneider J et al; Mov Disord 1998;13:637-642:
The novel neuronal nicotinic acetylcholine agonist SIB-1508Y
given to MPTP* monkeys made them vomit but didn't help their
PD symptoms. But very low doses combined with a small amount
of levodopa did help.
* MPTP=1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine

Hauser J et al; Mov Disord 1998;13:643-647:
In a controlled trial on new PD patients tolcapone, either alone
or combined with selegiline, was fairly well tolerated but had
no symptomatic benefit.


CURRENT SCIENCE REVIEWS By Joe Bruman  September 1998 P. 3 of 4

Krack P et al; Mov Disord 1998;13:648-652:
In three advanced PD patients with severe dyskinesia, bilateral
stimulation of the pallidum internus (GPi) did away with
levodopa-induced dyskinesia (LID), but also reduced levodopa's
benefit against akinesia. Stimulation parameters should vary
between "off" and "on" phases for the best combination of the
two opposing effects.

Magnani G et al; Mov Disord 1998;13:653-660:
Event-related desynchronization (ERD) to voluntary movement is
an indicator of cortical activation. Tests showed that in PD,
ERD is impaired contralateral to the movement, but not
ipsilateral.

Marsattari S et al; Mov Disord 1998;13:684-689:
Eight out of 16 HIV patients also had parkinsonism, reversible
on withdrawal of neuroleptics in some but not all.

Lyons K et al; Mov Disord 1998;13:690-692:
Deep brain stimulation of the thalamus markedly improved daily
functioning in ET patients with otherwise intractable tremor.

Ondo W et al; Mov Disord 1998;13:693-698:
Both unilateral and bilateral pallidotomy in eight patients with
generalized dystonia proved safe and effective.

LeWitt P; Mov Disord 1998;13:731-734:
Levodopa-induced dyskinesia (LID) in two PD patients extended to
eye movements as well.

Korpelainen J et al; Clin Neuropharm 1998;21:251-254:
The MAO-A inhibitor moclobemide caused reversible hypersexuality
in two patients with stroke and one with PD.

Science News, 15 Aug 98;154 (news item):
Two antidepressants, buproprion (Wellbutrin) and the tricyclic
nortryptiline (Pamelor) reduce the craving of addicted smokers
for nicotine, possibly because both drugs enhance activity of
dopamine. [In curious contrast to PD, where lack of dopamine is
associated with non-smokers.]

Gu M et al; Ann Neur 1998;44:177-186:
Mitochondria, mysterious little bodies in human cells that
perform vital metabolic functions and carry their own DNA, may
be the evolutionary relic of an organism that invaded future
human cells long ago. A sign of PD is deficient mitochondrial
complex I in the substantia nigra and in platelets. This study
shows that it may be due to a mutation in the mitochondrial DNA.

Vaughan J et al; Ann Neur 1998;44;270-273:
Last year, workers thought they had found an autosomal-dominant
mutation of the gene for alpha-synuclein, associated with the
familial variant of PD. But these authors examined another
group of related PD patients, and found no such association.

Inselberg R et al; Ann Neur 1998;44:294:
Previous authors (CSR Nov 97) thought they had found a mutation
of the gene for apolipoprotein E, associated with early  onset
of PD. Two recent studies now show no such association.

CURRENT SCIENCE REVIEWS  By Joe Bruman  September 1998  P.4 of 4

Currie L et al; Neur 1998;51:283-285:
Of 383 PWP surveyed, 61 (16%) reported early-morning dystonia.

Palhagen S et al; Neur 1998;51:520-525:
In a trial of selegiline vs. placebo in 157 new PD patients, it
delayed UPDRS progression and the need to start levodopa,
apparently a neuroprotective rather than a symptomatic effect.

Comella C et al; Neur 1998;51:526-529:
PD patients with sleep-related injury frequently have REM sleep
behavior disorder (RBD), which may be treated with drugs such as
clonazepam.

Hornykiewicz O; Neur 1998;51S2:S2-S9:
(Review) Biochemical aspects of PD.

Yamamoto M; Neur 1998;51S2:S10-S12:
(Review) While DA agonists alone may delay the need for
levodopa, there is no clinical evidence of neuroprotection.

Ogawa N; Neur 1998;51S2:S13-S20:
(Review) Early use of DA agonists in PD that delay the need for
levodopa also delays onset of levodopa-induced adverse effects.

Poewe W; Neur l998;51S2:S21-S24:
(Review) All current oral DA agonists are less effective and
less well tolerated than levodopa, hence their use as initial
treatment should be limited to patients at risk for
levodopa-induced dyskinesia, i.e., young-onset PD patients.

Quinn N; Neur 1998;51S2:S25-S29:
(Review) Classification of fluctuation types in PD.

Chase T et al; Neur 1998;51S2:S30-S35:
(Review) Glutamatergic (NMDA) receptors may be as important in
PD as dopamine receptors, and more attention to that aspect of
the disease may lead to safer and more effective treatment.

Djaldetti R, Melamed E; Neur 1998;51S2:S36-S40:
(Review) Some response fluctuations in late PD may be due to
poor absorption of levodopa taken by mouth, for which several
corrective measures are availalble.

Science News; 22 Aug 1998;120-122:
Cultured human nerve cells have successfully repaired some brain
damage in rats due to induced stroke as well as induced PD. Now
the first in a planned trial on 12 human stroke victims has had
her transplant and awaits the outcome. [The huge potential
market of diseases other than PD has inspired a race to be first
with the substitute for transplantable human fetal cells.]

--
J. R. Bruman   (818) 789-3694
3527 Cody Road
Sherman Oaks, CA 91403-5013