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CURRENT SCIENCE REVIEWS By Joe Bruman January 2000 Page 1 of 3 Science News, 27 Nov 1999:342(review): A review of the Lancet, 13 Nov 99 editorial (CSR DEC 99) on the current status of surgical treatment for PD. Lancet, 6 Nov 1999:1623: Determined opponents in US Congress, backed by the AMA, blocked Oregon's Death With Dignity (assisted suicide) Act, but their bill also preempts the judgement of doctors who prescribe pain- killing narcotics in large doses. de Bie R et al; Lancet, 13 Nov 1999:1665-1669: A randomized study of 37 unilateral pallidotomy recipients showed quantitative improvement of PD symptoms, but 2 of the 37 subjects had major adverse effects. Lancet, 13 Nov 99:1658(editorial): Research and debate over the value of xenotransplantation (e.g., pig cell transplant for PD- J.B.) have reached the point where governments ought to begin approving clinical applications. Schrag A et al; Lancet, 20 Nov 1999:1771-1775: A clinical records study covering a large population around London suggests that prevalence of progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) is underestimated, due largely to misdiagnosis as PD. Kilian J et al; Lancet, 27 Nov 1999:1841-1845: Following sudden deaths of 2 physically well patients soon after starting the popular neuroleptic clozapine (Clozaril), Australian authorities surveyed 8000 other new users (who were already registered for blood monitoring) and found 23 cases of potentially fatal cardiomyopathy or myocarditis (heart damage). Gale C et al; Lancet, 18 Dec 1999;2116-2118: To test the suspicion that neurodegenerative disease might be more prevalent among survivors of extremely harsh conditions in Japanese POW camps in World War II, they studied 11134 records for listing of PD as cause of death, but found no significant difference from the general population. Ouchi Y et al; Ann Neur 1999;46:723-731: A PET study of 10 early-stage PD patients suggests that asymmetrical changes of dopamine transporters and D1 receptors in the nigrostriatal system might be an early diagnostic sign. Papa S et al; Ann Neur 1999;46:732-738: Recording from single cells of the internal globus pallidus of parkinsonian monkeys during "off" and "on" states showed that the firing rate is nearly suppressed during dyskinesias. Borthwick G et al; Ann Neur 1999;46:787-790: Lab study of cells from ALS patients suggests that cell death in that disease may be due to oxidative damage in mitochondrial DNA. Tröster A et al; Neur 1999;53:1774-1780: Neuropsychological and quality-of-life study of 38 essential tremor (ET) patients who received unilateral deep-brain stimulation (DBS) of the thalamus showed general improvement. CURRENT SCIENCE REVIEWS By Joe Bruman January 2000 p. 2 of 3 Pradham S et al; Neur 1999;53:1781-1786: Five patients having Japanese encephalitis, a viral disease endemic in Asia, had distinctly parkinsonian symptoms, which abated on recovery. Magnetic resonance imaging (MRI) study of those patients showed lesions predominantly in the substantia nigra, the first demonstration of parkinsonism from a virus. Simon D et al; Neur 1999;53:1787-1793: Study of related patients with multisystem degeneration, including prominent parkinsonism, found association with a mutant gene in the mitochondrial DNA. Shulman L et al; Neur 1999;53:1862-1865: A patient of 48, with PD for 17 yr and taking amantadine (Symmetrel) for 8 yr, developed chronic livedo reticularis, a peculiar mottling of limbs. Tried to quit amantadine but PD symptoms worsened. Forced to quit upon appearance of trophic skin ulcers and peripheral neuropathy, both of which resolved upon discontinuing amantadine. Rinne J et al; J Neur N'surg Psych 1999;67:737-741: In positron-emission tomography (PET), they studied a new marker [18F]ß-CFT that maps function of the dopamine transporter and permits improved assessment of disability in PD. Hutchinson M, Raff U; J Neur N'surg Psych 1999;67:815-818: Until now, presymptomatic diagnosis of PD could be done by positron-emission tomography (PET) scan but not by the much cheaper magnetic resonance imaging (MRI) technique. Authors describe a new way of using MRI that may possibly permit such early diagnosis, and later staging of the disease. BMJ, 13 Nov 1999: Special Issue: Entire issue devoted to the impact of new technologies in medicine, with interesting reviews of new brain-imaging methods, stem cell technology, gene therapy, and xenotransplantation. Tandberg E et al; Mov Disord 1999;14:922-927: They did a questionnaire study of excessive daytime sleepiness (EDS) and sleep benefit in 245 PD patients. EDS prevalence of 15.5% was much higher than in diabetes patients or controls. Kuopio A et al; Mov Disord 1999;14:928-939: Extending a previous population-based study, they queried 123 PD subjects and 246 controls to find environmental factors. As usual, smoking was a negative correlate, but so also was keeping domestic and farm animals. Ahlskog J et al; Mov Disord 1999;14:940-946: Using single-proton-emission computed tomography (SPECT) and the marker [1223I]ß-CIT to map dopamine transporter activity, they studied 12 PD patients, with and without the addition of pergolide (Permax), to see its effect on imaging, finding none. Wenning G et al; Mov Disord 1999;141:947-950: They studied records of 77 people who had various parkinsonian disorders, for latency (time to onset) of recurrent falling. PSP patients began early, those with MSA, DLB, or LBD somewhat later, and PD patients were significantly latest of all. CURRENT SCIENCE REVIEWS By Joe Bruman January 00 Page 3 of 3 de Bie M et al; Mov Disord 1999;14:951-957: They found significant benefit from unilateral pallidotomy in 26 advanced-PD recipients. This looks like the same study reported in Lancet, 13 Nov (see above) but I'm not sure. Pinter M et al; Mov Disord 1999;14:958-963: Comparing 7 PD patients who received deep-brain-stimulation (DBS) of the ventral intermediate (VIM) thalamic nucleus with healthy controls, they conclude that tremor suppression by VIM stimulation improves postural stability but not locomotion. Siebner H et al; Mov Disord 1999;14:964-971: They studied changes in handwriting during bilateral deep-brain stimulation (DBS) of the subthalamic nucleus (STN) in 12 recipients with advanced PD, finding that it improves fine motor control as well as the cardinal PD signs. Vermes I et al; Mov Disord 1999;14:1008-1010: The protein Annexin V adheres to dying cells; its concentration in cerebrospinal fluid (CSF) of PD patients is lower than in healthy controls, suggesting that apoptosis is a factor in PD. Ebersbach G et al; Mov Disord 1999;14:1011-1013: A double-blind crossover study in PD patients shows, contrary to an earlier report, that transdermal (patch) nicotine worsens, rather than improves, motor performance. Molho E et al; Mov Disord 1999;14:1014-1016: They tried olanzapine (Zyprexa) as the proposed alternative to clozapine (Clozaril) for treatment of drug-induced psychosis in PD patients. While it improved psychotic symptoms, it worsened motor performance in 9, 6 dramatically, of the 12 subjects. Shimura-Miura H et al; Ann Neur 1999;46:920-924: They find the enzyme 8-oxo-dGTPase increased in the mitochondria of substantia-nigra neurons in PD, suggesting use as a marker of oxidative stress and mitochondrial respiratory failure. Arch Neur 1999;56:1446-1447 (editorial): Explanation of magnetic resonance spectroscopy (MRS) as an improvement over magnetic resonance imaging (MRI) technique for studying distribution of specific compounds in the brain, rather than just the overall density map shown by MRI. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013