Message-ID: <[log in to unmask]> Date: Tue, 29 Feb 2000 17:19:45 -0800 From: "J. R. Bruman" <[log in to unmask]> Reply-To: [log in to unmask] X-Mailer: Mozilla 3.0C-NC320 (Win95; U) MIME-Version: 1.0 To: Parkinsn E-Mail Forum <[log in to unmask]> Subject: CSR MAR 00 Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit CURRENT SCIENCE REVIEWS By Joe Bruman March 2000 Page 1 of 3 Siegel K, Metman L; Arch Neur 2000;57:198-204: Augmenting former studies of unilateral pallidotomy, they measured gait parameters before and after in 11 bilateral recipients, finding walking speed approximately doubled. Schwarz J et al; Arch Neur 2000;57:205-208: By single-photon-emission computed tomography (SPECT) of 28 early-PD patients and 9 controls, with the dopamine transporter marker [I-123]IPT, they found that transporter binding in the striatum is reduced, suggesting a means of preclinical diagnosis. Olanow C; Arch Neur 2000;57:263-267: Responding to 4 cases of severe liver damage associated with the COMT inhibitor tolcapone (Tasmar), a special study panel of hepatologists and neurologists concluded that: (1) Tolcapone is effective treatment for PD symptom fluctuations. (2) Risk of irreversible liver injury is negligible if certain liver enzymes are monitored. (3) Required frequency of monitoring may possibly be reduced if no enzyme increase occurs during the initial 6 months. (4) Required withdrawal of tolcapone upon a single occasion of enzyme level above normal range is unnecessarily restrictive. A cutoff at 2 to 3 times upper level of normal should be sufficient to ensure safety of patients taking tolcapone. Laine K et al; Clin Neuropharm 2000;23:22-27: Plasma concentration of selegiline and its metabolite, despite its short half-life, appears to accumulate during the first few days of use, in an 8-day test on 12 healthy volunteers. Authors feel, however, that effects remain comparable with a single dose. Bonuccelli U et al; Clin Neuropharm 2000;23:28-33: Long-term PD patients on levodopa often complain that motor symptoms worsen at day's end. Comparison of objective motor scores with blood samples in 52 assorted PD patients, however, failed to show significant correlation, suggesting that pharmaco- kinetics of levodopa is not to blame. Parkinson Study Group; Clin Neuropharm 2000;23:34-54: Describing a large controlled trial now underway, comparing pramipexole (Mirapex) and levodopa as initial treatment for PD. Toner L et al; Clin Neuropharm 2000;23:54-58: The soporific zolpidem (Ambien), found by chance to improve PD motor symptoms (CSR JUN 97), has caused delirium, hallucinations, and nightmares in some [non-PD] users. Sunami M et al; Clin Neuropharm 2000;23:59-81: Many drugs have adverse neurologic effects. Interferon-a given to a patient with chronic hepatitis-B caused severe akathisia (inability to sit still 10 sec); unresponsive to clonazepam, thioridazine, beta-blockers, anticholinergics, bromocriptine, or levomepromazine. Finally, a 25mg levodopa dose iv did the trick, removing the condition completely. CURRENT SCIENCE REVIEWS By Joe Bruman March 2000 Page 2 of 3 Hu M et al; Brain 2000;123:340-352; Magnetic resonance spectroscopy (MRS) and positron-emission tomography (PET) study of 14 non-demented PD patients and 9 healthy controls showed reduced metabolism in the temporo- parietal area, correlated with cognitive impairment, in the PD group. Shagufta Z et al; Ann Neur 2000;47:218-228: Although proprioception (internally cued sense of position) usually appears normal in routine clinical testing of PD patients, careful study shows that it is impaired. Manson A et al; J Neur N'surg Psych 2000;68:196-201: They developed a portable device to reliably and objectively assess dyskinesia in PD. Reuter I et al; J Neur N'surg Psych 2000;68:238-241: They found 4 patients initially diagnosed with a Parkinson-plus syndrome, that turned out to be late-onset Huntington's disease. Clarke, C; J Neur N'surg Psych 2000;68:254-255: Criticizes report (CSR OCT 99) of increased mortality in PD. Manson A et al; J Neur N'surg Psych 2000;68:260 (abstract): Some patients getting effective control of PD symptoms by subcutaneous apomorhine developed troublesome nodules, which were avoided by switching to intravenous infusion. Benamer H et al; J Neur N'surg Psych 2000;68:263 (abstract): Single-proton-emission computed tomography (SPECT) may detect PD before clinical symptoms appear. Eventual severity may relate to factors other than nigrostriatal degeneration. Marion M-H; J Neur N'surg Psych 2000;68:267 (abstract): Amantadine, possibly through its action on NMDA receptors, was useful in reducing severe dyskinesias of late-stage PD patients. BMJ, 22 Jan 2000:204 (news item): Severed spinal cord in rats was restored by injection of a "cocktail" of nerve growth factor, brain-derived neurotrophic factor, neurotrophin-3, and glial-cell line-derived factor. Lancet, 29 Jan 2000;497-498: Lancet's editorial favoring xenotransplantation (CSR JAN 00) is attacked on basis of both risk and ethics (anti-vivisection). Both groups complain of inadequate recognition by the medical establishment. Tison F et al; Lancet, 3 February 2000;495-496: Comment on a previous Lancet article (CSR JAN 00) on prevalence of multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), with a new survey of a large French cohort showing MSA prevalence of about 2 per 100,000 general population. Kompoliti K et al; Neur 2000;54:458-462: In a controlled study using apomorphine as a dopamine agonist, they found that speech impairment in PD was unaffected. They conclude that neither laryngeal nor articulatory function is under prominent dopaminergic control. CURRENT SCIENCE REVIEWS By Joe Bruman March 2000 Page 3 of 3 Gwinn-Hardy K et al; Neur 2000;54:504-507: They found a small kindred of idiopathic PD with no genetic link to any established locus, including a-synuclein, parkin, or tau genes, or residence on chromosomes 2p or 4p. Schrag S et al; Neur 2000;54:697-702: Differential diagnosis of atypical parkinsonian syndromes such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA) or cortico-basal [ganglia] degeneration (CBD) is difficult and often unsuccessful. In a controlled study, these experienced practitioners found routine magnetic resonance imaging (MRI) scans to be helpful, if not always conclusive. Simon D et al; Neur 2000;54:703-709: In contrast to authors' finding in multiple system atrophy (MSA) patients (CSR JAN 00), a controlled study of mitochondrial DNA in PD patients revealed no significant association with any previously reported mutations. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013