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CURRENT SCIENCE REVIEWS By Joe Bruman April 2000 Page 1 of 2 Kew M; Lancet; 19 February 2000:591-592 (commentary): Moderately elevated (120-500 U/L) serum concentrations of the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are the most used indicators of mild or chronic damage by a virus, toxin, or drug. But ALT/AST levels don't reliably indicate the degree of cumulative necrosis, which on rare occasion may lead to fulminant (sudden) liver failure [e.g., four cases in clinical trials of tolcapone (Tasmar)]. Schrag A et al; Lancet, 26 February 2000;754-755: More letters exchange about prevalence of PSP and MSA (CSR JAN 00, MAR 00). Sorting these conditions from early PD is difficult because clinical symptoms are imperfectly defined, and also because cases are so rare that the ordinary general practitioner is unlikely to become familiar with them. Page W, Tanner C; Lancet, 4 March 2000:843: Unlike the prior study of British WW II POWs (CSR JAN 00), a similar study of American POWs shows higher prevalence of PD reported as cause of death. Lancet, 18 March 2000:991 (news item): Comment on the pig cell transplant trial cited below: This and the Science News article appear to stem from a news conference by the Massachusetts firm Diacrin, who hope to market the embryonic neural tissue if and when the procedure is approved. Snow B et al; J Neur N'surg Psych 2000;68:313-316: The discovery of parkinsonism caused by MPTP from a botched batch of kitchen-brewed heroin was a unique windfall for PD researchers, because it allows use of lab animals instead of human subjects to test all kinds of drugs and other treatment. Moreover, the original victims have been carefully followed and studied. High resolution positron-emission tomography (PET) now shows, however, that MPTP-induced parkinsonism is distinct from idiopathic PD, so the study model is imperfect. Sawle G; J Neur N'surg Psych 2000;68:276 (editorial): Commentary and history on the item above. Rivaud-Pechoux S et al; J Neur N'surg Psych 2000;68:381-384 : Certain eye movements (saccades) are impaired in PD and not improved by levodopa. But in 8 PD patients, bilateral stimulation of the subthalamic nucleus (STN) reduced the impairment. Goetz C et al; Neur 2000;54:710-714: Authors examined 105 early-stage PD patients in the placebo group of a controlled trial of ropinirole (Requip) and found that 16% of them experienced objective improvement of PD symptoms. Benarroch E et al; Neur 2000;54:963-968: Autonomic failure, mainly orthostatic hypotension, in patients with multiple system atrophy (MSA) is accompanied by loss of certain neurons in part of the medulla; but in PD patients with similar autonomic failure, that is not the case. CURRENT SCIENCE REVIEWS By Joe Bruman April 1999 Page 2 of 2 Schumacher J et al; Neur 2000;54:1042-1050: To test safety and efficacy of unilateral embryonic pig cell transplants in PD patients, they followed 12 recipients for a year. They found variable but general improvement in symptoms, no porcine retrovirus and no serious adverse effects. Schmand B et al; Neur 2000;54:1058-1064: In a controlled neuropsychological study of 35 PD patients receiving unilateral pallidotomy, they found no significant effects upon cognition or behavior. Science News, 18 Mar 2000:180(news item): Unlike other neurons of the adult central nervous system, olfactory cells can regenerate naturally, thanks apparently to protection by special cells called olfactory ensheathing glia. Spanish researchers cut the spinal cords of lab rats, then injected those glial cells at the severed ends, which then regrew enough connections to restore hindquarters mobility. Science News, 25 Mar 2000;197(news item): Some details about the pig cell transplant trial cited above: In this first trial to establish safety, a relatively small amount of tissue was used. Nevertheless, symptom improvement was "dramatic" in 3 of the 10 advanced-PD subjects, moderate in 3 others, while the remaining 4 were unchanged. A new study with 18 subjects, using 4 times the former amount of tissue, includes a control group getting sham transplants (at first). Jankovic J et al; Arch Neur 2000;57:369-372: In a followup as long as 12 years of 800 early-PD subjects of the original Deprenyl And Tocopherol As Treatment Of Parkinson's (DATATOP) study, they found that original investigators had altered their diagnosis in only 65 cases. Henderson J et al; Ann Neur 2000;47:345-352: Although degeneration of dopaminergic feedback from the substantia nigra to the corpus striatum is a defining feature of PD, glutamatergic inputs to the striatum from the cerebral cortex and a part of the thalamus* are more important. Postmortem study of 9 patients and 8 controls showed significant neural degeneration of that region as well, and since it is important in movement control, PD symptoms may be worsened. (*: "centre median-parafascicular complex") Di Maria E et al; Ann Neur 2000;15:374-377: As well as several clinical features, corticobasal degeneration (CBD, formerly CBGD) and progressive supranuclear palsy (PSP) are found to share certain anomalies of the tau protein gene. Ramaker C et al; Mov Disord 2000;15:55-64 To assess the value of bromocriptine (Parlodel) as adjunct therapy for levodopa-induced motor complications of PD, they reviewed 8 different reports of controlled trials conducted between 1966 and 1999, but complain that the generally poor trial methodology prevents any important conclusions. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013