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Out of hundreds of papers to be presented next week at the American Academy Of Neurology's 52nd annual shindig in San Diego, only about 19 were directed at PD- Hasty reviews appear below. Cheers, Joe Highlights, AAN 52nd Annual Meeting, from: Page 1 of 2 Neurology 2000;54:Supplement 3:April 2000 S19.004 Marek K et al: As a part of the CALM-PD study to compare levodopa vs. pramipexole as initial therapy, they demonstrate that b-CIT/SPECT imaging may be used to monitor longitudinal reduction in dopamine transporter density in early PD. S19.005 Korczyn A et al; Comparison of the non-ergot D3/D2 dopamine receptor agonist ropinirole (Requip) vs. levodopa as initial therapy for elderly PD patients showed that Requip is safe and effective. S19.006 Swope D; Following a report by an advanced-PD patient with severe motor fluctuations and dyskinesia who was also taking sildenafil (Viagra) for erectile dysfunction, an open-label trial with an additional 5 male and 3 female PD patients confirmed that Viagra does indeed reduce dyskinesia in advanced PD. S59.001 Goerendt I et al; Using positron-emission tomography (PET) imaging to map regional cerebral blood flow in 13 PD patients and 12 healthy controls, they explore the adaptive use of alternative circuits used by PD patients in motor and cognitive task processing. S59.002 Eidelberg D et al; Using PET imaging of 16 early-PD patients and 9 healthy controls during a motor learning and execution task, they found a fundamental difference between the two groups, in the relationship of performance and brain activation. In PD, dysfunction of basal ganglia is compensated by means of additional cortical activity. S59.003 Piccini P et al; By means of PET scans using 2 different tracers, they compared dopamine storage capacity and receptor availability between 6 PD patients (including 1 fetal transplant recipient) and 6 normal controls, finding incidentally that the transplant improved both functions. S59.004 Lee C et al; In vivo PET studies in normal human subjects show that ratios of DAT to VMAT2 decrease regionally in PD and also with aging. S59.005 Yi W et al; Single-proton-emission computed tomography (SPECT) using the new tracer Tc-99m-TRODAT-1, in 32 PD patients and 15 normal controls, proved convenient and powerful detection of the change in dopamine transporters caused by PD. S80.001 Nutt J et al; Using tapping speed as a measure of bradykinesia in a 4-year followup of 18 PD subjects on levodopa, they found that patients reported motor fluctuations despite the fact that the degree and length of short-duration response didn't change. S80.002 Goetz C et al; Hallucinations appear in about a third of PD patients on chronic dopaminergic drug treatment. A controlled study of the neuroleptic olanzapine (Zyprexa) was stopped for safety reasons, but not before it was shown to aggravate PD. Highlights AAN 52nd Annual Meeting Page 2 of 2 S80.003 Arnulf I et al; They examined 10 non-demented patients with long-standing levodopa-responsive PD and hallucinations, finding association with REM sleep and behavior disorders. S80.004 Rajendran P et al; A detailed questionnaire study of 201 PD patients revealed that 40% use at least one alternative therapy (e.g., vitamins/herbs, acupuncture, massage) often not telling their doctor. S80.005 Zesiewicz T et al; Using a driving simulator to compare 39 PD patients and 25 controls, they found the PD group had significantly more simulated collisions. S80.006 Nelson L et al; By structured interview of 496 new PD patients and 541 controls, they found some association of PD risk with garden herbicide exposure, and a stronger one with use of household pesticiides. S83.001 Vitek J et al; A 3-year followup of 14 PD recipients showed that microelectrode-guided unilateral posteroventral pallidotomy improved all the cardinal motor signs of PD for at least that long. S83.002 Pahwa R et al; Simultaneous bilateral stimulation implants of the subthalamic nucleus in 16 recipients improved "on" time and other PD signs as well as reducing dyskinesia, for at least the 3-month followup period. Despite several adverse events, they feel benefits outweigh the risks. S83.003 Antonio D et al; Eight recipients of chronic subthalamic nucleus (STN) stimulation at 6-month followup had no significant loss of cognitive function. S83.004 Bonnet A et al; They studied night-time sleep and motor symptoms in 10 PD recipients of bilateral STN stimulation, finding that while insomnia results mainly from motor disability, leg movements and REM sleep behavior disorders come from systems other than the nigro-striatal-pallido-cortical pathways. S83.005 Ellias S et al; At about 3-year followup, porcine fetal cell transplants in 12 patients with moderate to severe PD had no major safety problems and continued to show improvement in PD motor symptoms. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013