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CURRENT SCIENCE REVIEWS By Joe Bruman June 2000 Page 1 of 2 Houeto J et al;Arch Neur 2000;57:461-465: A 6-month followup of 23 consecutive recipients of bilateral implants for deep-brain stimulation (DBS) of the subthalamic nucleus (STN), with placement guided by magnetic resonance imaging and microelectrode recording, showed general improvement of motor symptoms, fluctuations, and dyskinesia, along with a reduced requirement for levodopa. Rinne J et al;Arch Neur 2000;57:470-475: They tested cognitive function in 28 PD patients and 16 controls, while using positron-emission tomography (PET) to map regional activity of the putamen, caudate nucleus, and frontal cortex. PD patients as a group had cognitive impairment, but there was no significant association with the PET results. Chan D et al;Arch Neur 2000;57:501-503: Following the landmark discovery of mutant a-synuclein genes in some European familial PD clusters (CSR AUG 97), they couldn't find either mutant in a large cohort of Chinese PD patients, and conclude that the association is a rare occurrence. Morgante L et al;Arch Neur 2000;57:507-512: A population-based study in Sicily of 59 deceased PD patients and 118 controls showed that PD patients have shorter than average survival duration. Palomeras E et al;Arch Neur 2000;57:570-571: They report a patient receiving gabapentin (Neurontin) to treat essential tremor. On addition of 80mg/day of propranolol (Inderal), which alone had not been reported to cause movement disorder, he developed severe dystonia. Reduction of propranolol to 40mg/day has resolved the dystonia problem, so they suspect a heretofore unreported interaction of the two drugs. Fenelon G et al;Brain 2000;123:733-745: Statistical analysis of neuropsychological examination results in 216 European PD patients revealed that hallucinations are more prevalent than previously reported, and not fully explained as only a side effect of dopaminergic treatment. Lombardi W et al;Brain 2000;123:746-758: In a group of pallidotomy recipients they found correlation of precise lesion site and resulting effects, plus evidence that there are cognitive circuits in the pallidum distinct from the motor circuits. Nour S et al;Brain 2000;1123:781-789: Urinary voiding (micturition) in men is a complex process of several coordinated events, and dysfunction is common in PD and other neurodegenerative diseases. Authors measured bladder pressure and other parameters in 12 normal healthy men, while also mapping control activity in the brain by means of PET scan. CURRENT SCIENCE REVIEWS By Joe Bruman June 2000 Page 2 of 2 Piccini P et al;J Neur N'surg Psych 2000;68:589-596: Controlled trial of the COMT inhibitor entacapone (Comtan) as a single dose taken with Sinemet CR showed enhanced and prolonged therapeutic response in PD patients, comparable with efficacy when combined with regular Sinemet. Bejjani B-P et al;J Neur N'surg Psych 2000;68:595-600: Besides the main symptoms of PD, bilateral stimulation of the subthalamic nucleus (STN) enhances benefit of levodopa in those signs and symptoms, such as postural instability, that normally respond less well to levodopa alone. Hauser R et al;Clin Neuropharm 2000;23:75-81: They studied patient self-evaluation to develop a home diary format for assessment of therapy efficacy. Besides recording "off" intervals, they recommend including "on" intervals with and without troublesome dyskinesia. Snow B et al;Clin Neuropharm 2000;23:82-85: A controlled trial of amantadine (Symmetrel) confirms that it reduces levodopa-induced dyskinesias without worsening other motor symptoms of PD. Jorga K et al;Clin Neuropharm 2000;23:98-105: They tested the effect of tolcapone (Tasmar) withdrawal in a controlled 12-week trial of 59 patients with fluctuating PD. Withdrawal was well tolerated, causing only transient elevation of COMT, unrelated to peripheral levodopa metabolism and hence not considered an adverse effect. Morrish P et al;Neur 2000;54:1721-1722: Debate with authors of earlier study (CSR SEP 99) on discordant incidence of PD in twins. Ross G et al;JAMA 2000;283:2674-2679: A study of 102 PD patients shows that higher coffee intake is associated with lower incidence of PD. The effect seems to be independent of smoking, where a similar correlation was found. Forloni G et al;Ann Neur 2000;47:632-640: Alpha-synuclein, associated with Lewy bodies and certain types of PD, has a nonamyloid component (NAC) which also appears in the senile plaque of Alzheimer's disease. Authors found NAC to be neurotoxic both in vitro and in vivo (rat models). Bejjani B-P et al;Ann Neur 2000;47:655-658: If levodopa-induced dyskinesia (LID) in advanced PD is due to sensitization of striatal receptors caused by long-term intermittent use of levodopa, experiments with patients having deep-brain stimulation (DBS) implants in the subthalamic nucleus (STN) show that the sensitization may be reversible. Hawkes C:Ann Neur 2000;47:682: Critical comment on earlier study (CSR JUN 99) of discordant PD incidence in twins. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013