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CURRENT SCIENCE REVIEWS By Joe Bruman Sept. 2000 Page 1 of 3 Arnulf I et al;Neur 2000;55:281-288: Sleep disorders are common in PD. They include vivid dreams and, during rapid-eye-motion (REM) sleep, behavioral disorders (RBD) which may include violence, such as punching, shoving, or kicking one's bed-partner. Another feature of PD is daytime hallucinations and delusions, usually associated with long use of levodopa or dopamine agonists. In detailed study of 10 PD patients who experienced hallucinations and 10 who didn't, strong association of RBD and daytime hallucinations suggests that the latter may be dream imagery, reflecting a narcolepsy-like REM sleep disorder. Maillard L et al;Neur 2000;55:377-383: The basal ganglia (striatum and pallidum) are major nodes for signals of motor control, and many previous studies have found association between specific parts of the body and specific areas of the brain. Authors here used magnetic resonance imaging (MRI) of 6 volunteers while performing specified tasks with face, fingers, or toes, to map the representation in the brain of those parts. Pillon B et al;Neur 2000;55:411-418: As part of an ongoing series of studies to validate safety and efficacy of deep-brain stimulation (DBS) in PD, authors tested cognitive function in 56 DBS recipients at 3 and 12 months after surgery, with stimulator either "on" or "off", and found no significant deficit. Yasui K et al;Neur 2000;55:437-440: PD patients taking levodopa may have elevated homocysteine, a known risk of vascular disease, that can be reduced by a diet containing plenty of folate, a B-complex vitamin present in leafy green vegetables. Homocysteine also is elevated by a certain gene mutation, with effect additive to that of levodopa. Niranjan A et al;Neur 2000;55:443-446: Drug therapy for essential tremor (ET) is not nearly so effective as that for PD, but either deep-brain stimulation (DBS) or localized ablation of the thalamus (thalamotomy) is a promising alternative. The latter may need repetition in time as its effects fade, but the usual invasive surgery is always risky. So this team used the non-invasive gamma-knife technique for thalamotomy on 11 patients, including 8 with ET, concluding that it is safe and effective. Swerdloff M et al;Neur 2000;55:456-457(letters) Acerbic debate over role of amantadine (Symmetrel) in peripheral neuropathy leading to severe leg ulcers in a certain PD patient (CSR JAN 00). CURRENT SCIENCE REVIEWS By Joe Bruman Sept. 2000 Page 2 of 3 Maruyama M et al;Ann Neur 2000;48:245-250: Autosomal-recessive juvenile parkinsonism (AR-JP) has symptoms responsive to levodopa just like idiopathic PD, except for its association with a mutant of the "parkin" gene. Authors found clusters of AR-JP in 6 unrelated Japanese families. Grondin R et al;Ann Neur 2000;48:250-253: Elderly people develop impaired motor performance of upper limbs even though they may not have PD; and so do elderly monkeys. Authors tested 6 young monkeys and 7 aged ones, by observing the time to reach through an opening and grab a treat, as affected either by levodopa or by the dopamine agonist piperazine (GBR- 12909). Both drugs improved performance of the old monkeys, suggesting possible benefit to old people who don't have PD. Bloem B et al;Ann Neur 2000;48:268: Frail, elderly, institutionalized people who cannot walk and talk at the same time (SWWT) are also at higher risk of falling. Authors here compared 38 such inmates who also had PD against 35 who didn't, and found that SWWT predicts higher risk of falling only in those who don't have PD, not in those who do. They suggest it is because SWWT represents a cognitive, not a motor, deficit, and that PD is not associated with cognitive deficit. Molinuevo J et al;Arch Neur 2000;57:921(editorial), 983-988: Formal examination and 6-month followup of 15 advanced-PD recipients of bilateral subthalamic nucleus (STN) deep-brain stimulation (DBS) electrode implants confirmed that STN DBS is a safe and effective substitute for levodopa therapy. Lang A;Arch Neur 2000;57:1118-1125: Detailed summary review of surgical options for PD, state of the art, and unresolved questions for future scientific trials. Despite optimistic claims and sometimes dramatic results, the scientific evidence supporting surgery as alternative to drug therapy is relatively weak. Louis E et al;Arch Neur 2000;57:1194-1198: Examination of 115 essential tremor (ET) patients in northern Manhattan, New York, to compare age at onset, rate of progression and anatomic distribution, suggests that there may be distinct subtypes of ET. Sohn Y et al;Arch Neur 2000;57:1214-1218: Two people poisoned simultaneously by carbon monoxide (CO) had comparable loss of dopamine neurons (as revealed by MRI), but only one developed parkinsonism signs and intellectual damage. Injury to white matter of the pallidum occurred in both, but was much worse in the one who developed parkinsonism signs. Pincus M et al;Arch Neur 2000;57:1231-1232(letters); Dispute over previous claim (CSR MAR 00) that bilateral pallidotomy improved a PD patient's gait impairment. CURRENT SCIENCE REVIEWS By Joe Bruman Sept 2000 Page 3 of 3 Marek K;Arch Neur 2000;57:1237: An abstract from the 2nd annual meeting of the American Society for Experimental Neurotherapeutics, 23-25 March 2000: Discusses potential of positron-emission tomography (PET) and single-photon emission computed tomography (SPECT) for assessment of neurode- generation and neuroprotection in PD. If you want the 1521-line, 27-page, revised cumulative INDEX to 6 years of these monthly CSRs (CSRINDX SEP 00), normally in MS Word 2000 format, I'll fill individual requests. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013