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CURRENT SCIENCE REVIEWS By Joe Bruman October 2000 Page 1 of 3 Lane R:J Neur N'surg Psych 2000;69:289: After 6 years of near-zero mention in professional literature about PD, but ample discussion among patients, we now learn that "chronic fatigue is a very common complication of... diseases such as ... Parkinson's disease" (editorial comment on Chronic Fatigue Syndrome paper, pp 302-307). Well, well. Schrag A et al:J Neur N'surg Psych 2000;69:308-312: By questionnaire to subjects of a population-based study of PD prevalence, authors found that the factors most commonly affecting quality of life in PD are depression, postural instability, and cognitive impairment. Soliveri P et al;J Neur N'surg Psych 2000;69:313-318: They applied a battery of cognition tests and motor scales to about 5 dozen patients having either PD, Striatonigral Degeneration (SND), or Progressive Supranuclear Palsy (PSP), on two occasions averaging 21 months apart, to detect and compare rates of progression. Benke Th et al;J Neur N'surg Psych 2000;69:319-325: A preliminary study in 53 PD patients of repetitive speech phenomena, both hyperfluent and disfluent, in PD at different stages of disease progression. Rettig G et al;J Neur N'surg Psych 2000;69:326-336: In the largest long term followup to date, in 42 PD recipients of unilateral pallidotomy, examined as long as one year after surgery, cognitive impairment was minimal compared with the robust improvements in motor function. Pal P et al;;J Neur N'surg Psych 2000;69:337-344: In examination 3 years later of 15 unilateral pallidotomy recipients with PD, control of dyskinesias and tremor persisted, but all other early benefits were lost, and activities of daily living continued to worsen. Haberler C et al;Ann Neur 2000;48:372-376: Postmortem study of 8 PD patients who had deep brain stimulation (DBS) for as long as 70 months showed no damage to adjacent tissue by chronic DBS. Lancet, 26 August 2000, 693(editorial): Laboratory study of stem cells offers the most promising pathway to a means of preventing or curing PD, but some people think all or part of such study is immoral, and have organized opposition. The status of this ethical/scientific/political battle varies widely among different nations, but Lancet thinks a recent UK report on stem cells may hasten its resolution. CURRENT SCIENCE REVIEWS By Joe Bruman October 2000 Page 2 of 3 Lancet, 9 September 2000, 917(news item): In a PET study of orthostatic hypotension, researchers found that all the PD subjects studied had lost norepinephrine-producing neurons in the heart. While it's known that PD affects peripheral autonomic functions (notably bowel motion) controlled outside the cns, this is (I think) the first positive evidence that a neuro- transmitter other than dopamine is involved in PD. Onodera H et al;Lancet, 26 August 2000, 739-740: In test of chemosensitivity to hypoxia in 25 PD patients and 11 controls, even in early stages of PD the former had subnormal hypoxic response accompanied by blunted perception of dyspnoea, that might account for the unusual frequency of respiratory failure in PD. Science News, 2 September 2000:148(news item): Status in the U.S. of the stem cell controversy (see above). Pahapill P, Lozano A;Brain 2000;123:1767-1783: (review article) In PD, significant loss of neurons in the pedunculopontine* nucleus suggests that area as the source of akinesia and gait disturbance in PD, which might be a promising site for potential future therapy. *[The peduncle is a stalk which connects the cerebellum to the midbrain at the pons. JB] Hadjikoutis S et al;Brain 2000;123:1863-1873: Since the pharynx passage is common to both swallowing and breathing, it's possible to aspirate material into the airway. To avoid that, swallowing normally is followed by exhalation. Patients having various neurological diseases may inhale, more often than healthy subjects, after swallowing, but authors couldn't find any association with the frequency of subsequent choking or coughing episodes. Kulisevsky J et al;Mov Disord 2000;15:613-626: They studied a group of new PD patients for up to 24 months to compare the effects on cognition of levodopa versus pergolide (Permax), but found no big difference. Leiguardia R et al;Mov Disord 2000;15:627-640: Disruption of spatial organization and interjoint coordination in Parkinson's disease, progressive supranuclear palsy, and multiple system atrophy, study by computergraphic analysis. Homann C et al;Mov Disord 2000;15:641-647: The Bradykinesia Akinesia Incoordination Test (BRAIN TEST), an objective and user-friendly means to evaluate patients with parkinsonism, by finger-tapping performance. Hauser R et al;Mov Disord 2000;15:658-663: Evidently responding to reports (CSR JUL 99) of blackout-related automobile accidents, they studied a lot of pramipexole (Mirapex) users and came up with advice not to drive if sleepy. CURRENT SCIENCE REVIEWS By Joe Bruman October 2000 Page 3 of 3 Shulman L et al; Mov Disord 2000;15:664-668: An extensive chart study, to test the common opinion that dopamine receptor agonists have too many bad side effects for use in treating very elderly PD patients, showed that they were well tolerated by nearly half of the subjects. Shiba M et al;Mov Disord 2000;15:669-677 A records study of PD patients and controls suggests that anxiety disorders are associated with PD, and may appear as long as 20 years before PD's motor symptoms. Ondo W et al;Mov Disord 2000;15:678-682: Open-label tests suggested that gabapentin (Neurontin) is helpful against essential tremor (ET), but a multiple-dose, double-blind, placebo-controlled trial failed to confirm that. Hurtado J et al;Mov Disord 2000;15:683-691: Analysis of temporal correlation between tremor of different muscles of the same and different limbs in 4 PD patients. Benamer H et al;Mov Disord 2000;15:692-698: Correlation of PD severity and duration with striatal dopamine uptake, as observed by Single-Photon-Emission Coomputed Tomography (SPECT) using the marker 123I-FP. Maraganore D et al;Mov Disord 2000;15:714-719: A case-control study of several mutant genes for possible association with PD turned up the M3 allele of the liver- detoxifying enzyme N-acetyltransferase 2 (NAT2) as a likely prospect. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013