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CURRENT SCIENCE REVIEWS By Joe Bruman March 2001 Page 1 of 3 Loring D, Meador K:Neur 2001;56:146(editorial): The evocative nature of emotional content for sensory and motor systems. Mentions decreased emotional processing in PD, and how sufficient arousal may overcome hypokinesia. Crucian G et al;Neur 2001;56:159-165: Impaired movement is a feature of PD, but motor response to external stimuli having emotional content [e.g., startle reflex] is often exaggerated. Acting possibly because PD patients, especially at the fluctuating stage, are notably more emotional, authors in a controlled study asked each subject to recall an emotional episode. The verbal response of PD patients was longer and contained more words than that of the controls. Kuhn W et al;Neur 2001;56:281(letters): Discussing earlier report (CSR SEP 00) that homocysteine, an important risk factor for heart disease and stroke, is elevated in PD patients on chronic levodopa treatment, and especially in those having certain forms of the gene C677T/MTHFR, they suggest genotyping before starting levodopa, and monitoring such patients during treatment. Manson A et al;Brain 2001;124:331-340: Apomorphine is very effective against PD motor symptoms, but causes severe nausea by mouth (po). Therefore it's usually given by injection (sc), but after some time forms an unpleasant nodule at the injection site. So, they switched 6 patients at the severe fluctuation stage to intravenous (iv) usage via catheter. That change greatly reduced the need for supplemental oral PD drugs, and virtually eliminated "off" periods, but at a cost of frequent and hazardous (requiring cardiothoracic surgery) complications. Marsden J et al;Brain 2001;124:378-388: In a series of 10 PD patients having electrodes implanted for deep-brain stimulation (DBS) of the subthalamic nucleus (STN), they recorded electrical activity there, electroencephalogram (EEG) activity over supplementary motor and sensorimotor areas of the cortex, and electromyelogram (EMG) activity from the contralateral wrist extensors simultaneously, while the patient was directed to move his wrist. The three signals were coherent at various frequencies, and the STN site most consistently so in the range 15-30Hz proved also to be optimal for symptomatic relief, when stimulated at higher [100Hz or so] frequency. Dujardin K et al;Brain 2001;124:389-398: Since motor symptoms of both sporadic and familial PD seem to be identical, authors wondered if cognitive impairment is likewise similar. In a study of 12 assorted patients plus controls, loss of executive function was common to both of the PD groups, but explicit memory recall was impaired only in sporadic PD. CURRENT SCIENCE REVIEWS By Joe Bruman March 2001 Page 2 of 3 BMJ, 3 February 2001:259 (news item) Methylphenidate (Ritalin) helps attention deficit-hyperactivity disorder (ADHD) by raising level of dopamine in the brain. Dopamine is thought to play an important role in motivation, both by imparting a sense of pleasure and by subduing neural activity that might lead to distraction. Fox S, Brotchie J;Mov Disord 2000;15:1064-1069: PD affects links that use neruotransmitters other than dopamiine. Postmortem assay of tissue from certain sites in the brain known to be overactive in PD indicates over twice the normal binding of 5-HT2C, a member of the serotonin family. Grevle L et al;Mov Disord 2000;15:1070-1074: Searching DNA of 72 PD patients plus 81 controls, they found significant association of PD with the variant allele A1 of the dopamine D2 receptor gene. Farrer M et al;Mov Disord 2000;15:1075-1083: Study of gene markers in 9 French families probably affected by autosomal-dominant PD, in 5 chromosomal regions known to be associated with familial PD, led to conclusion that familial PD is genetically heterogeneous. Wenzelburger R et al;Mov Disord 2000;15:1084-1094: Using cameras and other instruments to measure kinetic tremor of 13 PD patients during a standardized reach-to-grasp movement test, they found that motion tremor differs from stationary (postural or rest) tremor. Stefanova E et al;Mov Disord 2000;15:1095-1103: Comparison of visuomotor skill-learning ability between 39 early- PD patients, 30 patients recovering from heart surgery, and 31 matched controls showed impairment in the PD group, not linked to cognitive decline, motor symptom severity, or mood change. Keijsers N et al;Mov Disord 2000;15:1104-1111: A study of 16 PD patients demonstrated the reliability and validity of using neural networks to detect and assess severity of levodopa-induced dyskinesia. Schrag A et al;Mov Disord 2000;15:1112-1118: From a battery of questionnaires and tests on 124 PD patients, they conclude that PD interferes with various aspects of quality of life, particularly those related to physical and social functioning. Fernandez H et al;Mov Disord 2000;15:1119-1124: Drawing on a database of over 400,000 nursing-home residents in 5 States, they compared effects of estrogen usage among 10,145 elderly female PD patients. Although users were more likely to be under treatment for depression, they were more independent and had less cognitive impairment. CURRENT SCIENCE REVIEWS By Joe Bruman March 2001 Page 3 of 3 Ho A et al;Mov Disord 2000;15:1125-1131: In a study in 15 PD patients and 15 controls to measure accuracy in perceiving volume of one's own speech, the PD group was better than the controls. Dromey C et al;Mov Disord 2000;15:1132-1138: A 6-month follow-up of 7 recipients of deep-brain stimulation (DBS) implants in the subthalamic nucleus (STN) showed general improvement in motor performance, but not in quality of speech. Laitinen L et al;Mov DIsord 2000;15:1139-1144: A preoperative MRI study found lacunar cysts (dilated perivascular spaces) in the pallidum and putamen of 40 consecutive pallidotomy recipients, but the outcome of the surgery was unaffected. De Marinis M et al;Mov Disord 2000;15:1215-1220: They compared sympathetic skin response and cardiovascular autonomic function among 15 PD patients, 15 with MSA and autonomic failure, and 15 controls. Those functions were impaired in the MSA group but not in the PD or control groups. Leentjens A et al;Mov Disord 2000;15:1221-1224: To test validity of the Beck Depression Inventory they applied it to 53 PD patients, concluding that it's not specific enough to use alone for diagnosis. Di Rocco A et al;lMov Disord 2000;15:1225-1229: In an open-label trial on 13 PD patients, S-Adenosyl-Methionine (SAMe Plus, Betaine) improved depression and was well tolerated. Mohr E et al;Mov Disord 2000;15:1230-1237: In a 12-week open study of 17 PD patients, risperidone (Risperdal) improved dopamine-induced psychosis without adverse effect upon motor symptoms. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013