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Current Science Reviews by Joe Bruman January 1996 Olanow, C. et al: Ann Neur 1995; 38:771-777: A careful new placebo-controlled study of 101 patients with mild (early) PD seems to show that Deprenyl (Eldepryl, selegiline) retards the progress of PD symptoms after all. This is the latest round in a controversy which has gone on for several years, and it looks convinc- ing. Symptoms were evaluated by the UPDRS, primarily a measure of motor function. While the precise action of Deprenyl remains unknown, the study seems to indicate a true neuroprotective effect and not just symptomatic relief. The effect is suspected to be a counter to oxidative stress, which in turn may be due to cytotoxic free radicals caused by levodopa therapy. (Incidentally, Olanow's institution, Mount Sinai Medical Center in New York City, is beginning a trial of an alternative to Deprenyl, which is also a MAO-B inhibitor but does not metabolize to amphetamine- see my post on PDF of 5 Dec 95) Morrish, P. et al: J Neur Neurosurg Psych 1995; 59:597-600: 27 recent-onset PD patients were studied via FD PET to check validity of that technique for early diagnosis. Authors found FD PET to be accurate, but the disease has a highly variable rate of progression, and the preclinical period is short (on the order of 2 years). Avorn, J. et al: JAMA 1995; 274:1780-1782: Authors tested the effect of metaclopramide (Reglan), a drug commonly used in elderly patients for gastric problems, on subsequent misdiagnosis of PD, as indicated by administration of levodopa. In a large sample of Medicaid patients, those getting Reglan were three times more likely to begin using levodopa, suggesting that Reglan side effects are commonly misdiagnosed as PD. (I'm not sure I follow the logic of that conclusion.) Sandyk, R.: Int J Neur 1994; 69:125-130 (from fall 1995 APDA newsletter): 50% to 80% of PD patients have abnormal glucose tolerance (diabetes) which may be aggravated by levodopa therapy, and may reduce the efficacy of that therapy against PD symptoms. Author therefore recommends that PD patients should be routinely screened for glucose intolerance. (Might this also suggest that perhaps diabetes may predispose to PD?) J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403