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Current Science Reviews by Joe Bruman February 1996 (part 2) Ruottinen H, Rinne U: J Neur Neurosurg Psy 1996; 60:36-40: A double-blind test of Entacapone, a 2nd-generation COMT inhibitor, found it prolonged the effect of levodopa and permitted reduction in dosage. Salzman E: NEJM 1996;334:116-118: A vascular surgeon reports coping with PD for 20 years after diagnosis (perhaps 40 years from earliest signs) and a physician's insight into progress of the disease, followed finally by a completely successful pallidotomy in August 1995. Bennett D et al: NEJM 1996;334:71-76: Authors sampled 467 residents over 65 in the area of East Boston, Mass. Parkinsonism was very common (52% in the group over 85) but the study did not distinguish PD from other conditions involving parkinsonism, such as AD, sub-cortical vascular disease, and MSA. During the mean follow-up period of 9.2 years, 78% of those with parkinsonism died, compared to 49% of the remainder. Adjusted for age and sex, the ratio was 2 to 1. Among the classic symptoms of bradykinesia, gait disturbance, rigidity, and tremor, gait disturbance was most prominently related to early mortality. de Rijk M et al: Neur 1995;45:2143-2146: A survey of nearly 7000 old people in Rotterdam confirmed that PD incidence increases markedly with age, reaching as high as 5% in the oldest cohort. Wang S-J et al: Arch Neur 1996;53:66-71: To test the hypothesis that Asians and blacks might have genetic protection against PD, authors surveyed nearly all people over 50 (3915) on the islet of Kinmen, off the coast of Taiwan. PD incidence was slightly lower than in more-developed countries, but much higher than in mainland China, suggesting that benetic factors are less important than other criteria. Gai W et al: Brain 1995; 118:1447-1459: Microscopic postmortem studies revealed ubiquitin (a protein which may bind to abnormal or damaged neurites) in cases of PD but not of AD, motor neuron disease, or MSA. The distinction may prove useful for research into the nature of PD. Mattes J, Weintraub M: JAMA 17 Jan 1996; 182: Doctors debate policy and legal liability for reporting patients having impaired ability to drive a car. J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403