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Some relevance to our on-going discussions can be found in the following abstracts: Title A crossover, controlled study comparing pergolide with bromocriptine as an adjunct to levodopa for the treatment of Parkinson's disease. <Author Pezzoli G; Martignoni E; Pacchetti C; Angeleri V; Lamberti P; Muratorio A; Bonuccelli U;De Mari M; Foschi N; Cossutta E; et al Address>Institute of Clinical Neurology, University of Milan, Italy. SourceNeurology, 45: 3 Suppl 3, 1995 Mar, S22-7 Abstract A single-blind, crossover study was carried out to compare the efficacy and safety of pergolide against that of bromocriptine in 57 patients with Parkinson's disease who showed a declining response to levodopa therapy. Patients were randomly assigned to receive either bromocriptin e followed by pergolide, or pergolide followed by bromocriptine. Both drugs were administered for 12 week s. Patients were assessed by a clinician blinded to treatment assignment using the New York Unive rsity Parkinson's Disease Scale. The average daily dose of pergolide was 2.3 +/- 0.8 mg and of bromocripti ne 24.2 +/- 8.4 mg. Addition of pergolide or bromocriptine resulted in a significant improvement in total scores when compared with the previous treatment of levodopa alone (pergolide, p = 0.0001; bromocriptine, p = 0.0005). Pergolide was more effective than bromocriptine in daily living scores (p = 0.02) and motor scores (p = 0.038). No differences in the incidence of dyskinesias, dystonias, or psychosis were observed between groups. Fewer adverse events were recorded in the pergolide group, and most patients and physicians preferred pergolide to bromocriptine. Pergolide as adjunctive therapy to levodopa was more effective than bromocriptine in this short-term trial. ====================================================================== Document: [Treatment of complicated Parkinson disease with a solution of levodopa-carbidopa and ascorbic acid] Original Title -Tratamiento de la enfermedad de Parkinson complicada con una solución de levodo pa-carbidopa y ácido ascórbico. Author>Linazasoro G; Gorospe A Address Unidad de Trastornos del Movimiento. Clínica Quirón, San astián. <Source Neurologia, 10: 6, 1995 Jun-Jul, 220-3 Abstract We prescribed a solution of levodopa-carbidopa and ascorbic acid (LCAAS) to 21 Parkinsonian patients with motor complications. Eight patients continued the treatment for a mean period of 16.8 months, experiencing substantial increases in the number of hours with good functional capacity. Both ersome symptoms such as dystonia and akathisia in off periods disappeared in all cases in which they had been present and LCAAS was tolerated (in 6 of the 8 patients who continued in the study and in 4 who abandoned treatment late). Intake of other anti-Parkinsonian drugs was reduced. Thirteen patients abandoned the study, citing exacerbation of biphasic dyskinesia as the main reason. We conclude that LCAAS i s a useful therapy in some Parkinsonian patients whose motor complications are not managed with conventional drug treatment. Screening of patients is probably of utmost importance to ensure that LCAAS is not administered to patients who already suffer intense biphasic dyskinesia. Language of Publication>Spanish Unique Identifier 96023053 ============================================================== Title Dopa-responsive dystonia. <Author>Nygaard TG Address>Department of Neurology, Columbia University, New York, USA. Source> Curr Opin Neurol, 8: 4, 1995 Aug, 310-3 <Abstract< The past 18 months have seen significant advances in our understanding of dopa(dihydroxyphenylalanine)-responsive dystonia. Clinical investigations have broadened the spectrum of disease with particular attention manifestations in infancy. Pathophysiological investigations have revealed features that distinguish dopa-responsive dystonia from childhood- onset parkinsonism. A pathological study has confirmed the 'developmental' nature of the disease. Finally, mutations causing the autosomal dominant form of dopa-responsive dystonia have been identified in the gene coding for GTP cyclohydrolase I. Mutations in tyrosine hydroxylase have been identified in two brothers and put forward as evidence of an autosomal recessive form of the disease. Language of PublicationEnglish <Unique Identifier 96020179</TT> <Publication Type JOURNAL ARTICLE<REVIEWREVIEW, TUTORIAL Country of Publication</>UNITED STATES Regards, Margaret Tuchman