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Current Science Reviews by Joe Bruman June 1996 (part 2 of 4) Goetz C et al; Neur 1995;45:669-671: PD patients in nursing homes are more likely to have hallucinations and die sooner than those in community dwellings. Tison F et al; Neur 1995;45:705-708: Among 4050 elderly people surveyed, dementia was 8 times more likely in PD patients living at home, and even more likely in those that were institutionalized. Dogali M et al; Neur 1995;45:753-761: In 18 pallidotomy recipients whose drug therapy had failed, PD symptoms and dyskinesia improved. Medical requirements were unchanged, but better tolerated because of reduced dyskinesia. Pahwa R et al; Neur 1995;45:822-824: Ten patients with intractable essential head tremor were improved by botulinum toxin injections. Baloh R et al; Neur 1995;46:458-460: In one large family, migraine seems to be inherited, with links to vertigo and essential tremor. All symptoms improved by actazolamide (Diamox). Friedman J et al; Ann Neur 1996;39:535-538: Authors did posteroventral pallidotomy on 4 patients with advanced PD, using the promising noninvasive gamma knife rather than conventional stereotactic surgery. Although MRI scans later confirmed the lesion target accuracy, 3 of the 4 patients suffered no clear effects, good or bad. In the 4th, contralateral dyskinesia completely resolved, but he also became transiently demented and psychotic. Authors speculate on possible reasons for the failures. Eidelberg D et al; Ann Neur 1996;39:450-459: Stereotactic unilateral pallidotomy in 10 advanced PD cases was followed by PET scans to show regional changes of metabolism. Clinical improvement has persisted up to 2 years, although mechanism of the ablation technique is still not well understood. Significant metabolic changes occurred in several regions remote from the lesion site. Science News; 18 May 1996:311 (news item): In aging mice, oxidative free radicals were found in specific areas of the brain whose functions were most impaired, the level rising with age. Enzensberger W, Fischer P; Lancet; 11 May 1996:1337: Metronome was best among 4 sources of periodic stimuli in improving gait of 22 PD patients, who liked it as well. It raised speed, lengthened stride, and reduced freezing incidents. Volkmann J et al; Neur 1996;46:1359-1370: Authors used electromagnetic detection combined with MRI to locate site of oscillation that procuces resting tremor in 7 PD patients, in areas of the frontal and parietal cortex. J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403