 |
 |
CURRENT SCIENCE REVIEWS (revised) By Joe Bruman July 1996 p.1 Aminoff M, Western J Med 1994;161:303-308: Slightly dated but excellent concise introduction to PD therapy. Treats many current topics such as iron, ganglioside, glutamate, and COMT. Worth sending for a reprint if they are still available. Lozano A et al; J Neurosurg 1996;84:194-202: The Toronto authors performed 70 pallidotomies using micro- electrode recording to locate precisely the desired target area of the posteroventral globus pallidus internus. They also used microstimulation and recording to locate and avoid the optic tract, and recommend both techniques. Their conclusion that pallidotomy is effective treatment for PD helps pave the way for its acceptance as reimbursable by health-care insurers. Obeso J et al; Lancet, 25 May 1996:1490: Authors argue that pallidotomy evaluation by traditional scoring protocols is too pessimistic and should be revised. Morrish P et al; Brain 1996;119:585-591: Using study by fluorodopa PET scan of PD patients and healthy controls, authors found that the rate of disease progression is best indicated by FD uptake in the putamen, with a mean preclin- ical period of about 3 years. Morris M et al; Brain 1996;119:551-558: Shortened stride length, which leads to the characteristic shuffling gait of PD patients, can be improved by attentional strategies and visual cues. Lancet, 8 Jun 1996;1614 (news review): New insight into the role of iron as a possible cause of PD. Aarsland D et al; Arch Neur 1996;53:538-542: Estimates of dementia incidence in PD patients vary from as low as 8% to as high as 81%. In 245 Norwegian patients, authors found dementia in 27%. Waterston J et al; Ann Neur 1996;39:749-760: Control of horizontal head and eye movement (tracking) is impaired in PD. Quinn N; Ann Neur 1996;39:826: Assessment of pallidotomy benefits to PD patients is made difficult by lack of definitive diagnostic criteria. The surgery lessens levodopa-induced dyskinesia in PD patients but not in patients having a condition other than PD. Carpentier A et al; Neur 1996;46:1548-1551: The beta-blocker propranolol (Inderal) markedly reduces levodopa- induced dyskinesia (but not dystonia) in PD. Nakimura S et al; Neur 1996;1693-1696: Large histaminergic neurons in the tuberomammillary nucleus of the posterior hypothalamus are associated with maintenance of wakefulness, energy reserve, blood pressure, and circadian rhythm. They are adversely affected in MSA but not in PD. CURRENT SCIENCE REVIEWS(revised) By Joe Bruman July 1996 p.2 Uitti J et al; Neur 1996;46:1551-1556: The NMDA antagonist amantadine (Symmetrel) seems to have a neuroprotective effect in slowing progression of PD. It also seems to increase life expectancy of PD patients. In a 15-year study, 250 patients taking amantadine were compared with 596 not taking it. At ten years after first visit to the Movement Disorders Center, about 65% of those taking amantadine had survived, compared with about 40% of the others. Authors suggest that further conntrolled and randomized study is warranted. Lancet, 15 Jun 1996;1684 (news item): Self-destruction (apoptosis) of neurons seems to be mediated by the nerve growth factor receptor p75. But in embryonic neurons its action is reversed, to enhance survival. Researchers hope someday to apply that property to treat cell-death diseases of the CNS, such as motor neuron disease, Alzheimer's disease, and Parkinson's disease. Silverstein P; Postgraduate Medicine 1996;99:52-68: Review of symptoms and drug treatment of PD, evidently intended for GP physicians but in nontechnical language easily accessible to PD patients. NOTICE: This revision of the CSR for July 1996 is cleared (I hope) of the unwanted wraps caused by exceeding 65 characters per line. Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403