Print

---

CURRENT SCIENCE REVIEWS   By Joe Bruman   September 1997  p. 1 of 3

Factor S, Friedman J; Mov Disord 1997;12:483-496:
They review current data on the neuroleptic clozapine, which show
that it not only relieves drug-induced psychosis in PD, but also
has some value against motor and sensory symptoms.

Lyytinen J et al; Mov Disord 1997;12:497-505:
In a controlled double-blind trial, they studied the effect of
selegiline combined with entacapone and levodopa in 13 PD patients.
Entacapone enhanced the response to levodopa, selegiline improved
it further, and no safety problems arose.

Merello M et al; Mov Disord 1997;12:506-508:
By a questionnaire survey of 312 PD patients, they found that about
half feel better for an hour or more after sleeping, to the degree
that they could skip or delay the morning dose of levodopa.

Bonnet A et al; Mov Disord 1997;12:509-513:
Urinary disfunction occurs in PD as well as multiple system atrophy
(MSA) but the specific symptoms differ. They studied complaints of
35 PD patients and 15 with striatonigral degeneration, a form of
MSA otherwise hard to distinguish from PD, and conclude that
urinary symptoms are useful for that purpose.

Jimenez-Jimenez F et al; J Neur N'Surg Psych 1997;63:120:
Drug-induced hallucinations in PD are usually visual, sometimes
auditory. They report a patient who suffered cenesthetic (viscera-
related) hallucinations, that were controlled by clozapine.

Martinez-Martin P et al; J Clin Neuropharm 1997;20:183-194:
They devised and compared a scale of gait impairment in PD against
several more general motor deficit scales, with favorable results.

Ruggieri S et al; J Clin Neuropharm 1997;20:201-209:
An open-label trial of the atypical neuroleptic clozapine on 36
PD patients with dopaminergic psychoses showed it to be effective
at low dosage, without compromising motor function.

Fetoni V et al; J Clin Neuropharm 1997;20:239-244:
Comparing 10 MSA patients with 9 PD patients showed, contrary to
some opinion, that the striatonigral form of MSA sometimes does
respond to levodopa, but with differences that may be useful in
diagnosis.

Munoz J et al; J Clin Neuropharm 1997;20:245-252:
They treated 20 PD patients having disabling motor fluctuations
with apomorphine, administered either nasal or subcutaneous, for
over 2 years. Both groups enjoyed about equal reduction of "off"
time and other symptoms, but some in the nasal group switched to
subcutaneous or dropped out because of local irritation.

Riggs J: J Clin Neuropharm 1997;20:276-278:
Last year's sensational claim of excess mortality in PD patients
given selegiline was wrong, because of a basic analytical error.

Rabey J et al; J Clin Neuropharm 1997;20:322-337:
Feeling that the popular United Parkinson Disease Rating Scale
(UPDRS) suffers inconsistency between raters, they offer a more
objective and simpler scale of their own.

CURRENT SCIENCE REVIEWS   By Joe Bruman   September 1997  p. 2 of 3

Muir K et al; J Clin Neuropharm 1997;20:311-321:
Looking for a well-tolerated glutamate antagonist, they tried the
NMDA antagonist aptiganel hydrochloride on  20 healthy volunteers.
(Neuroprotection of aptiganel in ischemic stroke should also apply
to PD.) Higher doses raised blood pressure and caused some CNS
symptoms, but iv infusions up to 0.03mg/kg were well tolerated.

Miyawaki E et al; J Clin Neuropharm 1997;20:300-310:
They review recent reports on benefits of serotonin-selective
reuptake inhibitors against motor disturbances of PD.

Zappia M et al; Ann Neur 1997;42:245-248:
Short-duration response, for evaluating a single dose of levodopa,
is masked by persistent effects of long-term use. Therefore they
withheld levodopa for up to 10 days before the test, in a group of
PD patients, and recommend that such a "washout" is important to
accuracy of the test.

Miyoshi Y et al; Ann Neur 1997;42:208-214:
In trials of Amgen, Inc.'s Glial Cell-Line Derived Neurotrophic
Factor (GDNF) on MPTP monkeys, GDNF alone improved PD symptoms,
but it also enhanced the benefits of Sinemet while reducing the
adverse effects.

SmithKline Beecham; Ann Neur 1997;42:August (full-page ad):
They hint at a new PD drug soon, but don't say what.

Chana P et al; Mov Disord 1997;12:608:
Following an earlier report, they tried gabapentin on 7 patients
and found it helpful against most PD symptoms. Since gabapentin
has no affinity for D1, D2, glutamatergic, or cholinergic
receptors, they haven't a clue about how it works.

Pappert E et al; Mov Disord 1997;12:608-610:
For convenience and dose accuracy, PD patients often take Sinemet
(levodopa/carbidopa) as a water solution, with ascorbate (e.g.,
orange juice). Levodopa solution is stable for several days under
ordinary conditions, but carbidopa solution is not, degrading to
less than half strength in 24h. To ensure adequate dosage of
carbidopa, they recommend that Sinemet solution should be used
within 24h after preparation.

Meco G et al; Mov Disord 1997;12:610-612:
They followed 10 PD patients up to a year in an open-label study
of the neuroleptic risperidone against levodopa-induced psychosis.
It helped, probably by blocking serotonin, but it also worsened
motor symptoms in the more sensitive patients.

Derex L, Trouillas P; Mov Disord 1997;12:612-613:
A 50-year-old patient was hospitalized 13 yr after diagnosis when
severe PD symptoms failed to respond to conventional therapy.
They found deficient calcium and vitamin D, and supplements of
those materials dramatically restored most of the lost motor
function. They infer that abnormal calcium metabolism can cause PD.

Louis E et al; Neuroepidemiology 1997;16:124-133:
Although essential tremor (ET) is the most common movement
disorder, genetic susceptibility is poorly known, for lack of well-
designed studies, so they describe theirs.
CURRENT SCIENCE REVIEWS   By Joe Bruman   September 1997  p. 3 of 3

Buss D et al; Br J Clin Pharmacol 1997;43:119-121:
In a single-blind study of 10 patients having essential tremor,
they found that aminophylline, as normally given intravenous for
asthma, aggravates ET.

Jankovic J et al; Arch Neur 1997;54:289-294:
They examined 251 members in 4 family clusters of essential tremor.
Although clinical signs are quite variable, computer simulation
suggests that a total genome search for a marker would be useful.

Louis E et al; Arch Neur 1997;54:197-200:
The extent of familial clustering of essential tremor is poorly
known. They examined 25 cluster members and 58 of their relatives,
finding that interviews alone of patient relatives are inadequate,
and should be accompanied by physical examination to determine if
they are affected.

Soukup V et al; Arch Neur 1997;54:947-950:
They gave a battery of tests sensitive to cortical dysfunction
(various forms of cognition) to 14 PD patients, 2 days before
pallidotomy and 3 months after, and found no cognitive loss.

BMJ, 2 Aug 97:275 (news item):
A battery of tests on 30 U. S. Air Force employees working around
jet fuel for average 12 yr, and 25 non-exposed controls, confirmed
that occupational exposure, as well as short-term acute exposure
to jet fuel, causes a variety of neurological damage.
--
J. R. Bruman   (818) 789-3694
3527 Cody Road
Sherman Oaks, CA 91403-5013