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CURRENT SCIENCE REVIEWS   By Joe Bruman  February 1998  Page 1 of 3

Antonini A et al; Brain 1997;120:2187-2195:
They used PET scans with two different markers, Fluorodopa and
Raclopride, on 10 PD patients, 9 with MSA, and 30 controls, to
look for diagnostic distinction between MSA and PD. The fluorodopa
scans showed disease but didn't differentiate, while raclopride
(radioactive C to measure glucose metabolism) was successful.

Moeller J, Eidelberg D; Brain 1997;120:2197-2206:
The substantia nigra degenerates both in PD and in normal aging,
but the detailed patterns of degeneration differ. They studied 37
PD patients and 20 normal controls using PET and the glucose marker
fluorodeoxyglucose and found that PD doesn't simply accelerate the
aging process, it alters the pattern. By extrapolating backward
from the measured patterns, they also suggest that PD has a fairly
short preclinical (latent) period of about 4.5 years.

van Elst L et al; Brain 1997;120:2219-2228:
Vision defects are common in PD. Presenting calibrated (grid)
stimuli to 27 PD patients, 6 with MSA, and 27 healthy controls
showed that the PD group had less contrast sensitivity than the
others. Authors speculate that the loss is mediated by retinal
effects, and that it may help in differential diagnosis.

Sedek G et al; Clin Neuropharm 1997;20:531-541:
In a dosage tolerance and safety test, they gave various doses of
Sinemet and tolcapone to 20 healthy volunteers, finding that the
optimum dose of tolcapone about doubled the half-life of levodopa.

Miyawaki E et al; Clin Neuropharm 1997;20:523-530:
They tracked 811 levodopa-responsive PD patients for up to 15 years,
for motor complications ascribed to chronic levodopa therapy,
including "wearing off" and sudden unpredictable "off" effects,
concluding that they become more common with duration, although some
patients stayed complication-free into the second decade of the
disease.

Oakes D; Clin Neuropharm 1997;20:342:
The somewhat rancorous debate over selegiline goes on. The author
here rebuts a prior argument (CSR Sep 97) about proper treatment
of statistical mortality data.

Beijjani B et al; Neur 1997;49:1564-1569:
The probe used for Deep-Brain Stimulation (DBS) has a choice of four
stimulation sites along its length, allowing a comparison after the
implantation is complete. Stimulation at the top (dorsal) surface of
the pallidum had effect strikingly different from stimulation at the
lower (posteroventral) surface. Current functional models of the
basal ganglia don't explain paradoxical effects of either pallidotomy
or DBS; for example, how levodopa-induced dyskinesia (LID) can be
suppressed simultaneously with improvement of classic PD signs; and
authors suggest maybe different neuroanatomic systems are involved.

Churchyard A et al; Neur 1997;49:1570-1576:
Severe dementia affects 10% to 20% of PD patients, usually after age
65. Postmortem study of 27 PD patients and 11 controls, who had been
previously examined for cognitive impairment, showed more frequent
anomalies (Lewy bodies, plaques, tangles, etc,) in the hippocampus
of PD patients who had been demented.


CURRENT SCIENCE REVIEWS   By Joe Bruman   February 1998  p. 2 of 3

Leighton W et al; Neur 1997;49:1577-1579:
Certain mutations of the dopamine transporter (DAT) gene are prime
suspects in PD, since DAT is involved with presynaptic uptake of
dopamine in the substantia nigra, and a strong correlation was
previously found in a cohort of Caucasians. However, in a sample
of 203 PD patients and 230 healthy controls of Chinese descent, no
such association of the most common mutation was found.

Bennett D et al; Neur 1997;49:1580-1587:
After a structured training protocol three nurse clinicians, along
with a neurologist, administered a modified Unified Parkinson's
Disease Rating Scale (UPDRS) to 75 older subjects, and the
agreement of results shows that with such training, nurse
clinicians are competent to administer the scale.

Bonuccelli U et al; Neur 1997;49:1587-1590:
A double-blind test of clozapine, both acute and chronic, on 17
PD patients with mixed (resting and/or postural) levodopa-resistant
tremor showed that it is effective for at least 15 months. Authors
therefore suggest that in such cases clozapine should be tried
first, before resorting to thalamotomy or VIM stimulation.

Biousse V et al; Neur 1998;50:258-265:
Proximity of the optic tract to the currently preferred lesion site
for pallidotomy in PD carries the risk of vision impairment if the
location is inaccurate. Experience with 40 such operations showed
that microelectrode recording (monitoring localized response or
response to localized stimuli) is a safe and effective means of
ensuring accurate placement of the lesioning probe, even if the
optic tract itself is used as a guide.

Ondo W et al; Neur 1998;50:266-270:
Application of the Unified Parkinson's Disease Rating Scale (UPDRS)
to 34 consecutive PD pallidotomy recipients, immediately before and
3 months after the procedure, showed that unilateral pallidotomy is
safe and effective against PD motor symptoms, often bilaterally.

Kobayashi T et al; Ann Neur 1998;43:120-123:
Genetic comparison of 176 confirmed PD patients with 223 healthy
controls revealed a significant association of PD with mutation
of the gene encoding the "E2 subunit of the alpha-ketoglutarate
dehydrogenase complex".

Guang-xi Z et al; J Neur N'surg Psych 1997;63:754-758:
Analysis of cerebrospinal fluid (CSF) from 23 PD patients, 8 with
peripheral neuropathy but not PD, and 12 healthy controls showed
that concentration of beta-phenylethylamine (PEA) is depressed in
the cerebrospinal fluid (CSF) of PD patients.

Evidente V, Gwinn K; J Neur N'surg Psych 1998;64:5:
Many survivors of the 1915-35 encephalitis pandemic developed
parkinsonism several years after recovery. Old photos of one
such victim show the familiar rigid stance, stooped posture, bent
knees, blank expression, and arms stiffly fixed at sides.





CURRENT SCIENCE REVIEWS   By Joe Bruman   February 1998  p. 3 of 3

Tsai C et al; J Neur N'surg Psych 1998;64:33-36:
Transcranial magnetic stimuli delivered over the motor cortex of
two patients with primary orthostatic tremor briefly suppressed
it, suggesting that a central oscillator involving the motor
cortex plays a crucial role in either generation or modulation
of such tremor.

Meco G et al; J Neur N'surg Psych 1998;64:135:
Risperidone, a new atypical antipsychotic with potent serotonin-S2
and secondary dopamine-D2 antagonist properties, was given to 8
PD patients suffering levodopa-induced dyskinesia (LID). Besides
its neuroleptic effect it markedly reduced LID, during followups
for as long as 21 months.

Mesholam R et al; Arch Neur 1998;55:84-90:
They compared data from 43 previously published reports about
anosmia (loss of smell sense) in Alzheimer's and Parkinson's,
concluding that the loss is acute in both diseases, but not
different. They speculate about use for preclinical diagnosis.

J. R. Bruman   (818) 789-3694
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Sherman Oaks, CA 91403-5013