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CURRENT SCIENCE REVIEWS By Joe Bruman November 1999 P. 1 of 2 Becker G et al; Neur 1995;45:182-184: One might think the brain's bony case prevents imaging with the simple technique of ultrasound, but it turns out that acoustic windows make it possible. They compared PD patients with healthy controls, and found the substantia nigra in the PD group to be distinctly more reflective than normal. Berg D et al; Neur 1999;53:1026-1031: Extending their work reported 4 years ago (above), they checked a large number of apparently healthy subjects by ultrasound, and those subjects whose substantia nigra was more reflective were found by PET and MRI to have signs of PD that was not evident in careful clinical examination. So, screening by transcranial ultrasound may provide effective and useful early warning. Koller W et al; Neur 1999;53:1012-1019: A 5-year controlled study of 618 PD patients compared the effects of immediate-release (regular) Sinemet with the sustained-release version (Sinemet CR), finding no big long-term differences. Braune S et al; Neur 1999;53:1020-1025: PD may affect the autonomic nervous system as well as the motor centers, in a different way than multiple system atrophy (MSA). Scintigraphy with the marker MIBG of the heart offers a sensitive test of such failure in PD, as well as distinction from MSA. Honig L et al; Neur 1199;53:1158: The lively debate about whether smoking protects against PD or is merely a negative attribute of PD (CSR FEB 99) continues. Riggs J et al; Neur 1999;53:1158-1159: Debate over recent report (CSR MAR 99) that cancer mortality risk is reduced among PD patients, and not fully explained by the fact that they are less likely to be smokers. Aarsland D et al; J Neur N'surg Psych 1999;65:492-496: In a 4-yr followup of a previous survey, they studied neuropsychiatric symptoms in 139 PD patients. Depression and hallucination were most frequent, and more so in nursing homes than in patients' own homes. Wang L et al; J Neur N'surg Psych 1999;65:497-503: The brain's response to external stimuli can be observed by scalp electrodes. Authors found response to standardized visual stimuli distinctly slower in PD patients. Khudados E et al; J Neur N'surg Psych 1999;65:504-510: Signals from voluntary muscles to the brain about position, load, and movement are called proprioception. Study of 21 PD patients and 21 healthy controls showed proprioception impaired in PD. Schrag A et al; J Neur N'surg Psych 1999;65:511-517: One-year followup of 22 unilateral pallidotomy recipients showed lasting improvement of dyskinesia, but other "on"-state or ipsilateral "off"-state motor improvements were slight, if any. Harhangi B et al; They studied three mutant frequencies of the N-acetyltransferase-2 (NAT-2) gene in a large cohort of Rotterdam residents, but found no association with PD. CURRENT SCIENCE REVIEWS By Joe Bruman November 1999 P. 2 of 2 Merello M et al; Clin Neuropharm 1999;22:273-376: A formal trial of the NMDA antagonist memantine in 12 advanced PD patients showed improvement of most symptoms but not drug- induced dyskinesia. Linazasoro G et al; Clin Neuropharm 1999;22:277-280: With the help of positron-emission tomography (PET) of 5 PD patients, they confirmed that chronic administration of pergolide (Permax) and presumably, other dopamine agonists, causes reduction of D2 receptor activity. Doan V et al; Clin Neuropharm 1999;22:281-287: They compared effects of oral L-dopa, injected levodopa methyl ester (LDME), and apomorphine when combined with either of two experimental D1 agonists, in MPTP monkeys. Kunig G et al; Clin Neuropharm 1999;22:301-305: A formal trial of pramipexole (Mirapex) in 11 PD patients showed it to be effective against akinesia and rigidity, and markedly so against resting tremor. Baum L et al; Clin Neuropharm 1999;22:839-841: A certain gene mutation that appears in Alzheimer's disease doesn't seem to be a major factor in PD. Praamstra P et al; Mov Disord 1999;14:790-799: Results of various neuropsychological tests of response to a cognitive stimulus suggest that the relation of signal-related to movement-related activity in the motor cortex is altered in PD. Duan W et al; Ann Neur 1999;46:587-597: Supporting the evidence for apoptosis (cell self-destruction) as a factor in PD, a protein called "prostate apoptosis response-4" (Par-4) increased dramatically in the midbrain dopaminergic neurons of monkeys with MPTP-induced PD. In human cell cultures, blocking Par-4 protected against apoptosis. Langston J et al; Ann Neur 1999;46:598-605: Postmortem study of 3 original patients who developed severe L-dopa-responsive parkinsonism in 1982 after mistakenly taking 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) revealed that, although the MPTP insult was briefly transient, neuron loss continued unchecked for years afterward. Ashby P et al; Brain 1999;122;1919-1931: They observed electromyographic response to selected single stimuli via electrodes in 14 parkinsonian recipients of sub- thalamic nucleus (STN) deep-brain stimulation (DBS) implants. Results suggest that control of tremor by STN DBS is due to activation of a large-fibre system parallel to and near the implanted electrode. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013