Post: 081028

Deuschl G, Koller W (eds);Neur 2000 Supplement 4:S1-S46:
Nine articles (to be reviewed separately elsewhere) summarizing present knowledge about Essential Tremor, surprisingly neglected in view of its prevalence (about 5% of population over 40).

Minagar A et al;Neur 1999;53:433-434:
Scopolamine, a plant-derived belladonna alkaloid, long valued for its anticholinergic and sedative properties, is very popular as a transdermal patch to prevent seasickness. But it also may cause psychosis in susceptible users. Authors report a patient who, besides other drugs, was taking Sinemet, Mirapex, and Eldepryl for PD. Patient's hallucinations, delusions, and agitation reverted promptly to normal state when the patch was removed.

Zappia M et al;Neur 2000;54:1910-1915:
It's generally accepted that levodopa therapy in early-stage PD has a short-duration response (SDR), lasting a few hours after each dose, and a long-duration response (LDR) that can persist for several days after treatment is stopped. But this double-blind crossover trial in 24 patients shows LDR much more likely with bigger doses 24 or 48 hours apart, than with roughly equivalent smaller doses 8 hours apart. This flatly opposes the conventional wisdom that (for reasons other than LDR) excursions of L-dopa plasma concentration should be minimized by taking it in frequent small doses.

Hurtig H et al;Neur 2000;54:1916-1921:
Pathologic study of 22 demented and 20 nondemented PD patients confirms that, as indication of dementia, presence in the cortex of a-synuclein-containing Lewy bodies is more sensitive than Alzheimer's-like pathology such as tangles or amyloid plaques.

Brooks D;J Neur N'surg Psych 2000;68:685-690 (editorial)
Concise review of dopamine agonists for treatment of PD, with arguments for preference over levodopa as initial treatment, and feature details for each of the 5 major ones.

Bassotti G et al;J Neur N'surg Psych 2000;68:768-770:
Responding to prevalence of constipation in PD, they measured internal and external physical parameters in 31 patients, to help define the phenomenon.

Krack P et al:Neur 2000;54:2182-2184:
Case report of parkinsonism following ischemic stroke which, despite similarity to MRI and PET scan features of PD, didn't respond either to levodopa or to subthalamic nucleus DBS.

Allain H;BMJ, 13 May 2000;1287-1288:
Brief tutorial on diagnosis and treatment of depression in PD, urging more usage of antidepressant drugs, such as SSRIs.

Ross G et al;JAMA, 24 May 2000:2674-2679:
Higher coffee intake is associated with lower incidence of PD, probably related to caffeine but independent of smoking.

Di Monte D et al;Mov Disord 2000;15:459-466:
The simulated PD due to MPTP is dose-sensitive. Monkeys given MPTP insufficient to cause visible signs of PD nevertheless developed dyskinesia when given levodopa, but not as consistently as those with full-blown MPTP-induced PD.

Montgomery E et al;Mov Disord 2000;15:467-473:
First of 2 reports about their test battery for early detection of PD. The first trial, of 19 normal controls and 18 patients with suspected PD, was for calibration of the tests.

Montgomery E et al;Mov Disord 2000;15:474-478:
In this second report of their early-PD detection test battery, which includes tests of motor function, olfaction, and mood, the authors tried it out by following 212 test subjects for a year.

Goetz C et al;Mov Disord 2000;15:479-484:
They monitored progression of PD motor impairment in two groups having similar duration of the disease but at different stages of progression, namely Hoehn-Yahr II and Hoehn-Yahr III. Those who reached Stage III sooner continued to deteriorate faster during the ensuing 4-year followup.

Hauser R et al;Mov Disord 2000;15:485-489:
Observing rate of PD progression, to test new therapy such as a neuroprotective agent, requires eliminating symptomatic effects of any current therapy. A typical regimen, bromocriptine plus levodopa/carbidopa, requires a 2-week washout beforehand.

Fernandez H et al;Mov Disord 2000;15:490-496:
They studied records of 24,402 PD patients in nursing homes, finding behavioral problems equally common in about 1/3 of men and women, but with gender differences in the type of problem behavior and drug treatment given for it.

Welsh M et al;Mov Disord 2000;15:497-502:
By questionnaire to some subjects in a safety and efficacy trial of tolcapone (Tasmar), they found illness impact and adjustment to illness independent on whether a subject was getting tolcapone or placebo.

Benamer T et al;Mov Disord 2000;15:503-510:
In a blinded study of 158 confirmed PD patients, 27 with ET, and 35 healthy controls, they determined that visual assessment of single-photon-emission computerized tomography (SPECT) using the marker [123I]-FP-CIT can accurately distinguish PD from ET.

Montgomery E et al;Mov Disord 2000;15:511-515:
Response of PD, ET, and normal control groups to a standardized physical task suggests that PD and ET have some common features.

Louis E et al;Mov Disord 2000;15:516-523:
They tried a standardized diagnostic questionnaire on 95 ET patients and confirmed that it is accurate and reliable.

Lancet, 17 June 2000, 2142 (feature editorial)
Concise review of stem cell research, transplantation, and regeneration prospects for degenerative diseases such as PD.

BMJ, 3 June 2000:1492 (news item):
Analysis of existing data on 8004 men who have been subjects of several other reports in a long-term study showed an inverse relation between caffeine (mostly as coffee) intake and incidence of PD. Casual users were a third as likely, and heavy users (28 ounces or more of coffee per day) only a fifth as likely as non-users, to develop PD.

Nurmi E et al;Ann Neur 2000;47:804-808:
Positron-emission tomography (PET) scans about two years apart, in 8 PD patients and 7 healthy controls, provided sensitive indication of the rate of PD progression.

Jahanshahi M et al;Brain 2000;123:1142-1154:
Study of 13 PD recipients of deep-brain stimulation (DBS) implants in different locations, to see if DBS affects executive or cognitive function in such patients, with mixed results.

Eisensehr I et al;Brain 2000;123:1155-1160:
Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD) may occur together with PD or independently. Authors used single-photon-emission computed tomography (SPECT) to compare patients having PD, those with RBD, and controls, finding reduction of striatal dopamine transporters common to the first two groups.