bluuebunny/crossref_metadata_2025_split huggingface dataset:
A hypothesis on the pathophysiological mechanisms that underlie levodopa‐ or dopamine agonist‐induced dyskinesia in Parkinson's disease: Implications for future strategies in treatment
Authors: Crossman A. R. 
Published: December 2004

AbstractLong‐term treatment of human Parkinson's disease with levodopa or dopamine agonists is often complicated by the appearance of abnormal involuntary movements (dyskinesias) that are extremely difficult to control. Little is known of the cause, pathophysiological mechanisms, or possible strategies for amelioration of this manifestation of dyskinesia. A hypothesis is set forth on the neural mechanisms that mediate levodopa‐ or dopamine agonist‐induced dyskinesia (in particular chorea) as a side effect of the treatment of parkinsonism. Evidence is drawn from both clinical observations and experimental studies in a spectrum of movement disorders ranging from ballism through chorea to parkinsonism. It is proposed that (a) All forms of chorea, whatever their origin, share a common underlying neural mechanism. (b) Disordered activity of the subthalamic nucleus is central to the generation of choreic movements. In levodopa‐ or dopamine agonist‐induced dyskinesia, (c) The site of action of dopaminergic agents in causing chorea is the putamen. (d) The specific pathophysiological state conducive to the appearance of chorea is brought about by the long‐term exposure of the dopamine‐depleted (parkinsonian) putamen to exogenous dopaminergic agents. (e) Long‐term exposure to dopaminergic agents causes (either directly or indirectly) preferential inhibition of the subpopulation of putaminal neurones that project specifically to the lateral segment of the globus pallidus. This causes disinhibition of lateral pallidal neurones, which become overactive and physiologically inhibit the subthalamic nucleus. (f) The hypothesis suggests a number of possible strategies that might be useful for the alleviation of levodopa‐induced dyskinesia.
Rett syndrome and associated movement disorders
Authors: FitzGerald Patricia M. , Jankovic Joseph , Percy Alan K. 
Published: December 2004

AbstractRett syndrome, a progressive neurodegenerative disorder described only in female subjects, is manifested by a wide spectrum of behavioral and motor abnormalities. We studied 32 patients with this disorder, ages 30 months to 28 years old, and characterized their extrapyramidal disturbance. The most common motor abnormalities were stereotyped movements and gait disturbance, seen in all patients. Bruxism, oculogyric crises, parkinsonism, and dystonia were also common, but myoclonus and choreoathetosis were seen only infrequently. The hyperkinetic movement disorders tended to dominate in younger patients, while bradykinetic disorders were more evident in the older patients. This study provides evidence that movement disorders seen in Rett syndrome reflect age‐related neurodegenerative changes in the basal ganglia.
Is focal hand dystonia associated with psychopathology?
Authors: Grafman Jordan , Cohen Leonardo G. , Hallett Mark 
Published: December 2004

AbstractThe purpose of this study was to determine if patients with focal hand dystonia have any significant psychopathology. We studied 20 patients with hand cramps who were participating in a therapeutic trial of botulinum toxin injectins. Patients were interviewed and administered the Minnesota Multiphasic Personality Inventory (MMPI), Beck Depression Inventory, Spielberger State‐Trait Anxiety Scale, a finger tapping test, and a choice serial reaction time test. Behavioral ratings were also obtained. Group statistics indicated that all personality scale scores and performances on motor tasks were within normal limits. Four out of 20 patients demonstrated mild depression. Trait anxiety scores were higher than state anxiety scores, suggesting that receiving medical treatment had a beneficial effect on mood. The number of depressive symptoms endorsed on the MMPI was correlated with reaction time speed but not finger dexterity. None of the 20 patients reported a remarkable psychiatric history. These results indicate that hand cramps are not associated with serious psychopathology.
Focal dystonia secondary to cerebral toxoplasmosis in a patient with acquired immune deficiency syndrome
Authors: Tolge Celina F. , Factor Stewart A. 
Published: December 2004

AbstractA variety of movement disorders have been reported in patients with acquired immune deficiency syndrome (AIDS) and cerebral toxoplasmosis. We describe a 29‐year‐old man with left arm and hand focal dystonia secondary to Toxoplasma abscesses in the right lenticular nucleus and thalamus. Although a few cases of dystonia have been reported in AIDS, this patient represents the first reported case of focal dystonia secondary to toxoplasmosis.
Intermittent vertical supranuclear ophthalmoplegia and ataxia
Authors: Nightingale S. , Barton M. E. 
Published: December 2004

AbstractA 6‐year‐old girl is described with a history of episodes of severe ataxia precipitated by fever since the age of 11 months and in whom mental and physical development was otherwise normal. The ataxia was associated with a complete vertical supranuclear ophthalmoplegia and normal horizontal eye movements. After resolution of the attack she had no abnormal movement of her limbs or clinical evidence of ophthalmoplega, though electro‐oculograms showed a presistent mild deficit of vertical saccades. In between the attacks hyperglycinuria, an elevated plasma glycine level (687 μmol L−1), and negative screening for organic aciduria suggest that she may have nonketotic hyperglycinaemia. To our knowledge, intermittent vertical supranuclear ophthalmoplegia and ataxia in a normally developing child has not been reported previously.
Domperidone‐induced acute dystonia and polycystic ovary syndrome
Authors: Bonuccelli Ubaldo , Nocchiero Aldo , Napolitano Alessandro , Paoletti Anna Maria , Melis Gian Benedetto , Corsini Giovanni Umberto , Muratorio Alberto 
Published: December 2004

AbstractThe occurrence of acute dystonic reactions (ADRs) due to domperidone administration in two young women is reported. In both patients, a typical polycystic ovary (PCO) syndrome was found. The possibility that the relative hyperestrogenism typical of PCO syndrome acted as a facilitating factor for ADR is discussed.
A case of postanoxic encephalopathy with cortical action and brainstem reticular reflex myoclonus
Authors: Brown P. , Thompson P. D. , Rothwell J. C. , Day B. L. , Marsden C. D. 
Published: December 2004

AbstractA patient with postanoxic encephalopathy, with both action‐ and stimulus‐sensitive reflex myoclonus, is described. The action myoclonus was multifocal and cortical in origin. In contrast, reflex myoclonus elicited by somaesthetic and auditory stimulation was generalised. The earliest reflex electromyograph activity was recorded in the sternocleidomastoid; myoclonic activity then spread up the brainstem and down the spinal cord, suggesting that this reflex myoclonus had its origin in the caudal brainstem. Stimulus sensitivity was greatest in the limbs. The bulbospinal motor pathways involved in the generalised reflex myoclonus were rapidly conducting, and this characteristic distinguishes this form of brainstem reflex myoclonus from that described in hyperekplexia.
Treatment of idiopathic spasmodic torticollis with botulinum toxin a: A double‐blind study on twenty‐three patients
Authors: Lorentz I. T. , Subramaniam S. Shanthi , Yiannikas C. 
Published: December 2004

AbstractIn a double‐blind, placebo‐controlled study, 23 patients suffering from intractable spasmodic torticollis (ST) were given successively either botulinum toxin A (BTA) or normal saline by intramuscular injections in the affected muscles. Evaluation was carried out by three blinded observers, using a clinical and video assessment of the severity of torticollis, employing a scoring system described by Tsui (1). Patients were also asked to subjectively comment on changes in the amount of pain and on changes in the activities of daily living (ADL). BTA was proven to be superior on all forms of assessment to placebo, and these results were statistically significant. Side effects mainly consisted of pain at the injection site. Tiredness occurred at equal frequency with BTA and placebo. No serious or systemic side effects were noted. Botulinum toxin is a safe, effective and relatively simple treatment for spasmodic torticollis.
Creutzfeldt‐Jakob's disease presenting with ataxia and a movement disorder
Authors: Sethi Kapil D. , Hess David C. 
Published: December 2004

AbstractWe describe a 62‐year‐old patient who presented with ataxia and dystonia with mild dementia and was shown at autopsy to have Creutzfeldt‐Jakob's disease. Movement disorders may be the presenting feature of Creutzfeldt‐Jakob's disease, and this entity should be considered in the differential diagnosis of an otherwise obscure movement disorder even when the typical electroencephalographic pattern is absent.
Delayed onset movement disorders as a complication of central pontine myelinolysis
Authors: Tison F. X. , Ferre X. , Julien J. 
Published: December 2004

AbstractThis report describes a case of central pontine myelinolysis occurring after a rapid correction of profound hyponatremia. Delayed‐onset generalized dystonia and choreoathetosis then appeared. A small pontine myelinolysis was demonstrated by magnetic resonance images, but striatal myelinolysis could not be established. Aspects of movement disorders associated with the osmotic demyelination syndrome are briefly reviewed and discussed.
Jaw dystonia triggered by biting into hard food
Authors: Lagueny A. , Caix P. , Schuermans P. , Julien J. 
Published: December 2004

AbstractWe report an unusual case of eating dystonia induced by attempts to bite into hard food and resulting in prolonged jaw opening spasms. Mastication was severely impeded. Simultaneous bilateral electromyogram (EMG) of the masticatory muscles during mastication of hard food showed an abnormal prolonged activity in the anterior digastrics with an abnormal cocontraction of these muscles during contraction of the jaw‐closers and a prolonged inhibition of the jaw‐closers until the hard bolus was softened. This action dystonia seems to be trigered when more than a certain pressure is exerted on the peridontal mechanoreceptors and could result from a defective central command control of their sensory inputs. Local injections of botulinum toxin had little effect.
Intraventricular infusion of epidermal growth factor restores dopaminergic pathway in hemiparkinsonian rats
Authors: Pezzoli Gianni , Zecchinelli Anna , Ricciardi Sante , Burke Robert E. , Fahn Stanley , Scarlato Guglielmo , Carenzi Angelo 
Published: December 2004

AbstractWe assessed the effect of a 35‐day delayed intracerebroventricular (ICV) infusion of epidermal growth factor (EGF) on the survival and function of the substantia nigra (SN) dopaminergic neurons after a unilateral mechanical transection of rat nigrostriatal pathway. EGF infusion for 28 days resulted in a twofold increase in the number of surviving tyrosine‐hydroxylase (TH)–positive SN neurons and a significant increase in ipsilateral striatal TH‐positive fiber staining compared to controls at 200 days following the injury. In addition, there was a persistent enhancement of behavioral recovery, as indicated by a reduction in amphetamine‐induced rotations. We conclude that EGF exerts a neurotrophic effect on the dopaminergic neurons in this experimental model of parkinsonism.
Electroconvulsive therapy in Parkinson's disease and other movement disorders
Authors: Faber Raymond , Trimble Michael R. 
Published: December 2004

AbstractEarly case reports note marked improvements in the signs of Parkinson's disease (PD) in several patients with coexisting psychiatric disorders after treatment with electroconvulsive therapy (ECT). Studies since 1959 reveal improvement of parkinsonism in over half of PD patients receiving ECT, regardless of the presence or absence of psychiatric comorbidity. Druginduced parkinsonism, tardive dystonia, and tardive dyskinesia have also been shown to improve with ECT administration; tic syndromes have achieved mixed results. In animals, ECT enhances dopamine‐mediated effects and increases GABA concentrations in the CNS. Optimal parameters relevant to the antiparkinsonism effects of ECT require further study.
Intrafamilial correlation in idiopathic torsion dystonia
Authors: Fletcher N. A. , Harding A. E. , Marsden C. D. 
Published: December 2004

AbstractAge of onset and severity of idiopathic torsion dystonia (ITD) were studied in 100 British families containing 107 index cases and 79 secondary cases. Analysis of variance of these clinical features did not suggest that ITD is genetically heterogenous, and they were similar in Jewish and non‐Jewish patients. Intrafamilial correlation for age of onset was low, particularly between parents and their offspring, suggesting that the ITD phenotype may be determined in part by nongenetic factors or an allelic modifying gene.
Abnormal conduction in corticospinal pathways in Wilson's disease: Investigation of nine cases with magnetic brain stimulation
Authors: Meyer B.‐U. , Britton T. C. , Bischoff C. , Machetanz J. , Benecke R. , Conrad B. 
Published: December 2004

AbstractElectromyographic (EMG) responses evoked by transcranial magnetic brain stimulation were studied in nine patients with Wilson's disease (WD). Six of the nine patients had prolonged central motor latencies (CMLs), reduced amplitude, or absent responses in at least one of the examined muscles. In one patient, abnormal EMG responses normalized following treatment with penicillamine. Pathophysiologically abnormal EMG responses might result from a potentially reversible impairment of corticomotoneuronal pathways and/or a reduced excitability of motoneurons due to basal ganglia dysfunction. The possible pathophysiological mechanisms are discussed.
An unusual cause of recurrent chorea
Authors: Caviness John N. , Muenter Manfred D. 
Published: December 2004

AbstractRecurrent chorea is described in a 61‐year‐old woman who had had chorea gravidarum when she was younger. The recurrent chorea appeared to be induced by a topical vaginal cream that contained conjugated estrogen. This case is consistent with the existence of a recurrent syndrome of hormone‐induced chorea. The effect of estrogen on the basal ganglia is complex and not fully understood.
Regional changes in 2‐deoxyglucose uptake associated with neuroleptic‐induced tardive dyskinesia in the cebus monkey
Authors: Mitchell I. J. , Crossman A. R. , Liminga U. , Andren P. , Gunne L. M. 
Published: December 2004

AbstractThe neural mechanisms that mediate a primate model of tardive dyskinesia have been investigated using the 2‐deoxyglucose (2‐DG) uptake technique. Three groups of Cebus monkeys were used. Some of the animals received long‐term neuroleptic treatment. These animals were allotted to one of two groups depending on whether they developed tardive dyskinesia or not. A third group of animals served as untreated controls. The neuroleptic‐treated dyskinetic animals showed reduced uptake of 2‐DG in the medial segment of the globus pallidus and in the ventral anterior (VA) and ventral lateral (VL) nuclei of the thalamus relative to that seen in the equivalent structures in the neuroleptic‐treated nondyskinetic and untreated control animals. The data are interpreted as suggesting that tardive dyskinesia is mediated by underactivity of the pathways from the subthalamic nucleus to the medial pallidal segment and the substantia nigra pars reticulata, which in turn result in a loss of gammaaminobutyric acid‐ergic inhibition of the VA and VL thalamic nuclei. This suggests that tardive dyskinesia shares a common underlying neural mechanism with other hyperkinesias such as chorea and ballism.
Baclofen in the treatment of idiopathic dystonia in children
Authors: Greene Paul E. , Fahn Stanley 
Published: December 2004

AbstractBaclofen benefits some patients with adult onset dystonia, but few reports document the response to baclofen of children with idiopathic dystonia. Sixteen of 80 patients <age 21 years with idiopathic dystonia seen by the Movement Disorder Group at Columbia‐Presbyterian Medical Center in New York were treated with baclofen. Five had substantial improvement in symptoms, two had moderate improvement, and nine failed to benefit. Three of the improved patients had tranient improvement on high dose anticholinergics, but had sustained, dramatic improvement when baclofen was added. At last follow‐up, five patients maintained improvement for a mean 3.8 years (19 months–8 years) on a mean 79 mg of baclofen (40–120 mg). Response to baclofen did not correlate with age at onset of dystonia or age at onset of therapy, but did correlate with duration of symptoms before therapy (3 years for those who improved vs 7.8 years for those who did not: p <.002 by t‐test). Baclofen can be an effective treatment for childhood dystonia.
Tardive tremor
Authors: Stacy Mark , Jankovic Joseph 
Published: December 2004

AbstractA variety of hyperkinetic movement disorders has been associated with the use of neuroleptics (dopamine receptor blocking drugs), but tardive tremor has not been previously documented. We describe five patients in whom tremor occurred after chronic treatment with neuroleptics, was aggravated by and persisted after neuroleptic withdrawal, and improved after treatment with the dopamine depleting drug tetrabenazine. This involuntary oscillatory movement, with a frequency range of 3–5 Hz, was most prominent during maintenance of a posture, but was also present at rest and during a goal‐directed movement. The tremor was accompanied by other tardive movement disorders, including akathisia, chorea, dystonia, myoclonus, and stereotypy. There was no family history or other explanation for tremor in these patients. We suggest that this hitherto unreported movement disorder is best termed “tardive tremor”.
When did Ray Kennedy's Parkinson's disease begin?
Authors: Lees A. J. 
Published: December 2004

AbstractRay Kennedy's Parkinson's disease probably began during his distinguished career as a professional soccer player at least 10 years before the first unequivocal physical signs and 14 years before the diagnosis was finally made, when he was 35‐years old. Early prodromal symptoms included intermittent subtle disturbances of movement and posture affecting the right arm and leg, mild facial immobility, episodes of profound malaise and lack of energy, inner feelings of tremulousness, excessive unprovoked bouts of perspiration, and accompanying feelings of heat. Abnormalities of movement in the right arm can be seen in video footage of soccer games up to 8 years before his disability came to medical attention. Many of his premorbid personality traits are characteristic of those believed to be associated with the subsequent development of the malady. At least in some patients with Parkinson's disease, the search for instigating aetiological factors should focus 10–20 years before the cardinal signs can be recognised with certainty.
Clozapine prevents recurrence of psychosis in Parkinson's disease
Authors: Factor Stewart A. , Brown Diane 
Published: December 2004

AbstractPsychosis secondary to dopaminergic therapy can limit the ability to manage motor symptoms of advanced Parkinson's disease (PD). We report the results of an open label 3‐month trial that evaluated the antipsychotic effects of clozapine in eight PD patients with drug‐induced psychosis. Response was quantified using a simplified brief psychiatric rating scale and two PD scales. Clozapine significantly improved psychiatric scores at low doses. The use of every other day regimens (not previously utilized) led to good control of symptoms and minimized side effects. Clozapine also had a positive sleep effect in four patients and improved dyskinesia in one. Finally, this treatment prevented recurrence of psychosis while levodopa doses were significantly increased and while other antiparkinsonian medications were added. Motor disability related to PD improved as a result of these treatment adjustments. We conclude that clozapine is effective in treating drug‐induced psychosis in PD and allows for safe optimization of antiparkinsonian therapy.
Ethosuximide and tremor in Parkinson's disease: A pilot study
Authors: Pourcher E. , Gomez‐Mancilla B. , Bédard P. J. 
Published: December 2004

AbstractFollowing the demonstration of an antitremor effect of ethosuximide in the 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP) monkey model, we have tested the effect of this drug in 10 patients with typical parkinsonian tremor. Six patients suffered from Parkinson's disease with prominent, relatively drug‐resistant rest tremor. The other four patients had a druginduced parkinsonian tremor due to neuroleptic agents taken for a psychiatric condition. Five of the six parkinsonian patients and three of the four psychiatric patients reported within a few days a marked and intolerable exacerbation of their tremor. One patient in each group was improved, and this improvement was verified in repeated examinations. Thus, for unknown reasons, the effect of ethosuximide was not as predicted by the monkey model. Among possible explanations is the fact that we had chosen patients with drug‐resistant tremor.
Exposure to well water and pesticides in Parkinson's disease: A case‐control study in the madrid area
Authors: Jiménez‐Jiménez Félix Javier , Mateo Dolores , Giménez‐Roldán Santiago 
Published: December 2004

AbstractPast exposure to well water and pesticides was assessed in 128 unselected Parkinson's disease (PD) patients and 256 age and sex‐matched controls. All were residents in a defined urban area of Madrid, Spain. In keeping with other reports, we found that exposure to well water might be a factor associated with the likelihood of developing PD, though only prolonged exposures of 30 years or longer were significantly different between PD and controls (p < 0.02). In contrast, past exposure to pesticides did not appear to be associated with an increased risk of developing PD. Prolonged well water drinking antedating the development of PD was not associated with early onset of the disease, nor did such cases progress to greater disability. Future casecontrol studies addressing prolonged well water consumption as a risk factor in PD should look for differences in the content of substances other than pesticides in the water as determined by the source of water to which patients may have been specifically exposed.
Interlimb coordination in Parkinson's disease
Authors: Lazarus Jo‐Anne C. , Stelmach George E. 
Published: December 2004

AbstractThis study examined the degree to which Parkinson's disease (PD) patients could “spatially link” the upper limbs to facilitate the performance of bimanual simultaneous movements. Six right‐handed PD patients, and seven normal age‐ and sex‐matched controls performed three different tasks: (a) an isotonic elbow flexion as rapidly as possible through an angle of 30°; (b) an isometric contraction of the flexor muscles at the elbow joint to 40% and 60% of maximal volitional force (MVF) for a period of 5 s; (c) an isometric contraction for 2.5 s with one limb, then simultaneously performing an isotonic flexion with the contralateral limb while maintaining the isometric contraction for 2.5 s more. As expected, PD patients were significantly slower in performing the isotonic movement and produced lower peak velocities than the controls. More importantly, the two groups were differentially affected during the bimanual condition. In normals, movement time decreased and peak velocity increased in the bimanual condition. In contrast, PD patients showed increased movement times and sometimes decreased peak velocities in the bimanual condition. The results suggest that normal subjects utilize bilateral outflow to symmetrical muscle groups to synchronize the two limbs in the bimanual task, whereas PD patients dissociate the two limbs.