bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subthalamic nucleus stimulation for Parkinson's disease preferentially improves akinesia of proximal arm movements compared to finger movements
Authors: Wenzelburger Roland , Kopper Florian , Zhang Bao‐Rong , Witt Karsten , Hamel Wolfgang , Weinert Dieter , Kuhtz‐Buschbeck Johann , Gölge Mukaddes , Illert Michael , Deuschl Günther , Krack Paul 
Published: October 2003

AbstractDeep brain stimulation of the subthalamic nucleus (STN‐DBS) reduces akinesia in Parkinson's disease but its impact on fine motor functions was unknown. We assessed the effects of DBS and a levodopa (L‐dopa) test on the timing of the precision grip in 18 patients. Improvement on UPDRS‐items reflecting hand functions and the shortening of the first phases of the precision grip were more distinct in the L‐dopa test than in the pure STN‐DBS condition. Other akinesia items and the time for build‐up of lifting force were equally improved in both conditions. This suggests that routine STN‐DBS might not be equally effective on all aspects of fine motor functions. © 2003 Movement Disorder Society
Voxel‐based morphometry detects cortical atrophy in the Parkinson variant of multiple system atrophy
Authors: Brenneis Christian , Seppi Klaus , Schocke Michael F. , Müller Jörg , Luginger Elisabeth , Bösch Sylvia , Löscher Wolfgang N. , Büchel Christian , Poewe Werner , Wenning Gregor K. 
Published: October 2003

AbstractTo determine magnetic resonance imaging (MRI) patterns of brain atrophy in parkinsonian syndromes, we applied voxel‐based morphometry (VBM) to segmented gray matter, white matter, and cerebrospinal fluid compartments of T1‐weighted brain volumes of 12 patients with probable multiple system atrophy–parkinson variant (MSA‐P) and 12 Parkinson's disease patients, comparing them with 12 normal controls matched for age. In comparison to controls, a cortical atrophy pattern was observed in MSA‐P patients with significant clusters of volume loss in primary sensorimotor cortices bilateral, supplementary motor areas bilateral, right premotor cortex, prefrontal cortex bilateral (middle frontal gyri) and insular cortices bilateral; subcortical atrophy occurred bilaterally in caudate nuclei and putamen as well as in the midbrain. Furthermore, an enlargement of the cerebrospinal fluid compartment was found in the lateral ventricles, third ventricle, perimesencephalic and cerebellomedullar cavities. In PD patients, significant atrophy only occurred in left caudate head with enlargement of left lateral ventricle. Comparing MSA‐P to PD patients, MSA‐P showed a similar cortical pattern of atrophy as compared to controls. We conclude that VBM reveals selective cortical atrophy in patients with MSA‐P affecting primary and higher order motor areas as well as prefrontal and insular cortices. Further studies are required to determine clinical and/or subclinical correlates of cortical atrophy in MSA‐P. © 2003 Movement Disorder Society
One‐year treatment with standard and sustained‐release levodopa: Appropriate long‐term treatment of restless legs syndrome?
Authors: Trenkwalder Claudia , Seidel Victor Collado , Kazenwadel Jörg , Wetter Thomas C. , Oertel Wolfgang , Selzer Roland , Kohnen Ralf 
Published: October 2003

AbstractTo investigate the long‐term efficacy and safety of sustained‐release (SR) in combination with regular‐release (RR) levodopa/benserazide in the treatment of restless legs syndrome (RLS), an open‐label, prospective, extension study of a preceding double‐blind crossover trial was performed for 12 months. Twenty‐three severely disturbed RLS patients (7 men, 16 women) received a combination of RR and SR levodopa. Patients were treated on average for 10 months with a mean daily dose of 203 ± 101 mg of RR and of 185 ± 93 mg of SR levodopa. The mean daily total dose was 388 ± 162 mg levodopa. Efficacy was documented using patient's rating scales, sleep diaries, and investigator's global ratings with the Clinical Global Impressions (CGI). Ten of 23 patients completed the 1‐year extension. Between baseline of the crossover trial and endpoint of the extension study (last‐observation‐carried‐forward method, intention‐to‐treat population), quality of sleep improved (+3.5 ± 1.9, 7‐point scale), sleep latency was shortened (−131 ± 152 minutes), and total sleep time lengthened (+ 190 ± 136 minutes). Severity of RLS at time of falling asleep (−6.5 ± 3.4, 11‐point scale) and during the night (−6.0 ± 3.5) was markedly lower at the end of the extension but severity of RLS during the day (+1.9 ± 5.0) slightly increased. Of 13 dropouts, 8 patients discontinued therapy because of worsening RLS during the day. This trial shows that long‐term treatment with the combination of RR and SR levodopa/benserazide in RLS patients with late‐night problems was efficacious and not limited by tolerability problems in 40% of patients, whereas in the majority of patients, aggravating daytime problems required termination of the levodopa therapy within the 1‐year treatment period. © 2003 Movement Disorder Society
Impact of placebo assignment in clinical trials of Parkinson's disease
Authors: Goetz Christopher G. , Janko Kimberly , Blasucci Lucy , Jaglin Jean A. 
Published: October 2003

AbstractInformed consent procedures in placebo‐controlled trials are developed to ensure that subjects entering studies clearly understand the possibility of placebo assignment. The extent of patient understanding and the impact of learning that they were assigned placebo treatment have not been extensively studied. By using a standardized questionnaire, we interviewed 50 consecutive placebo‐treated patients from 14 placebo‐controlled clinical trials of Parkinson's disease (PD) after completion of their involvement. All patients interviewed understood that their study contained a placebo arm. All had hoped to receive the study drug rather than placebo, and more than half the subjects believed they had improved clinically during their placebo exposure. Positive impressions of enrollment in placebo‐controlled trials were more frequent than negative, included helping to advance science (86%); liking the experience, education, and attention associated with the clinical trial (90%); and participating in research for the benefit of other patients as well as for themselves (80%). If another placebo‐controlled trial was offered, 88% expressed that they would possibly, likely, or definitely be interested in enrollment. PD patients clearly understand the concept of placebo‐controlled trials they complete them, but they are inaccurate in assessing whether they received placebo treatment. Although most wish they received the active compound being tested, the overall view of participation in placebo‐controlled trials is viewed very positively by PD patients. © 2003 Movement Disorder Society
Levodopa improves physical fatigue in Parkinson's disease: A double‐blind, placebo‐controlled, crossover study
Authors: Lou Jau‐Shin , Kearns Greg , Benice Theodore , Oken Barry , Sexton Gary , Nutt John 
Published: October 2003

AbstractWe quantitatively investigated the effect of carbidopa/levodopa (25/100) on physical fatigue during finger tapping and force generation in a double‐blind, placebo‐controlled crossover study. Parkinson's disease (PD) subjects were randomly assigned to carbidopa/levodopa or placebo for Visit 1 or 2 and participated in the following two studies: (1) Finger tapping. Twenty‐five PD patients used their index fingers to strike two keys 20 cm apart on a musical instrument digital interface (MIDI) keyboard. The slopes of the regression line of dwell time and movement time were used to assess the rate of fatigue development. (2) Force generation. Twelve PD patients contracted the wrist extensors maximally to obtain a baseline maximum voluntary contraction (BMVC) force. Then they repetitively contracted the wrist extensors at 50% of the BMVC for 7 seconds and rested for 3 seconds. An interval maximum voluntary contraction (IMVC) was measured every three repetitions. Fatigue was defined as an IMVC of less than 60% of the BMVC. The slope of the regression line of IMVC was used to assess the rate of force decline. These two studies were repeated 1 hour after carbidopa/levodopa (25/100) or placebo. Subjects filled out the Multidimensional Fatigue Inventory (MFI) at the beginning of the first visit. Results showed that the slope of dwell time decreased with levodopa but not with placebo (P = 0.004). The rate of force decline also decreased with levodopa but not with placebo (P = 0.01). The subscores in the dimension of physical fatigue in the MFI did not correlate with the rate changes in dwell time or the rate changes in force decline. We concluded that (1) levodopa improves physical fatigue in finger tapping and force generation, (2) physical fatigue in Parkinson's disease is at least partially related to dopamine deficiency, and (3) the MFI measures different aspects of physical fatigue compared with those measured by finger tapping and force generation. © 2003 Movement Disorder Society
Direct economic impact of Parkinson's disease: A research survey in the United Kingdom
Authors: Findley Leslie , Aujla Manjit , Bain Peter G. , Baker Mary , Beech Catherine , Bowman Clive , Holmes Jeremy , Kingdom Wendy K. , MacMahon Douglas G. , Peto Viv , Playfer Jeremy R. 
Published: October 2003

AbstractThe direct costs of care were evaluated prospectively in a sample of people with Parkinson's disease (PD) in the United Kingdom in 1998. The subjects were drawn from a random sample of general practitioner practices within a representative sample of 36 Regional Health Authorities and the equivalent. A total of 444 resource use questionnaires with usable data were returned (response rate, 59%). The total mean annual cost of care per patient for all patients by age was £5,993 (€9,554, n = 432). Hoehn and Yahr stage significantly (P < 0.001) influenced expenditure by stage as follows: 0 and I, £2,971 (€4,736, n = 110); II, £3,065 (€4,886, n = 89); III, £6,183 (€9,857, n = 120); IV, £10,134 (€16,155, n = 87); V, £18,358 (€29,265, n = 17). National Health Service costs accounted for approximately 38% and social services for 34% of the direct costs of care. Drug expenditure accounted for 24% of overall costs in the <65 years age group and 10% in patients aged >85 years. A move from home to residential care was associated with an approximately 500% cost increase. In conclusion, PD imposes significant direct costs on public services and on individuals. These costs should be taken into account when allocating public funds. © 2003 Movement Disorder Society
Randomized, double‐blind study of pramipexole with placebo and bromocriptine in advanced Parkinson's disease
Authors: Mizuno Yoshikuni , Yanagisawa Nobuo , Kuno Sadako , Yamamoto Mitsutoshi , Hasegawa Kazuko , Origasa Hideki , Kowa Hisayuki ,   The Japan Pramipexole Study Group
Published: October 2003

AbstractWe compared the efficacy and safety of pramipexole (PPX) with placebo in the treatment of advanced Parkinson's disease (PD) as an adjunct to levodopa. A bromocriptine (BR) group was included to enable determination of the noninferiority of PPX relative to BR as the standard treatment. © 2003 Movement Disorder Society
REM sleep behavior disorder and vocal cord paralysis in Machado‐Joseph disease
Authors: Iranzo Alex , Muñoz Esteban , Santamaria Joan , Vilaseca Isabel , Milà Montserrat , Tolosa Eduardo 
Published: October 2003

AbstractWe evaluated the occurrence of REM sleep behaviour disorder (RBD) and vocal cord abductor paralysis (VCAP) in a group of 9 Machado‐Joseph disease (MJD) patients. RBD was diagnosed by clinical history plus audiovisual polysomnography in 4 men and 1 woman (55%). While dreaming, 4 fell out of the bed and the other injured his arms. Laryngoscopy detected bilateral VCAP in 1 patient with stridor who required emergency tracheotomy, and partial vocal cord abductor restriction in 2. RBD and VCAP are two potentially injurious conditions that should be considered part of the clinical spectrum of MJD. © 2003 Movement Disorder Society
VIM thalamic stimulation for tremor in a patient with IgM paraproteinaemic demyelinating neuropathy
Authors: Růžička Evžen , Jech Robert , Zárubová Kateřina , Roth Jan , Urgošík Dušan 
Published: October 2003

AbstractWe demonstrate the effect of deep brain stimulation of the ventral intermediate thalamic nucleus on intractable action tremor, in a 72‐year‐old man suffering from neuropathy associated with monoclonal gammopathy. © 2003 Movement Disorder Society
Periodic alternating nystagmus and rebound nystagmus in spinocerebellar ataxia type 6
Authors: Hashimoto Takao , Sasaki Osamu , Yoshida Kunihiro , Takei Yo‐ichi , Ikeda Shu‐ichi 
Published: October 2003

AbstractWe report on a family with ataxia type 6 (SCA6) showing peculiar oculomotor symptoms. The proband presented with periodic alternating nystagmus (PAN), and her 2 brothers had rebound nystagmus and gaze‐evoked nystagmus. They carried the identical mutation (the number of expanded CAG repeat, 24) in the CACNA1A gene. The intrafamilial variability of oculomotor symptoms may be ascribed to factors other than CAG repeat expansion size in SCA6. © 2003 Movement Disorder Society
Unclassifiable parkinsonism in two European tertiary referral centres for movement disorders
Authors: Katzenschlager Regina , Cardozo Adriana , Avila Cobo M. Rosario , Tolosa Eduardo , Lees Andrew J. 
Published: October 2003

AbstractIn view of reports on high frequencies of atypical parkinsonism from different parts of the world and in non‐white communities in the United Kingdom, we have prospectively surveyed 1,000 consecutive patients with parkinsonism presenting to two European tertiary referral centres for movement disorders (London, UK, and Barcelona, Spain). The aims of our study were to assess in a cross‐sectional, prospective manner the proportion of patients who could not be classified diagnostically, to identify the factors precluding classification, and to determine which diagnostic measures would increase the rate of classifiable cases. Diagnoses were established using published clinical diagnostic criteria for Parkinson's disease (PD) and for other conditions associated with parkinsonism. Twenty‐nine patients in London and 25 in Barcelona were initially considered unclassifiable; nine could be classified after further investigations. Levodopa (L‐dopa) responsiveness was found to have a pivotal role in establishing a clinical diagnosis in previously unclassifiable patients: In those 45 patients who remained unclassifiable, failure to respond to L‐dopa without other exclusion criteria for PD was the most common finding in each centre. Our results show that 4.0 to 5.0% of parkinsonian patients presenting to specialist clinics in Western Europe cannot be categorised using currently available clinical diagnostic criteria for parkinsonian syndromes. Prolonged follow‐up and neuropathological diagnosis will be needed to determine whether all these cases represent atypical presentations of established clinico‐pathological entities or whether some represent unrecognised new disorders. © 2003 Movement Disorder Society
Is the target for thalamic deep brain stimulation the same as for thalamotomy?
Authors: Kiss Zelma H.T. , Wilkinson Marshall , Krcek Jerry , Suchowersky Oksana , Hu Bin. , Murphy William F. , Hobson Doug , Tasker Ron R. 
Published: October 2003

AbstractDeep brain stimulation (DBS) has virtually replaced thalamotomy for the treatment of essential tremor. It is thought that the site for DBS is the same as the optimal lesion site; however, this match has not been investigated previously. We sought to determine whether the location of thalamic DBS matched the site at which thalamotomy would be performed. Eleven patients who had detailed microelectrode recording and stimulation for placement of DBS electrodes and subsequent successful tremor control were analysed. An experienced surgeon, blinded to outcome and final electrode position, selected the ideal thalamotomy site based on the reconstructed maps obtained intraoperatively. When the site of long‐term clinically used DBS and theoretical thalamotomy location was calculated in three‐dimensional space and compared for each of the x, y, and z axes in stereotactic space, there was no significant difference in the mediolateral location of DBS and theoretical lesion site. There was also no difference between the theoretical lesion site and the placement of the tip of the electrode; however, the active electrodes used for chronic stimulation were significantly more anterior (P = 0.005) and dorsal (P = 0.034) to the ideal thalamotomy target. This mismatch may reflect the compromise required between adverse and beneficial effects with chronic stimulation, but it also suggests different mechanisms of effect of DBS and thalamotomy. © 2003 Movement Disorder Society
Abnormal corticomuscular coherence is associated with the small amplitude cortical myoclonus in Parkinson's disease
Authors: Caviness John N. , Adler Charles H. , Sabbagh Marwan N. , Connor Donald J. , Hernandez Jose L. , Lagerlund Terrence D. 
Published: October 2003

AbstractCoherence is the degree of time‐locked correlation between two signals as a function of frequency. The purpose of this study was to test the following hypotheses: (1) corticomuscular coherence is abnormally increased in those Parkinson's disease (PD) patients with small amplitude cortical myoclonus, and (2) corticomuscular coherence peaks around the time of the myoclonus electromyographic (EMG) discharge. We studied Parkinson's disease patients with and without myoclonus and controls. The data were digitally collected and processed off‐line with EMG rectification, creation of 511‐msec epochs, Fast‐Fourier transform, and coherence analysis. In the 12 to 30 Hz frequency band, but not at 30 to 60 Hz or above, coherence peaks were observed in the PD subjects with myoclonus that were significantly greater than in the control subjects (P < 0.001) and in PD subjects without myoclonus (P < 0.001). The abnormal coherence values are evidence for abnormal rhythmic activity in cortical motor areas in those Parkinson's disease patients with myoclonus. In combination with previous findings on back‐averaging, our results show that this myoclonus occurs when neuronal populations are driven to an extreme amount of synchronous activity with higher corticomuscular coherence values. These results have mechanistic implications for cortical dysfunction in Parkinson's disease and for cortical myoclonus in general. © 2003 Movement Disorder Society
Severe generalized dystonia as a presentation of a patient with aprataxin gene mutation
Authors: Sekijima Yoshiki , Hashimoto Takao , Onodera Osam , Date Hidetoshi , Okano Tomomi , Naito Kosuke , Tsuji Shoji , Ikeda Shu‐ichi 
Published: October 2003

AbstractA 14‐year‐old girl, homozygous for an insertion mutation of aprataxin (APTX), 689 ins T, is described. She presented with severe generalized dystonia, ataxia, ocular motor apraxia, and areflexia. The dystonia of this patient suggests involvement of the basal ganglia or thalamus, along with clinical diversity in this disorder. © 2003 Movement Disorder Society
Developments in the molecular biology of DYT1 dystonia
Authors: Walker Ruth H. , Shashidharan P. 
Published: October 2003

AbstractThe identification of a mutation of the DYT1 gene as a cause of inherited dystonia has led to many insights regarding the genetics of this disorder. In addition, there is a rapidly expanding list of inherited dystonia syndromes, the genes for some of which have been identified or localized. The DYT1 mutation has been found in a variety of ethnic groups, and it may result in a range of phenotypes. To date, studies of torsinA, the protein product of the DYT1 gene, have not revealed its function, although its widespread distribution throughout the central nervous system suggests a universal role. TorsinA has structural homology to heat shock and chaperone proteins. Evidence from studies in cell cultures and Caenorhabditis elegans, and the presence of torsinA in inclusion bodies in several neurodegenerative diseases may be indicative of a function of this nature. Preliminary studies in humans with DYT1 dystonia and in DYT1 transgenic mice suggest disruption of the dopaminergic nigrostriatal system. A functional interference with neuronal signal processing induced by mutation of torsinA is consistent with current hypotheses regarding impairment of the center‐surround mechanism in the striatum. © 2003 Movement Disorder Society
Treatment of hypophonia with collagen vocal cord augmentation in patients with parkinsonism
Authors: Hill Amy N. , Jankovic Joseph , Vuong Kevin D.A.T. , Donovan Don 
Published: October 2003

AbstractWe conducted structured interviews of patients with Parkinson's disease (PD) and other parkinsonian disorders and their caregivers after augmentation of vocal folds with collagen injections. A total of 12 patients (mean age, 73.7 ± 8.6 years) completed the questionnaire after an average of 3.0 ± 1.7 collagen injections, with an average of 13.8 ± 7.4 weeks between each injection. In addition to improvement in all six voice quality questions, there was significant improvement (P < 0.05) in the Glascow Benefit Inventory (GBI) score. The injection procedure was tolerated well by patients with an average duration of benefit lasting 7.8 ± 8.5 weeks. Augmentation of vocal folds with collagen provides temporary improvement in voice in patients with parkinsonian hypophonia. © 2003 Movement Disorder Society
CPW balanced amplifier with a new branch‐line coupler
Authors: Yun Bub‐Sang , Yun Tae‐Soon , Lee Jong‐Chul , Kim Jong‐Heon , Lee Byungje , Kim Nam‐Young , Park Hyun‐Chang 
Published: October 2003

AbstractIn this paper, a balanced amplifier with coplanar waveguide structure for wireless LAN applications is presented. To reduce the input VSWR and improve stability, the balanced characteristic is adopted for the amplifier's design. The balanced amplifier is designed by several microwave simulation tools, such as Agilent ADS ver. 1.3, Agilent HFSS ver. 5.6, IMST COPLAN ver. 2.3, and Zeland IE3D ver. 8.0. The new branch‐line coupler shows an insertion loss of 3.5 dB and input/output return losses of greater than 20 dB at 5.8 GHz. The balanced amplifier, using a new CPW branch‐line coupler, shows a gain of about 10 dB at 5.8 GHz. © 2003 Wiley Periodicals, Inc. Microwave Opt Technol Lett 39: 349–351, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.11213
Harmonic suppression in microstrip multistage coupled‐ring bandpass filters using defected ground structures
Authors: Griol A. , Mira D. , Marti J. , Corral J. L. 
Published: October 2003

AbstractThe introduction of defected ground structures (DGSs) in microwave bandpass filters, based on microstrip coupled‐ring resonators to suppress higher harmonics, is investigated. Two topologies based on placing DGS units into and out of the coupled rings are considered and investigated. Harmonic suppression ratios for the second harmonic greater than 20 dB in a flat bandpass filter centered at 2.25 GHz are achieved for both structures. © 2003 Wiley Periodicals, Inc. Microwave Opt Technol Lett 39: 351–354, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.11214