bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Parkinson's disease in northwestern italy: Comparison of tracer methodology and clinical ascertainment of cases
Authors: Chiò Adriano , Magnani Corrado , Schiffer Davide 
Published: May 2005

AbstractThe prevalence of idiopathic Parkinson's disease (PD) in an area of Northwestern Italy (Socio‐Sanitary District of Cossato, 61, 830 inhabitants) was analyzed and the reliability of “drug tracer methodology” evaluated. The patients were identified by both conventional epidemiological methodology (general practitioners, consultant neurologist, computerized archives) and drug tracer methodology (registered levodopa prescriptions). The diagnosis of PD was clinically verified by examining all patients. Of 146 patients examined, 104 were affected by PD; the remaining by other types of parkinsonism. The crude point prevalence rate (October 20, 1991) was 168 per 100,000 population (95% confidence interval [95% CI] 138–204), with a progressive increase up to the 80–89 age group. Using “tracer” methodology, the estimated crude point prevalence rate was 196 (95% CI 163–235), with an overestimation of the prevalence in older patients and women and an underestimation in younger and less seriously affected cases. The uneven distribution of PD in Italy appears to be the result of, at least in part, methodological factors. “Tracer” methodology may cause biases in the evaluation of the epidemiological characteristics of PD, especially if the clinical diagnosis of cases identified by this method is not carefully verified. Nevertheless, it appears useful as an additional source of cases for descriptive surveys.
Tremor in ostensibly normal elderly people
Authors: Elble Rodger J. 
Published: May 2005

AbstractTremor in ostensibly normal people, aged 70–91, was assessed clinically and electrophysiologically with the goal of estimating the prevalence of abnormal tremor. Fifty Men and 50 women, mean age 76.0 ± 4.7 yrs, were recruited through advertisements for healthy volunteers (n = 50 “biased” control subjects) and from the spouses of patients referred to us for dementia or Parkinson's disease (n = 50 “unbiased” control subjects). All participants were interviewed and examined by the author. Tremor was assessed quantitatively with rating scales, triaxial accelerometry, electromyography, a digitizing tablet, and spectral analysis. Twenty‐three people (23%) were judged clinically to have mildly abnormal tremor resembling mild essential tremor. Twelve people with abnormal tremor belonged to the biased group and 11 were in the unbiased group. The clinical diagnosis of abnormal hand tremor correlated well with the presence of motor unit entrainment in the forearm EMG and with writing or drawing tremor that was measurable with a digitizing tablet. Only 10 of 23 people with abnormal tremor were aware of their tremor, and none had been diagnosed previously by a physician. Nine of 77 people (11.7%) with normal tremor, and five of the 23 people (21.7%) with abnormal tremor had this family history. Mild undiagnosed tremor, resembling essential tremor, is common in this age group.
Monoaminergic effects of high‐dose corticotropin in corticotropin‐responsive pediatric opsoclonus‐myoclonus
Authors: Pranzatelli Michael R. , Huang Yung‐Yu , Tate Elizabeth , Goldstein David S. , Holmes Courtney S. , Goldstein Edward M. , Ketner Karen , Kinast Morris , Lange Bernadette M. , Sanz Alfred , Shevell Michael I. , Stanford Richard E. , Taff Ingrid P. 
Published: May 2005

AbstractChildren with the opsoclonus‐myoclonus syndrome (OMS) usually respond to corticotropin (adrenocorticotrophic hormone, ACTH) treatment but the mechanism of benefit is unknown. We previously showed that both cerebrospinal fluid (CSF) homovanillic acid (HVA) and 5‐hydroxyindoleacetic acid (5‐HIAA) concentrations are low in pediatric OMS. In this study, we measured levels of CSF Dopa, catecholamines, deaminated metabolites of catecholamines, as well as HVA and 5‐HIAA in eight patients before and during treatment with ACTH. All the children were ACTH‐responsive with 50‐70% improvement in multiple clinical features of OMS. ACTH treatment reduced the HVA concentration in every child by a mean of 21% (p < 0.001). Treatment with ACTH was associated with significant correlations between dopaminergic markers such as HVA, dihydroxyphenylacetic acid (DOPAC), and Dopa. There were no significant changes in the CSF concentrations of the noradrenergic markers norepinephrine (NE) and dihydroxyphenylglycol (DHPG), or the serotonergic marker 5‐HIAA. The only child with a marked inflammatory pattern in CSF, which was reversed by ACTH, was atypical for a large increase in NE and decrease in 5‐HIAA levels. The pattern of decreased HVA and unchanged DOPAC levels could reflect decreased extraneuronal uptake of catecholamines (which steroids inhibit) or decreased 0‐methylation of catecholamines in nonneuronal cells.
Apomorphine‐induced penile erections in Parkinson's disease
Authors: O'Sullivan John D. , Hughes Andrew J. 
Published: May 2005

AbstractPenile erections were regularly induced by intermittent subcutaneous injections of apomorphine in five patients with Parkinson's disease (PD) complicated by motor fluctuations. Four of the patients reported erectile dysfunction before beginning apomorphine and two of these report a significant improvement in their sexual function resulting from apomorphine use. Animal studies suggest central D2‐type dopamine receptor stimulation and oxytocin release from the paraventricular nucleus of the hypothalamus mediate the effect. Erections reported with other dopamine agonists and levodopa are probably mediated by the same mechanism. Apomorphineinduced erections in PD are probably more common than previously thought. The benefit of apomorphine on sexual function in some patients suggests a possible role in the treatment of impotence in PD.
Exteroceptive and interoceptive stimuli in dystonia
Authors: Greene Paul E. , Bressman S. 
Published: May 2005

AbstractSome patients with torsion dystonia experience a dramatic increase or decrease in symptoms when performing specific activities. The activities that influence dystonic symptoms vary from person to person. An activity or sensory stimulus that reduces symptoms has been called a “sensory trick” or, in cervical dystonia, a “geste antagoniste.” When a single activity induces symptoms of dystonia, the dystonia is called “task specific.” We have discovered that in some patients, thinking about a sensory trick or task affects the dystonia in the same way as actually performing the activity. We present three representative patients, and discuss the relevance of this observation to the understanding of dystonia.
Olfactory function in restless legs syndrome
Authors: Adler Charles H. , Gwinn Katrina A. , Newman Stephanie 
Published: May 2005

AbstractRestless leg syndrome (RLS) is usually idiopathic but may occur in patients with Parkinson's disease (PD). Both respond to dopaminergic medications. Whether these disorders share a common pathophysiology is unclear. Because PD is associated with a loss of olfactory function, we compared the olfactory function, we compared the olfactory function of patients with RLS with control and PD patients. Using the University of Pennsylvania Smell Identification Test (UPSIT), olfactory function was found to be normal in patients with idiopathic RLS and significantly reduced in patients with PD. This suggests that the pathophysiology of RLS differs from PD, and that RLS likely is not a “forme fruste” or a preclinical sign of PD.
Proton MR spectroscopic findings in paroxysmal kinesigenic dyskinesia
Authors: Kim Mee Ohk , Im Joo‐Hyuk , Choi Choong Gon , Lee Myoung Chong 
Published: May 2005

AbstractAlthough paroxysmal kinesigenic dyskinesia (PKD) has characteristic clinical features, the pathophysiology of PKD has remained unknown. The purpose of this study was to investigate the pathophysiology of idiopathic PKD by performing proton magnetic resonance spectroscopy (1H‐MRS) in five patients with idiopathic PKD. Three patients were familial and two sporadic. Single‐voxel 1H‐MR was performed on a GE 1.5‐T SIGNA MR system. Localized 1H‐MR spectra were obtained from the basal ganglia (n = 5), thalamus (n = 3), and supplementary motor area (SMA; n = 4) using STEAM sequence (stimulated echo acquisition mode; TR = 3.0 sec, TE = 30 msec, 64 AVG, volume = 8 mL) or PRESS (point resolved spectroscopy; TR = 3.0 sec, TE = 135 msec, volume = 4 mL). Peak ratios of Cho/Cr (Cho: choline, Cr: creatine) and mI/Cr (mI: myoinositol) were decreased significantly in the unilateral basal ganglia of two patients. In one, decreased peak ratio of mI/Cr in the unilateral basal ganglia was the only abnormality. In the remaining two, there was no significant abnormality. 1H‐MR spectra obtained from the thalamus and SMA were all within normal limits. In conclusion, these results suggest that underlying pathophysiological mechanism of PKD may be at least partially associated with the dysfunction of cholinergic system in the basal ganglia.
Resurgence of functional neurosurgery for Parkinson's disease: A historical perspective
Authors: Speelman J. D. , Bosch D. A. 
Published: May 2005

AbstractThe history of functional neurosurgery for the treatment of Parkinson's disease is reviewed. Two major stages may be distinguished: (1) open functional neurosurgery, which started in 1921 with bilateral cervical rhizotomy by Leriche. In 1937 Bucy performed the first motor cortectomy in a tremor patient, and subsequently introduced lesioning of the corticospinal tract at different levels. In 1939 Meyers started open transventricular surgery of the basal ganglia, which was abandoned in the 1940s because of high mortality. However, this operation drew attention to the basal ganglia and their efferent pathways as surgical targets for the relief of parkinsonian symptoms. (2) Stereotactic (closed) functional neurosurgery in patients was in 1947 for the first time performed by Spiegel and Wycis, soon followed by surgeons in various countries. Originally, the globus pallidus and the ansa lenticularis were the surgical targets but were replaced at the end of the 1950s by the ventrolateral thalamus. A few surgeons positioned their lesions in the subthalamic area. In both targets favorable results were reported for the treatment of tremor and rigidity with acceptable adverse events. In selected patients, bilateral surgery was performed. In 1969 the results of more than 37,000 stereotactic operations had been published. Criteria for the surgical technique and selection of patients were described, and various stereotaxic atlases became available. At that time, L‐dopa became generally available and the number of stereotactic operations declined dramatically. However, as a result of the shortcomings of the L‐dopa therapy in the long‐term treatment of Parkinson's disease, the thalamotomy gradually regained its place. New developments were the reintroduction of the pallidotomy by Laitinen in 1992 and the thalamic stimulation for pharmacotherapy‐resistant tremor by Benabid and collaborators in 1991. New insights in the pathophysiology of Parkinson's disease supported the revival of the functional stereotactic neurosurgery and recently caused the introduction of the subthalamic nucleus as a surgical target in the treatment of Parkinson's disease.
Factor structure of the unified Parkinson's disease rating scale: Motor examination section
Authors: Stebbins Glenn T. , Goetz Christopher G. 
Published: May 2005

AbstractThe Unified Parkinson's Disease Rating Scale (UPDRS) is widely used to asses Parkinson's disease (PD) disability but its metric properties have not been extensively studied. We investigated the factor structure and internal consistency of the Motor Examination section of the UPDRS in a sample of 294 consecutive patients with idiopathic PD who were assessed while in the “on” state. There was a high degree of internal consistency. Factor analysis revealed six clinically distinct factors, three bradykinesia measures (axial/gait, right and left), one rigidity measure, and two tremor measures (rest and postural). These factors accounted for 78% of the variance. Total Motor Examination scores and selected factors correlated well with other examiner‐determined global ratings of PD disability (Hoehn and Yahr stage and Schwab‐England Activities of Daily Living score). These results suggest that the Motor Examination section of the UPDRS provides a useful measure of PD function as well as severity measures of six clinical disability domains.
Effects of SIB‐1508Y, a novel neuronal nicotinic acetylcholine receptor agonist, on motor behavior in parkinsonian monkeys
Authors: Schneider Jay S. , Pope‐Coleman Anne , Van Velson Maria , Menzaghi Frederique , Kenneth Lloyd G. 
Published: May 2005

AbstractThe potential antiparkinsonian effects of the centrally acting, subtype‐selective neuronal nicotinic acetylcholine receptor agonist (S)‐(7‐)‐‐5‐ethynyl‐3‐(1‐methyl‐2‐pyrrolidinyl)‐pyridine (SIB‐1508Y) was assessed on motor symptoms and disability scale ratings in three monkeys previously made parkinsonian by chronic exposure to the dopaminergic neurotoxin 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP). Compared with levodopa (L‐dopa), SIB‐1508Y exerted only mild antiparkinsonian effects when administered alone. Emetic effects of this drug interfered with potential therapeutic effects at higher doses. However, when a low, ineffective dose of SIB‐1508Y was combined with low, ineffective doses of L‐dopa, a significant clinical effect was observed. These data suggest that subtype‐selective nicotinic acetylcholine receptor agonists may hold promise as antiparkinsonian agents, and when administered in combination with L‐dopa may allow a reduction in the dose of L‐dopa needed to achieve a significant clinical effect.
Event‐Related desynchronization to contingent negative variation and Self‐Paced movement paradigms in Parkinson's disease
Authors: Magnani Giuseppe , Cursi Marco , Leocani Letizia , Volonté Maria Antonietta , Locatelli Tiziana , Elia Aldo , Comi Giancarlo 
Published: May 2005

AbstractThe event‐related desynchronization (ERD) to voluntary movemtnt is an indicator of cortical activation with a high time resolution and a specific spatial representation. We have evaluated 10 patients affected by Parkinson's disease (PD), free from L‐dopa treatment for at least 12 hours, and 10 control subjects. Each subject underwent ERD examination during self‐paced movement (SPM) and during contingent negative variation (CNV) paradigms. ERD was measured as the percentage decrease of alpha band power and calculated for frequency bands of 1 Hz, ranging between 8 and 12 Hz. For group comparisons, the frequency showing the highest ERD was selected for each subject and for each side. In the control group. ERD in the CNV paradigm began over the contralateral centroparietal electrodes 1475 ms before movement onset of the right hand and 1375 ms for the left. In the SPM paradigm, ERD started over the contralateral central electrodes 2150 ms and 1775 ms before movement onset of the right and left hand, respectively. In the PD group, ERD started over the contralateral central areas 800 ms and 475 ms before movement onset of the right and left hand, respectively, for CNV paradigm and 1200 ms and 750 ms for the right and left hand, respectively, for SPM paradigm. Therefore, contralateral ERD began closer to movement onset in PD compared with the control group in both paradigms. ERD over the sensorimotor areas ipsilateral to the movement was not significantly different in PD compared with the control group. The finding of delayed contralateral ERD in PD is according to the view that functional cortical activation related to movement preparation is impaired in PD. The lack of group differences in the onset of ipsilateral ERD, which appears close to movement execution than contralateral ERD both in normal subjects and in PD, suggests that different mechanisms may be involved in generating ERD over the hemispheres ipsilateral and contralateral to the movement, and that only the latter are impaired in PD.
Apomorphine enantiomers protect cultured pheochromocytoma (PC12) cells from oxidative stress induced by H2O2 and 6‐Hydroxydopamine
Authors: Gassen Michael , Gross Aviva , Youdim Moussa B. H. 
Published: May 2005

AbstractA significant body of evidence has been provided to support the hypothesis that oxidant stress may be responsible for the degeneration of dopaminergic neurons in the substantia nigra pars compacta in Parkinson's disease. Apomorphine, a dopamine D1/D2‐receptor agonist in the clinical therapy of Parkinson's disease, has been found to be a potent antioxidant and to prevent free radical reaction in rat brain mitochondrial fraction. In this article we show that 1–10 µM of apomorphine protects rat pheochromocytoma (PC12) cells from the toxic effects of H2O2 (0.6 mM) and the neurotoxin 6‐hydroxydopamine (150 µM). Neither of these effects were exhibited by ascorbic acid, desferal, lisuride, or bromocriptine. Although pergolide exhibited some protection of PC12 cells against H2O2 toxicity, it was not as potent as apomorphine. In light of the present findings and the clinical reports that parkinsonian patients on long‐term apomorphine therapy stabilize clinically and can be weaned off L‐dopa, one may assume that apomorphine can exert a neuroprotective activity by way of its potent antioxidant properties.
Efaroxan, an alpha‐2 antagonist, in the treatment of progressive supranuclear palsy
Authors: Rascol Olivier , Sieradzan Kasia , Peyro‐Saint‐Paul Hélène , Thalamas Claire , Brefel‐Courbon Christine , Senard Jean Michel , Ladure Philippe , Montastruc Jean Louis , Lees Andrew 
Published: May 2005

AbstractWe have tested, in a prospective randomized, double‐blind, placebo‐controlled, crossover, 12‐week study, the effects of 2 mg efaroxan, a potent alpha‐2 antagonist, given three times per day to 14 patients with progressive supranuclear palsy. Efaroxan did not induce any significant change on any motor assessment criteria. The present data do not confirm the assumption that the blockade of alpha‐2 receptors might be a useful pharmacologic strategy to improve patients with progressive supranuclear palsy.
Pallidotomy for generalized dystonia
Authors: Ondo William G. , Michael Desaloms J. , Jankovic Joseph , Grossman Robert G. 
Published: May 2005

AbstractWe systematically evaluated the efficacy of both unilateral and bilateral stereotactic pallidotomy in eight patients with generalized dystonia. Six patients had a marked improvement in dystonic movements and motor function; the other two patients also benefited from the procedure but to a lesser extent. The severity of dystonia was assessed before and after surgery by the Burke‐Marsden‐Fahn Dystonia Scale (BMFDS), the Unified Dystonia Rating Scale (UDRS), and the Activity of Daily Living Scale (ADL). The BMFDS scores decreased by 59.0%, UDRS by 62.5%, and ADL by 47.8% postoperatively. Adverse events were limited to a transient weakness in one patient. We conclude that pallidotomy is a safe and effective treatment in medically refractory cases of generalized dystonia.
Muscle afferent block for the treatment of oromandibular dystonia
Authors: Yoshida Kazuya , Kaji Ryuji , Kubori Tamotsu , Kohara Nobuo , Iizuka Tadahiko , Kimura Jun 
Published: May 2005

AbstractOromandibular dystonia is a focal dystonia involving the masticatory and tongue muscles, causing difficulties in speech or mastication. We treated 13 patients with this condition by injecting diluted lidocaine and alcohol intramuscularly. This method is aimed at reducing muscle spindle afferent activity. The symptoms had been resistant to other therapies such as pharmacotherapy or dental treatment. All patients showed clinical improvement after this therapy with reduced EMG activities in the affected muscles, whereas control injection of normal saline gave no changes in EMG activities. The overall subjective improvement was 57.7 ± 25.1% (mean ± standard deviation) in a self‐rating scale. The mean response of the jaw elevator muscles (70 ± 13.1%) was significantly higher (p < 0.02, t test) than that of the depressor muscles (38 ± 28.4%). Despite the precise mechanism being unknown, this difference might be related to the smaller number of muscle spindles in the depressor than the elevator muscles. This therapy is useful for the treatment of drug‐resistant oromandibular dystonia.
Treatment of cervical dystonia: A comparison of measures for outcome assessment
Authors: Lindeboom Robert , Brans Jeroen W. M. , Aramideh Majid , Speelman Hans D. , De Haan Rob J. 
Published: May 2005

AbstractThere is little agreement on which outcome measures to use to express the efficacy of treatments for cervical dystonia. We analyzed change scores on various scales of 64 new patients with cervical dystonia before and after repeated injections with botulinum toxin.Method: The association between change in impairment (Tsui), and change in pain (TWSTRS‐Pain) and functional health (TWSTRS‐D, MOS‐20) was expressed in percentages of variance explained. Effect sizes of the outcome measures from patients who continued botulinum treatment and dropouts were compared. Performance of outcome measures to distinguish patients who continued treatment and dropouts was analyzed with ROC curves and areas under the curve (AUC).Results: Impairments explained ≤ 7% of the score variance in functional health. There were no differences between the effect sizes of impairment and pain of patients who continued treatment and dropouts (p > 0.60). This suggests a poor reflection of the treatment efficacy by these outcome measures. Conversely, there were significant differences between the effect sizes of the functional status scales of the patients who continued treatment and the dropouts (p ≤ 0.01). ROC curve analysis showed that the disability, handicap, and global disease burden scale accurately distinguished between the two groups (AUCs > 0.80). Impairments showed no discriminative accuracy (AUC = 0.46).Conclusion: Neurologic impairments have a small impact on the functional health of cervical dystonia patients. Disability, handicap, and a global measure of disease burden were the most suitable outcome parameters to express the clinical efficacy of botulinum therapy.
Conjugate eye deviations as dyskinesias induced by levodopa in Parkinson's disease
Authors: Lewitt Peter A. 
Published: May 2005

AbstractInvoluntary upward and lateral eye movements are described in two Parkinson's disease patients who also experience levodopa‐induced chreoathetoid limb movements simultaneously. These brief deviations of gaze represent a rare ocular manifestation of dyskinesia and are similar to oculogyric movements resulting from other causes.