bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with parkinson's disease
Authors: Soykan Irfan , Sarosiek Irene , Shifflett Jeannie , Wooten George F. , McCallum Richard W. 
Published: May 2005

AbstractThis study investigated whether domperidone could improve gastrointestinal symptoms in patients with Parkinson's disease who were receiving levodopa therapy. A total of 11 patients were studied. Following a baseline gastric emptying test, patients were treated with a starting dose of domperidone 20 mg p.o. q.i.d. A follow‐up gastric emptying test was repeated at least 4 months after starting domperidone therapy. At the beginning and at each 3‐month follow‐up visit, symptoms of nausea, vomiting, anorexia, abdominal bloating, heartburn, regurgitation, dysphagia, and constipation were evaluated and scored on a scale of 0–3. The overall mean follow‐up period was 3 years. Compared with their baseline evaluation, patients experienced a significant improvement in all symptoms (p < 0.05) except dysphagia and constipation. Gastric emptying of an isotope‐labeled solid meal was significantly faster, with a baseline result of 60.2 ± 6.4% retention of isotope 2 h after the meal compared with 37.0 ± 2.2% retention during domperidone therapy (p < 0.05). Patients' global assessment of Parkinson's disease remained stable or improved. Serum prolactin was elevated in all patients after domperidone therapy (p < 0.05). Domperidone therapy significantly reduces upper gastrointestinal symptoms and accelerates gastric emptying of a solid meal, but does not interfere with response to antiparkinsonism treatment.
Agreement among movement disorder specialists on the clinical diagnosis of essential tremor
Authors: Chouinard Sylvain , Louis Elan D. , Fahn Stanley 
Published: May 2005

AbstractEven though essential tremor (ET) is the most prevalent movement disorder, there has been little agreement in the neurologic literature regarding diagnostic criteria for ET. The authors attempted to determine the extent and source of agreement and disagreement among neurologists regarding diagnostic criteria for clinically definite ET. The authors designed and mailed a semistructured questionnaire to 160 neurologists who specialize in movement disorders in 24 countries. The questionnaire included three sections: a list of inclusion criteria, a list of exclusion criteria, and a list of potential clinical scenarios (for example, isolated site‐specific tremor and primary orthostatic tremor). The questionnaire was completed by 98 (61%) of 160 targeted neurologists. There was greater consensus regarding features considered unnecessary inclusion criteria for clinically definite ET (extent of disability, disease duration, and positive family history) than for those considered necessary inclusion criteria (postural versus action tremor). With regard to exclusion criteria, there was some consensus in terms of the presence of Parkinson's disease, dystonia, history of hyperthyroidism or concurrent use of tremor‐inducing medications, and cerebellar signs. The majority of neurologists would diagnose ET in the setting of isolated head or voice tremor. There are areas of both consensus and divergence among neurologists with regard to diagnostic criteria for ET. The choice of diagnostic criteria may vary depending on the intended use of the criteria (that is, clinical versus genetic studies). Hopefully, this study will foster further discussion to achieve a more general consensus.
Kinematic analysis of articulatory movements in central motor disorders
Authors: Ackermann Hermann , Hertrich Ingo , Daum Irene , Scharf Gabriele , Spieker Sybille 
Published: May 2005

AbstractThe various components of the central motor system are expected to play a similar role in speech production and in upper limb control. Slowed articulatory performance, therefore, must be expected in disorders of the corticobulbar tracts, cerebellum, and basal ganglia. Using an optoelectronic device, the present study recorded lower lip trajectories during production of sentence utterances in patients with Parkinson's disease (PD), Huntington's disease (HD), cerebellar atrophy (CA), and pseudobulbar palsy (PB). The various subject groups showed a similar range of overall motor disability. Patients with CA and PB exhibited slowed movement execution in terms of a reduced ratio of peak velocity to maximum amplitude (“stiffness”)‐ In contrast to upper limb motor control, the lip excursions showed an uncompromised shape of velocity profiles. Two different patterns emerged in HD. A single patient suffering from the akinetic‐rigid Westphal variant of this disease had articulatory hypometria, whereas the remaining subjects showed significant bradykinesia under increased temporal demands, concomitant with normal movement amplitudes. The PD patients had unimpaired velocity‐displacement relationships. Presumably, biomechanical constraints such as the rather small excursions of articulatory lower lip gestures or the scarce spindle supply of facial muscles account for the observed discrepancies between upper limb and speech motor control in PD.
Adult‐onset tics associated with peripheral injury
Authors: Factor Stewart A. , Molho Eric S. 
Published: May 2005

AbstractWe report the cases of two patients with adult onset, simple, nonvarying tic disorder that commenced after a peripheral (non‐CNS) injury. The first patient is a 38‐year‐old man who suffered a right facial injury when his car fell off its jack while he was working underneath. Bilateral facial twitching began hours after the trauma and was characterized as a sniffinglike gesture. The movements waxed and waned, were suppressible, and were associated with a premonitory sensation. The tics remitted after 9 months but still recur occasionally under stressful situations. The second patient is a 34‐year‐old man with a 3‐year history of abrupt, rapid head‐turning movements that began 12 months after a motor vehicle accident in which he injured his neck. The tics continue to wax and wane, are suppressible, and are associated with an urge. Neither patient suffered a head injury or had a family history of Tourette syndrome. Based on the clinical and historical features of these patients, the temporal relationship between the trauma and onset of tics, and the occurrence of tics only in the traumatized region, a causal relationship is possible. These may represent the first reported cases of tic disorder in association with peripheral injury. The mechanism by which the tic disorder resulted from the peripheral injury is unclear, but these patients might have been susceptible individuals and the trauma acted as a trigger.
How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world
Authors: Louis Elan D. , Ottman Ruth , Allen Hauser W. 
Published: May 2005

AbstractEssential tremor (ET) is the most common adult movement disorder, as much as 20 times more prevalent than Parkinson's disease. Estimates of the crude prevalence of ET range widely from 0.08 to 220 cases per 1000 persons, a 2750‐fold difference. There has been no formal attempt to synthesize these disparate results. Our purpose is to provide an overview of existing studies, to examine methodologic issues that may account for this tremendous variability in results, and to provide a more precise estimate of the prevalence of ET. Nineteen studies of the prevalence of ET were reviewed. Factors that contribute to broad range of prevalence estimates include (a) differences in study design that influence validity and (b) differences in characteristics of study populations that influence comparability of studies. If we limit our examination to studies that (a) provided diagnostic criteria for ET, (b) defined ET as an action tremor, and (c) used community‐based rather than service‐based designs, then five studies remain, and the prevalence of ET is 4.1 to 39.2 cases per 1000, a 9.6‐fold difference. Four of these five provided age‐stratified data. Among these four, the prevalence of ET in those over the age of 60 years was 13.0 to 50.5 cases per 1000, a 3.9‐fold difference.
Ropinirole in the treatment of early Parkinson's disease: A 6‐month interim report of a 5‐year levodopa‐controlled study
Authors: Rascol Olivier , Brooks David J. , Brunt Ehrout R. , Korczyn Amos D. , Poewe Warner H. , Stocchi Fabrizzio 
Published: May 2005

AbstractThe efficacies of ropinirole and levodopa were compared after 6 months of treatment in a planned interim analysis of a 5‐year, double‐blind, randomized, multicenter study of patients with early Parkinson's disease requiring dopaminergic therapy. The percentage of improvement in the Unified Parkinson's Disease Rating Scale total motor examination score was significantly higher for levodopa (44%) than for ropinirole (32%). The proportion of “responders” (Unified Parkinson's Disease Rating Scale improvement of at least 30%) did not differ between groups (levodopa, 58%; ropinirole, 48%). There was no difference between the groups for improvement on the Clinical Global Impression scale in patients with Hoehn and Yahr stages I, I.5, or II, but a significantly higher proportion of patients with Hoehn and Yahr stages II.5 or III showed Clinical Global Impression score improvement with levodopa. Emergent adverse events occurred in 84% of patients in both treatment groups, the principal symptom in each group being nausea. The incidence of serious adverse events was low (8% for ropinirole, 9% for levodopa). The results suggest that ropinirole and levodopa are equally effective in less severe Parkinson's disease; in more advanced Parkinson's disease, levodopa is superior.
Ropinirole versus bromocriptine in the treatment of early Parkinson's disease: A 6‐month interim report of a 3‐year study
Authors: Korczyn Amos D. , Brooks David J. , Brunt Ehrout R. , Poewe Warner H. , Rascol Olivier , Stocchi Fabrizzio 
Published: May 2005

AbstractWe compared the efficacy and safety of ropinirole with that of bromocriptine after 6 months of treatment in a planned interim analysis of a 3‐year, double‐blind, randomized, multicenter study of 335 patients with early Parkinson's disease requiring dopaminergic therapy. Patients, treated with or without selegiline, received either ropinirole or bromocriptine. The mean Unified Parkinson's Disease Rating Scale (UPDRS) total motor examination scores (Part III) at baseline were similar in the four strata. Overall, and in the non‐selegiline subgroup, the percentage improvement in the UPDRS total motor examination score was significantly higher for ropinirole than for bromocriptine, as was the proportion of “responders.” In the selegiline subgroup, however, there was no significant difference between treatments. Similarly, in the non‐selegiline subgroup, there was a significantly higher proportion of “improvers” on the Clinical Global Impression scale with ropinirole than with bromocriptine, whereas in the selegiline subgroup, there was no significant difference. Emergent adverse events occurred in 80% of patients in both treatment groups, the principal symptom in each group being nausea. The incidence of serious adverse events was low (3% for ropinirole, 6.6% for bromocriptine). The data indicate that (a) in the absence of selegiline, ropinirole is effective and superior to bromocriptine; and (b) selegiline does not affect the response in patients treated with ropinirole, but enhances the effects of bromocriptine.
The role of EDTA in provoking allergic reactions to subcutaneous infusion of apomorphine in patients with Parkinson's disease: A histologic study
Authors: van Laar Teus , van Hilten Bob , Neef Cees , Rutgers A. Wijnand F. , Pavel Stan , Anthony Bruijn J. 
Published: May 2005

AbstractOne of the formulations of apomorphine, used in clinical practice, contains sodium edetate (EDTA). EDTA is a chelator which indirectly prevents oxidation of apomorphine. A clinical and histologic study in four patients revealed that apomorphine with EDTA caused severe subcutaneous nodules, histologically characterized by an inflammatory infiltrate with a large amount of eosinophils, indicating a cell‐mediated allergic reaction. After withdrawal of EDTA, this allergic component completely disappeared, which was accompanied clinically by less extensive nodule formation with a softer consistency. It is therefore recommended that EDTA be excluded from apomorphine formulations.
Assessment of ability/disability in patients treated with chronic thalamic stimulation for tremor
Authors: Hariz Gun‐Marie , Bergenheim A. Tommy , Hariz Marwan I. , Lindberg Margareta 
Published: May 2005

AbstractChronic thalamic stimulation (CTS) has a documented good effect on tremor in patients with Parkinson's disease (PD) and essential tremor (ET). This study evaluates whether the alleviation of impairment, i.e., tremor, translates into improvement of the patient's ability in performing instrumental activities of daily living (IADL). Thirteen patients were assessed with an occupational therapy tool called Assessment of Motor and Process Skills (AMPS). This observation‐based scale rates the patient's motor and process skills needed to perform a given task. The evaluations were done at a mean of 13 months after surgery in the patient's home, and included assessments of IADL with the CTS activated and switched off, respectively. The results showed that most patients improved to variable degrees in their IADL ability when the thalamic stimulation was on. The improvement was more marked in patients operated on for tremor of their dominant hand. The improvement concerned mainly the skill items related to the patients' abilities of coordination, calibration, calibration, endurance, and accommodation during IADL task performance. The authors concluded that for some patients with tremor, CTS can improve independence in domestic activities of daily living.
Improvement of action tremor by chronic cortical stimulation
Authors: Nguyen J.‐P. , Pollin B. , Fève A. , Geny C. , Cesaro P. 
Published: May 2005

AbstractThe authors present a patient who had long‐term improvement of a severe upper limb action tremor after chronic cortical stimulation. A 40‐year‐old woman complained of facial pain and tremor of the left arm after removal of an acoustic neurinoma. A motor cortex stimulation was performed to treat the deafferentation facial pain in 1993. Chronic cortical stimulation induced complete relief of both pain and tremor and allowed the patient to recover functional capacity of the limb. These effects persisted throughout a 32‐month follow up. Differential effects on pain and tremor were observed when parameters of stimulation were varied, suggesting different mechanisms for the relief of pain and tremor. Attention was focused on control of the tremor. This effect could be the result of the inhibition of subcortical structures which are involved in tremor. Chronic cortical stimulation appears to be an effective treatment for controlling severe action tremors.
Change in lateralization of the P22/N30 cortical component of median nerve somatosensory evoked potentials in patients with cervical dystonia after successful treatment with botulinum toxin A
Authors: Kaňovský Petr , Streitová Hana , Dufek Jaroslav , Znojil Vladimir , Daniel Pavel , Rektor Ivan 
Published: May 2005

AbstractThe precentral P22/N30 cortical component of the median nerve somatosensory evoked potentials (SEPs) was recorded in 16 patients (11 women and five men) suffering from cervical dystonia before and after botulinum toxin therapy. Cervical dystonia was diagnosed as idiopathic in all patients: 13 patients suffered from right‐sided torticollis, and three suffered from left‐sided torticollis. The amplitude of the P22/N30 component and the side‐to‐side ratio of amplitude values were measured. Normal values were obtained by acquiring measurements in two groups of healthy volunteers (n1 = 20 and n2 = 20). The recordings in the first control group were done with the patient's head in a normal position, whereas, in the second control group, the patient kept the head intentionally rotated 60° to the right. Patients were treated with local injections of botulinum toxin A (BTX‐A). The mean duration of treatment was 8.3 months, and the mean total amount of BTX injected was 295 U. The P22/N30 precentral component was repeatedly recorded in patients after head posture had been corrected to the normal plane by BTX‐A treatment. The recordings showed that the amplitude of the P22/N30 precentral component recorded contralaterally to the direction of head deviation was significantly higher in patients before treatment than after treatment. Contralateral pretreatment amplitudes were also significantly higher (p < 0.01 and p < 0.05, respectively) than amplitudes in both groups of healthy volunteers. The mean side‐to‐side ratio of precentral P22/N30 component amplitudes was significantly higher in patients before treatment compared with after treatment and also compared with both control groups. These changes in dystonic patients probably reflect the direction of head rotation, the muscle pattern of torticollis, and the change in force of dystonic contraction after the treatment. The changes presumably could be the result of higher excitability of the precentral cortex contralateral to head rotation in patients with cervical dystonia and its change after successful BTX‐A treatment.
Geste device in tardive dystonia with retrocollis and opisthotonic posturing
Authors: Krack Paul , Schneider Sybilla , Deuschl Günther 
Published: May 2005

AbstractRetrocollis and opisthotonic posturing are typical clinical features of tardive dystonia and may be extremely disabling. We have treated five such patients with a custom‐made mechanical device that delivers constant contact to the occiput and shoulders. All patients experienced relief and their walking improved. This geste device, working like a geste antagonistique, may be useful for the management of some patients with severe axial dystonia with retrocollis and back arching.
Comparison of treatment of tardive dystonia and idiopathic cervical dystonia with botulinum toxin type A
Authors: Brashear Allison , Ambrosius Walter T. , Eckert George J. , Siemers Eric R. 
Published: May 2005

AbstractTo compare clinical parameters of patients treated with botulinum toxin type A (BTX) for treatment of idiopathic cervical dystonia (ICD) and for tardive cervical dystonia (TCD), we studied 156 patients (149 with ICD and 7 with TCD) who were treated with serial injections of BTX over 5 years. We hypothesized that patients with TCD and ICD would demonstrate similar improvement in severity scores after treatment with BTX. The diagnosis, dates, dosages, and frequency of BTX injected and severity assessments were recorded into a computerized database. Nonparametric Wilcoxon rank sum and signed‐rank tests were used to assess statistical significance. The change in severity scores between the first treatment and last treatment in both groups was not statistically significant (p = 0.4859), indicating similar improvement. The difference in BTX doses was significant (p = 0.0045). ICD patients (n = 149) received an average of 219.8 ± 63.5 units and those with TCD (n = 7) were treated with an average dose of 287.4 ± 60.3 units. The average number of days between treatments for individuals with ICD was 142.9 ± 85.8, similar to that for persons with TCD (144.7 ± 64.5) (p = 0.6075). Our analysis provides preliminary evidence that the improvement from the administration of BTX for patients with ICD and TCD is similar.
Posey and spiller and progressive supranuclear palsy: An incorrect attribution
Authors: Siderowf Andrew D. , Galetta Steven L. , Hurtig Howard I. , Liu Grant T. 
Published: May 2005

AbstractIn 1904 and 1905, respectively, William Campbell Posey and William Spiller both described the case of a patient with progressive ophthalmoparesis and imbalance that has come to be regarded as the earliest report of progressive supranuclear palsy. No autopsy was thought to have been performed on this patient. In this report, we review the clinical history provided by Posey and Spiller. We also report on the subsequent autopsy of their patient, which was performed by Spiller in 1906. The chief finding was a tumor involving the right cerebral peduncle and periaqueductal area. The autopsy findings prove conclusively that the patient described by Spiller and Posey had a midbrain neoplasm and not progressive supranuclear palsy.
Glial pathology but absence of apoptotic nigral neurons in long‐standing Parkinson's disease
Authors: Banati Richard B. , Daniel Susan E. , Blunt Stavia B. 
Published: May 2005

AbstractThe cause and mechanism of neuronal cell death in the substantia nigra of patients with Parkinson's disease (PD) are unknown. There is also controversy about whether the cell death results from a single event followed by cell loss consistent with aging or whether there is an ongoing pathologic process. Using postmortem tissue obtained from the Parkinson's Disease Society Brain Tissue Bank in London, we have sought to establish whether apoptosis, or more specifically DNA fragmentation of neurons, is a prominent feature of nigral pathology. In addition, we have studied microglial activation in the substantia nigra as an indicator of ongoing pathology using the highly sensitive markers CR3/43 and EBM11. Reactive astrocytes have been assessed using immunostaining for glial fibrillary acidic protein (GFAP). Ten patients with pathologically proven PD were studied. In all cases, regardless of disease duration, severity, drug treatment, or age of the patient, there was no evidence of apoptosis in the substantia nigra as assessed by in situ end‐labeling of DNA fragments using biotinylated dUTP and terminal deoxynucleotidyl transferase (TdT). In contrast, a case of multiple system atrophy (MSA) served as a positive control for the technique. In this case, positive DNA end‐labeling could be found in neurons and non‐neuronal cells in the brain stem. In the PD cases, there was, however, localized pathology in the substantia nigra as revealed by the CR3/43 and EBM11 markers for activated microglia. This process seemed independent of disease duration and was florid even in patients with severe neuronal loss. It remains to be determined to what extent the activation of glial cells reflects progressive nigral pathology, and whether those factors which are classically associated with prominent apoptotic neuronal cell death in vivo, such as neurotrophic factor deprivation, are prime causes of nigral neuronal loss in PD. Future studies should focus on recent‐onset PD or incidental Lewy body disease to further address these questions.
Influence of body load on the gait pattern in Parkinson's disease
Authors: Dietz Volker , Colombo Gerhard 
Published: May 2005

AbstractThe influence of body unloading (to 75, 50, and 25% body weight) on lower leg muscle activation during treadmill walking was investigated in patients with Parkinson's disease, age‐matched and young healthy subjects. The aim of the study was to test the hypothesis that patients suffer from impaired extensor load receptor function. Although lower leg flexor muscle electromyographic (EMG) activity was relatively independent of body load, lower leg extensor EMG activity was markedly load sensitive. The EMG amplitude of the latter decreased with body unloading during stepping in all three groups of subjects. The load sensitivity progressively increased from patients to age‐matched to young healthy subjects. In addition, the absolute level of leg extensor EMG amplitude during the stance phase of stepping became progressively larger from patients to age‐matched subjects to young healthy subjects. It is suggested that decreased sensitivity of extensor load reflex mechanisms contributes to impaired gait in elderly subjects and is more pronounced in parkinsonian patients.