bluuebunny/crossref_metadata_2025_split huggingface dataset:
[123]IBZM Binding predicts dopaminergic responsiveness in patients with parkinsonism and previous dopaminomimetic therapy
Authors: Schwarz Johannes , Tatsch K. , Gasser T. , Arnold G. , Oertel W. H. 
Published: May 2005

AbstractWe investigated the cases of 55 patients with parkinsonism and prior dopaminomimetic therapy in whom the response to this treatment was questionable or reported to be negative. None of these patients had shown motor fluctuations prior to this study. We compared the results of imaging of dopamine‐D2 receptors by using [123l]iodobenzamide‐single‐photon‐emission computed tomography (IBZM‐SPECT) with the improvement in motor signs following a subcutaneous injection of apomorphine and a subsequent increase in oral dopaminomimetic therapy. IBZM‐SPECT accurately predicted a positive or negative response to apomorphine in 37 (84%) of 44 patients. The sensitivity/specificity was calculated as 96.3%/64.7%. The sensitivity/specificity of IBZM‐SPECT for the response to oral treatment with levodopa (L‐dopa) was calculated as 100%/75%. After a follow‐up period of 2–4 years, 25 patients developed motor fluctuations. All of these patients had normal IBZM binding. Nine developed clinical signs indicating a basal ganglia disorder other than Parkinson's disease. Eight of these nine patients had reduced, and one patient had normal, IBZM binding. We conclude that normal IBZM binding is a useful predictor of a good response to dopaminergic drugs in patients with parkinsonism and a questionable response to previous dopaminomimetic therapy. Reduced IBZM binding seems to exclude a diagnosis of Parkinson's disease, because none of the latter patients clearly benefited from L‐dopa and 66.7% developed clinical signs indicating another disorder of the basal ganglia.
Sexuality in women with parkinson's disease
Authors: Welsh Mickie , Hung Lynn , Waters Cheryl H. 
Published: May 2005

AbstractThere is a renewed interest in sexuality in chronic disease states. Whereas there is some literature on male sexuality in Parkinson's disease (PD), no study has been devoted exclusively to women. We compared 27 women who had PD with community controls matched for age and marital status by using the Brief Index of Sexual Functioning in Women. Approximately 50% of both samples were sexually active. The women with PD were more likely to be dissatisfied with the quality of the sexual experiences. There were significant differences in the two groups with respect to anxiety or inhibition, vaginal tightness, and involuntary urination. Preoccupation with health problems interfering with sex and dissatisfaction with body appearance were also more prevalent in parkinsonian women, but not statistically different from controls. The PD patients were less satisfied with their sexual relationships and with their partners, and were more depressed as a group when compared with controls (Beck Depression Inventory of 11.8 vs 6.3). In both groups, age was associated with significant changes in satisfaction and activity. In summary, qualitative differences exist in the sexual experiences of women with PD compared with controls.
Efficacy of a patient‐training videotape on motor fluctuations for on‐off diaries in parkinson's disease
Authors: Goetz Christopher G. , Stebbins Glenn T. , Blasucci Lucy M. , Grobman Mitchell S. 
Published: May 2005

AbstractPatient on‐off diaries are used in clinical trials, but a method to assure agreement between patient and examiner has never been developed. We tested whether a patient‐teaching tape increased the rate of agreement between patient diary ratings and simultaneous neurologic assessment by a trained professional. A total of 32 consecutive patients who had Parkinson's disease with motor fluctuations independently completed a 4‐h on‐off diary (nine ratings) at the same time as an examiner. Those with <80% agreement with the examiner (n = 20) were randomized to view either a training tape that showed motor fluctuations (experimental group) or another videotape of general patient educational material (control group). All patients then underwent the same 4‐h assessment of motor fluctuations. To test for long‐term retention, they returned 1 month later and, without reviewing the videotape, underwent a final 4‐h correlation assessment. After the training tape, the experimental group showed significant improvement, whereas the control group showed no improvement. Furthermore, another month later, the improvement in the experimental group was retained. Based on these findings, we suggest that future clinical trials assessing motor fluctuations incorporate this tape into their basic methodology.
Quantitative study of mitochondrial complex I in platelets of parkinsonian patients
Authors: Blandini Fabio , Nappi Giuseppe , Timothy Greenamyre J. 
Published: May 2005

AbstractActivity of mitochondrial enzyme complex I (NADH‐ubiquinone oxidoreductase) is reduced in the substantia nigra of patients with Parkinson's disease (PD). A less pronounced decrease in the activity of this enzyme has also been reported in platelets of PD patients. To obtain quantitative information on platelet complex I in PD, we studied platelet complex I in 16 PD patients and 16 age‐matched controls by using a newly developed technique based on the binding of [3H]dihydrorotenone ([3H]DHR), an analog of the pesticide rotenone, to complex I. We also investigated the inhibitory effect of MPP+ (1‐methyl‐4‐phenyl‐pyridinium) on [3H]DHR specific binding to platelet complex I. PD patients and controls showed similar levels of [3H]DHR specific binding; preincubation of platelets with MPP+ caused the same degree of inhibition of [3H]DHR specific binding in the two groups. In PD patients, we observed a direct correlation between MPP+‐induced inhibition of [3H]DHR specific binding and the daily intake of levodopa, which may be related to drug‐induced changes in the transport of MPP+ into the platelet or in its binding to complex I. These findings demonstrate that the reported reduction in complex I activity in platelets of PD patients can not be accounted for by an abnormality at the level of the rotenone binding site (putatively the ND‐1 gene product), although they do not exclude differences in complex I activity between PD patients and controls.
123I‐IBZM binding compared with long‐term clinical follow up in patients with de novo parkinsonism
Authors: Schwarz Johannes , Tatsch Klaus , Gasser Thomas , Arnold Guy , Pogarell Oliver , Künig Gais , Oertel Wolfgang H. 
Published: May 2005

AbstractWe performed a prospective clinical follow up (mean follow up, 36 months; range, 24–56 months) of 65 patients with de novo parkinsonism in whom imaging of dopamine D2 receptors was performed before the initiation of dopaminomimetic therapy by means of 123I‐iodobenzamidesingle‐photon‐emission computed tomography (IBZM‐SPECT). The results of IBZM‐SPECT were comared with the long‐term response to dopaminomimetic drugs, the development of motor fluctuations, and the development of clinical signs incompatible with Parkinson's disease (PD). A total of 55 patients had normal and 10 patients had reduced IBZM binding; 45 patients showed a good response to levodopa (L‐dopa), 11 showed an equivocal response, and nine did not respond; 31 patients developed a fluctuating response to dopaminomimetic drugs and seven patients developed clinical signs indicative of multiple‐system atrophy (n = 5), progressive supranuclear palsy (n = 1), or corticobasal ganglionic degeneration (n = 1). Chi‐squared analysis showed a significant correlation of the results of IBZM‐SPECT with the long‐term response to dopaminomimetic therapy (p < 0.0001) and the development of motor fluctuations (p < 0.0001) or clinical signs incompatible with PD (p < 0.0001). We conclude that IBZM‐SPECT can help to differentiate between patients who will show a good response to L‐dopa and will develop motor fluctuations (most likely patients with PD) and those patients who will not respond to L‐dopa and might develop clinical signs compatible with another hypokinetic disorder of the basal ganglia.
Gait disorder and parkinsonian signs in patients with stroke related to small deep infarcts and white matter lesions
Authors: van Zagten Marian , Lodder Jan , Kessels Fons 
Published: May 2005

AbstractVascular parkinsonism is thought to be a distinct parkinsonian syndrome associated with small deep infarcts and white matter lesions (WMLs). We studied the prevalence of parkinsonian features (bradykinesia, rigidity, tremor, and gait disorder) in relation to small deep or territorial infarcts and WMLs on computed tomography (CT) in 62 lacunar and 41 territorial stroke patients, at 3.0 (median) years of follow up. One or more parkinsonian signs were found in 36% of these patients; 11% clinically had parkinsonism. parkinsonian signs were found more frequently in lacunar than in territorial stroke patients: bradykinesia in 45% and 7%, rigidity in 13% and 7%, tremor in 6% and 7%, and gait disorder in 16% and 7%, respectively. Patients with WMLs at study entry (n = 16) were compared with those without WMLs (n = 87): 56% and 25% had bradykinesia, 25% and 8% rigidity, 25% and 3% tremor, and 38% and 8% gait disorder, respectively. Regression analysis with adjusted odds ratios ([a]OR) showed that WMLs at study entry were associated with bradykinesia ([a]OR 8.0, 95% confidence interval [CI] 1.6‐41.6), gait disorder ([a]OR 7.1, 95% CI 1.5‐33.7), and tremor ([a]OR 7.0, 95% CI 1.2‐40.3). Bradykinesia was associated with lacunar stroke at study entry ([a]OR 11.5, 95% CI 2.4‐54.9). Thus, one third of our storke patients had one or more parkinsonian signs, and 10% clinically had a parkinsonian syndrome that differed from Lewy body parkinsonism: infrequent resting tremor, but frequent gait disorder. Parkinsonian signs were associated with WMLs and lacunar storke. Therefore, this study favors a distinct vascular parkinsonian syndrome.
Electrophysiological studies of early stage corticobasal degeneration
Authors: Lu C. S. , Ikeda A. , Terada K. , Mima T. , Nagamine T. , Fukuyama H. , Kohara N. , Kojima Y. , Yonekura Y. , Chen R. S. , Tsai C. H. , Chu N. S. , Kimura J. , Shibasaki H. 
Published: May 2005

AbstractWe conducted electrophysiological studies in two Asian patients with probable corticobasal degeneration (CBD). The duration of illness from onset was 16 and 20 months, respectively. The clinical manifestations were markedly asymmetric and characterized by cortical sensory loss, apraxia, action myoclonus, action tremor, and akinetic‐rigid parkinsonism. Neither patient responded to levodopa therapy. Simple photon‐emission computed tomography (SPECT) study showed significantly decreased regional cerebral blood flow in the frontoparietal areas and thalamus opposite to the predominantly affected limb. A series of electrophysiological studies failed to identify giant somatosensory evoked potentials (SEPs), enhanced long latency electromyography (EMG) reflex, and cortical spikes preceding myoclonic jerk. However, the earliest cortical component of the median nerve SEP was exclusively enlarged in one patient and preserved with depression of the subsequent components in the other patient. Significantly shorter postmotor‐evoked potential (MEP) silent period was found after the transcranial magnetic stimulation of the motor cortex in both patients. CBD is a unique clinical entity characterized by action myoclonus probably the result of the pathologic hyperexcitability of the motor cortex, based on a loss of inhibitory input form the sensory cortex.
Costs of drug treatment in Parkinson's disease
Authors: Dodel Richard C. , Eggert Karla M. , Singer Marika S. , Eichhorn Tobias E. , Pogarell Oliver , Oertel Wolfgang H. 
Published: May 2005

AbstractParkinson's disease (PD) has a major socioeconomic impact on society. The chronic, progressive course of the disease, which often leads to severe disability, results in high expenses for the medical resources used for treatment, care, and rehabilitation of patients as well as reduced or lost productivity as a result of illness or premature death. In Great Britain, it has been estimated that the National Health Service spends up to $383 million (1992) annually for the care of PD. This emphasizes the importance of assessing the costs related to this disease. A detailed knowledge of the cost allocation would provide a solid basis on which health care priorities can be rationally set. Next to hospitalization, drug treatment accounts for the highest expense for direct medical costs of PD. Therefore, this analysis focuses on the costs of drug treatment for PD. The cost analysis was based on a retrospective study of 409 patients with PD who were seen over a 1‐year period in our movement disorders clinic. The cost of therapy varied considerably depending on the severity of the condition (assessed in the “off” phase), the incidence of motor fluctuations, and the type of PD. In the early stage of the disease (Hoehn and Yahr stage I [HY I]), mean daily costs for therapy were DM (German marks) 6.60, which increased in later stages of the disease (HYV) to DM 22.00. If rare cases requiring continuous subcutaneous apomorphine infusion were included, mean daily costs of patients in HY V rose to DM 32.50 (the mean daily costs of subcutaneous apomorphine‐treated patients in HY V: DM 74.30). Patients with motor fluctuations accounted for higher costs (DM 16.50) compared with those without motor fluctuations (DM 7.80). With respect to the three subtypes of PD, the mean daily expenditure was DM 7.00 for the tremor‐dominant type, DM 12.40 for the akinetic‐rigid type, and DM 10.80 for the mixed type. In the group of 409 PD patients included in this analysis, the average daily expenditure for drug treatment totaled DM 10.70 per patient (including patients on subcutaneous apomorphine).
Differential diagnosis of parkinsonism with [18F]fluorodeoxyglucose and PET
Authors: Antonini Angelo , Kazumata Ken , Feigin Andrew , Mandel Francine , Dhawan Vijay , Margouleff Claude , Eidelberg David 
Published: May 2005

AbstractThe clinical differentiation between typical idiopathic Parkinson's disease (IPD) and atypical parkinsonian disorders (APD) is complicated by the presence of signs and symptoms common to both forms of parkinsonism. Metabolic brain imaging with [18F]fluorodeoxyglucose (FDG) and positron emission tomography (PET) may be a useful adjunct in differentiating APD from IPD. To explore this possibility, we studied 48 parkinsonian patients suspected as having possible APD because of a deteriorating response to dopaminergic treatment, the development of autonomic dysfunction, or both. A group of 56 patients with likely IPD served as control subjects. We used quantitative FDG/PET to measure regional rates of cerebral glucose use in IPD and APD patients. We used discriminant analysis to categorize IPD and APD patients based on their regional metabolic data. We found that a linear combination of caudate, lentiform, and thalamic values accurately discriminated APD from IPD patients (p < 0.0001). Significant metabolic abnormalities were present in the striatum and the thalamus of 36 of 48 (75%) APD patients. Our findings show that measurements of regional glucose metabolism can be used to discriminate patients with suspected APD from their counterparts with classic IPD. FDG/PET may be a useful adjunct to the clinical examination in the differential diagnosis of parkinsonism.
Imaging the pre‐ and postsynaptic side of striatal dopaminergic synapses in idiopathic cervical dystonia: A SPECT STUDY Using [123I] epidepride and [123I] β‐CIT
Authors: Naumann Markus , Pirker Walter , Reiners K. , Lange Klaus W. , Becker Georg , Brücke Thomas 
Published: May 2005

AbstractThere is increasing evidence that a dysfunction of the dopaminergic system may be involved in the pathogenesis of idiopathic dystonia. To visualize possible alterations of the pre‐ and postsynaptic side of striatal dopaminergic synapses, SPECT studies using the radiotracers [123I] epidepride and [123I] β‐CIT were performed in 10 patients with idiopathic cervical dystonia. Eleven age‐ and sex‐matched subjects served as controls. [123I] Epidepride is a new highly affine marker of D2 receptors, and [123I] β‐CIT binds to dopamine transporters on dopaminergic nerve endings. [123I] Epidepride binding was significantly reduced in both striata of dystonia patients compared with controls (p < 0.05). In contrast, striatal [123I] β‐CIT uptake did not differ from controls. We conclude that dopaminergic dysfunction in idiopathic focal dystonia mainly involves postsynaptic mechanisms and suggest a disturbance of the indirect pathway of the motor circuit resulting in a disinhibited thalamocortical stimulation.
Immobilization tests and periodic leg movements in sleep for the diagnosis of restless leg syndrome
Authors: Montplaisir Jacques , Boucher Sylvie , Nicolas Alain , Lesperance Paul , Gosselin Anik , Rompré Pierre , Lavigne Gilles 
Published: May 2005

AbstractPatients with restless leg syndrome (RLS) complain of motor restlessness, usually occurring while they rest in the evening. Two immobilization tests have been described to assess leg restlessness in these patients. In the first test, the patient sits in bed with his or her legs outstretched while electromyograms are recorded from right and left anterior tibialis muscles for an hour (Suggested Immobilization Test [SIT]); in the second test, the legs are immobilized in a stretcher (Forced Immobilization Test [FIT]). In the current study, the SIT and the FIT were compared in patients with RLS and normal control subjects matched for age and sex. More leg movements were seen in patients than in controls during immobilization tests, especially the SIT. These movements were periodic, occurring at a frequency of approximately one every 12 seconds. The SIT (index > 40) was found to discriminate between RLS and control subjects better than the FIT (index > 25). Patients were also recorded during two consecutive nights to measure periodic leg movements in sleep (PLMS). A SIT index greater than 40 and a PLMS index greater than 11 (highest PLMS index of 2 consecutive nights) were found to discriminate patients with RLS from control subjects with similar power. With each of these two measures, the clinical diagnosis was correctly predicted in 81% of patients and 81% of the control subjects. The SIT has several advantages over the measure of the PLMS index; it does not require an all‐night polygraphic recording and can be administered several times a day to measure circadian fluctuation of motor restlessness.
Ten years' experience with enteral levodopa infusions for motor fluctuations in Parkinson's disease
Authors: Syed Nadir , Murphy John , Zimmerman Thomas , Mark Margery H. , Sage Jacob I. 
Published: May 2005

AbstractWe report our long‐term experience using enteral levodopa infusions in 22 patients with Parkinson's disease and severe motor fluctuations. Amelioration of intractable dyskinesias was the most important factor that determined whether patients chose to continue using the infusion pump system. Mechanical and physical problems associated with enteral access were the most common reasons for which patients discontinued pump use. Nearly all patients continued to have dramatically increased on time for the duration of follow up, suggesting that technically less‐cumbersome systems that provide continuous dopaminergic stimulation are worthwhile and should be developed.
Hypometria in Parkinson's disease: Automatic versus controlled processing
Authors: Oliverira Rosinda M. , Gurd Jennifer M. , Nixon Phillip , Marshall John C. , Passingham Richard E. 
Published: May 2005

AbstractObjectives: The aim was to investigate whether patients with Parkinson's disease (PD) make movements that are of smaller amplitude when required to attend to a secondary task at the same time as performing a motor task.Methods: Thirteen patients with idiopathic Parkinson's disease (mean age, 67.1 yrs) and 14 healthy control subjects (mean age, 66.2 yrs) were tested. The motor task was repeated opposition of the thumb and forefinger and the secondary task was a lexical decision task.Results: The PD patients made hypometric movements, and the amplitude was further decreased when they performed the secondary task at the same time. There was no significant change for the control subjects.Conclusion: The unpaced motor task was less automatic for the PD patients than for the control subjects, and hence more subject to interference from a secondary task. We relate this to the underactivation of the supplementary motor cortex (SMA).
Limb‐kinetic apraxia
Authors: Denes Gianfranco , Mantovan Maria Cristina , Gallana Alessandra , Cappelletti Jee Yun 
Published: May 2005

AbstractFive cases of limb‐kinetic apraxia following primary degenerative cerebral pathology are reported. Apraxia appeared as the main symptom and was not concomitant to aphasia or to widespread cognitive impairments. Apraxia was not a consequence of elementary motor or sensory deficits, lack of coordination, or the result of the presence of rigid‐akinetic symptoms. The apraxia was usually unilateral, being present in both routine activities and testing sessions and consisting of the coarse, unilateral, awkward execution of correctly planned movements. Conceptual knowledge of the movements and their ideational plan was spared. The characteristics of apraxia fit the definition of limb‐kinetic apraxia originally proposed by Liepmann. The pertinent literature is reviewed.
Clinical comparison of tardive and idiopathic cervical dystonia
Authors: Molho Eric S. , Feustel Paul J. , Factor Stewart A. 
Published: May 2005

AbstractIt has been suggested that tardive cervical dystonia may be clinically indistinguishable from the idiopathic form and that the diagnosis rests solely on documenting an exposure to dopamine antagonist medications. To investigate this, we performed a retrospective evaluation of patient records on 102 patients with idiopathic and 20 patients with tardive cervical dystonia seen in our Movement Disorder Clinic over the past 8 years. Several clinical and demographic variables were compared and a number of differences were observed. The presence of extracervical involvement, retrocollis, and spasmodic head movements were individually found to be predictive of tardive cervical dystonia. Torticollis, laterocollis, and trick maneuvers were predictive of idiopathic cervical dystonia. Head tremor (42.2%) and family history of dystonia (9.8%) were present only in the idiopathic group. Cervical muscle hypertrophy was significantly more common in the idiopathic group (100% versus 75%). No difference was found between the two groups in their response to treatment with botulinum toxin A. These results indicate that clinical differences between idiopathic and tardive cervical dystonia exist. These differences may help to distinguish them in the clinical setting, improve diagnostic accuracy, and support the existence of a causal relationship between exposure to dopamine antagonist medications and chronic dystonia.