bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early combination therapy with bromocriptine and levodopa in parkinson's disease
Authors: Factor Stewart A. , Weiner William J. 
Published: December 2004

AbstractThe use of early combination therapy with bromocriptine (Br) and levodopa (LD) in Parkinson's disease is controversial. It has been suggested that treatment with this regimen would prevent or delay the onset of motor fluctuations and dyskinesia. Thus, some have recommended it as a standard of care. This recommendation is based on the theory that LD may accelerate the progression of PD and clinical experience using Br monotherapy in early Parkinson's disease, which suggested that Br causes fewer late complications. This article reviews these arguments and shows that the theories are uproven. A single, uncontrolled trial is often referred to as evidence for efficacy of early combination therapy. We critically review this and five other studies which have evaluated the treatment strategy. We show that the literature is often misleading and that these trials do not support the efficacy of early combination therapy. We conclude that there is no justifiable reason to use a combination of Br and LD in early parkinsonian patients.
Lewy bodies in the lateral hypothalamus: Do they imply neuronal loss?
Authors: Kremer H. P. H. , Bots G. Th. A. M. 
Published: December 2004

AbstractLewy bodies have been found in the hypothalamic lateral tuberal nucleus (NTL) and the adjoining tuberomammillary nucleus (TM) in Parkinson's disease (PD). The NTL is severely atrophic in Huntington's disease; the TM seems unaffected. In this study, we examined we examined the NTL and the TM of seven PD patients and one patient with presumed PD to assess whether the presence of Lewy bodies indicated neuronal loss. Most Lewy bodies were found in the TM, but they were also present in the NTL of seven of the eight patients. The number of NTL neurons in the PD patients was similar to a group of 14 nonneurological controls, seven Alzheimer's disease (AD) patients, and two AIDS patients with dementia. This challenges the hypothesis that Lewy bodies are a sign of significant cell death. The TM, whose cells could not be counted, did not seem depleted in neuronal numbers, although occasional neuronophagia was observed.
Axial motor disturbances after hypoxic lesions of the globus pallidus
Authors: Fève A. P. , Fénelon G. , Wallays C. , Rémy P. , Guillard A. 
Published: December 2004

AbstractFour subjects aged between 29 and 60 years were examined because of axial motor impairment after hypoxic brain injury. Magnetic resonance imaging revealed circumscribed lesions of the globus pallidus in every case. The association of freezing of the gait, speech disorders, axial bradykinesia, and postural disturbances, with no rigidity or tremor and little or no distal akinesia, suggests a role of the globus pallidus in controlling axial motion.
Laterality of onset in idiopathic torsion dystonia
Authors: Inzelberg Rivka , Ziber Nelly , Kahana Esther , Korczyn Amos D. 
Published: December 2004

AbstractIdiopathic torsion dystonia (ITD) is a dominantly inherited disorder with incomplete penetrance. It is important to identify factors that may cause dystonia or prevent its occurrence in a genetically predisposed individual. Because dystonia may be precipitated by peripheral triggers, we have investigated whether the preferential use of a limb affects the development of dystonia. Analysis of the correlation between the side of motor dominance and the limbs in which dystonic symptoms first appeared was performed in 49 patients with ITD ascertained in a country‐wide survey in Israel. The dominant motor side was determined in 45 cases (92%). Among 29 patients with lateralized limb onset, 24 showed right‐side motor dominance, of whom 21 had dystonia onset in a right limb. The first sign was in a left limb for all five cases with left‐side motor dominance (90% coincidence). The pattern of limb involvement was studied. Detection bias could be ruled out. The highly significant relationship between the motor dominance and the laterality of limb onset in ITD patients suggests that the preferred use of a limb may trigger the onset of dystonia.
Geniospasm: Hereditary chin trembling
Authors: Danek Adrian 
Published: December 2004

AbstractGeniospasm is a hereditary disorder characterized by episodic, usually stress‐induced involuntary trembling of the chin. Nineteen families from Europe and the U.S.A. suffering from this disorder have been described since 1894. We present three cases from two newly detected families. There was no evidence of any other nervous system abnormality, although abnormal EEG, sleep disorders, and involvement of other facial muscles have been described in rare cases. Geniospasm is transmitted as an autosomal‐dominant trait with high penetrance. It must be differentiated from facial myokymia, palatal tremor, and essential tremor affecting facial muscles. Neurophysiological and molecular mechanisms of this peculiar disorder are unknown.
Cisapride treatment of constipation in parkinson's disease
Authors: Jost W. H. , Schimrigk K. 
Published: December 2004

AbstractConstipation, a frequent symptom in Parkinson's disease (PD), is probably caused by degeneration of the autonomic nervous system, particularly the myenteric plexus. Cisapride is a drug that causes increased release of acetylcholine in the myenteric plexus. In a pilot study, cisapride therapy was investigated in 20 PD patients, 10 women and 10 men, who suffered from delayed intestinal transit. In all cases, cisapride therapy was associated with a significant acceleration of colonic transit, as measured by radioopaque pellets viewed on radiographs. Pellet count fell from a mean of 53.8 pretreatment to 30.4 after cisapride treatment. No adverse reaction and no “overshoot effects,” such as diarrhea, were seen. Our findings suggest that cisapride may alleviate the constipation associated with Parkinson's disease.
Visual and auditory evoked potentials in early onset parkinson's disease and their relationship to cerebrospinal fluid monoamine metabolites
Authors: Muthane Uday B. , Satishchandra P. , Subhash M. N. 
Published: December 2004

AbstractWe studied visual (VEP) and brainstem auditory (BAEP) evoked potential changes in 23 patients with early onset Parkinson's disease (EOPD) to establish the nature of the changes as well as their relationship to dopaminergic (DA) and serotonergic (5‐HT) disturbances, as determined by cerebrospinal fuid levels of homovanillic acid (HVA) and 5‐hydroxyindoleacetic acid (5‐HIAA). We also compared these parameters between the young onset (YOPD) and juvenile Parkinsonism (JP), the two subgroups of EOPD, to look for any possible differences between the two. In EOPD, the mean P100 latency of the VEP was significantly prolonged compared to controls (p < 0.001). However, within EOPD the evoked potential parameters were not significantly different between YOPD and the JP subgroups. P100 latency was abnormal in six patients (YOPD: 5, JP:1) (26%). Six patients (YOPD: 3, JP:3) (26%) had abnormal BAEP. A significant negative correlation (r: −0.89, p <1%) was observed between the P100 latency and CSF HVA levels. No correlation was observed between the BAEP interpeak latencies and either CSF HVA or 5‐HIAA levels. This study suggests that VEP and BAEP abnormalities do occur in EOPD (in both YOPD and JP), and that the prolongation of P100 latency is secondary to DA deficiency as in PD. The cause of BAEP abnormalities in EOPD. There was no correlation between the VEP or BAEP changes to either the age at onset or duration of EOPD.
Modulatory effect of clozapine on levodopa response in parkinson's disease: A preliminary study
Authors: Arevalo Gonzalo J. Gomez , Gershanik Oscar S. 
Published: December 2004

AbstractClozapine has been shown not only to be effective in ameliorating dopaminomimetic psychosis but to improve parkinsonian symptomatology. Six parkinsonian patients with motor fluctuations under levodopa treatment and severe interdose “off” periods (believed to be mediated by an inhibitory effect of subthreshold levels of levodopa) underwent a trial of clozapine. The effects of this drug on levodopa response were measured by means of an acute levodopa test both before and after receiving clozapine. After 1 month of treatment, clozapine 25 mg/day reduced parkinsonian scores at all stages of the evaluation (pre‐levodopa “off,” “on,” and interdose “off”). The effect was consistently more significant for the interdose “off.” Clozapine could be exerting its beneficial effects through the inhibition of an inhibitory effect mediated by low‐level dopaminergic stimulation, thus behaving as an apparent antiparkinsonian drug.
Inverse masticatory muscle activity due to syringobulbia
Authors: Merello Marcelo , Lees Andrew J. , Leiguarda Ramon , Guevara Juan , Nogués Martin 
Published: December 2004

AbstractThe clinical, radiological, and electrophysiological data of a 25‐year‐old woman with “inverse masticatory muscle activity” due to syringobulbia is presented. This uncommon brain stem syndrome may be due to disturbance in central programming of mastication.
Significant improvement of stiff‐person syndrome after paraspinal injection of botulinum toxin A
Authors: Davis Dave , Jabbari Bahman 
Published: December 2004

AbstractFollowing several months of low back pain, a 36‐year‐old developed progressive stiffness of the abdominal, low back, and thigh muscles. On examination, these muscles demonstrated marked hypertonia consistent with the clinical diagnosis of stiff‐person syndrome. The patient demonstrated increased lumbar lordosis and had focal hyperhidrosis at different sites. Electromyography showed continuous activity of the paraspinal and thigh muscles, and serum and cerebrospinal fluid antibodies to glutamic acid decarboxylase (GAD) were markedly elevated. Diazepam and Lioresal offered partial pain relief. Paraspinal muscle administration of botulinum toxin A reduced the tone of paraspinal and thigh muscles significantly and resulted in marked improvement of ambulation and cessation of pain.
Painless legs and moving toes: A syndrome related to painful legs and moving toes?
Authors: Walters Arthur S. , Hening Wayne A. , Shah Shashi K. , Chokroverty Sudhansu 
Published: December 2004

AbstractThe syndrome of painful legs and moving toes consists of continuous or semicontinuous involuntary writhing movements of the toes associated with pain in the affected extremity. We report a 57‐year‐old man with a 33‐year history of painless and semicontinuous involuntary movements of the toes of the left foot similar to those seen in painful legs and moving toes. There was no family history of movement disorder. The history and physical examination were negative for significant trauma, radiculopathy, or peripheral neuropathy. There were no other neurological findings or involuntary movements. It is unlikely that the involuntary movements were precipitated by neuroleptics or psychosis. CT scan of the head; EEG, CT, and MRI scans of the lumbosacral spine; and EMG and nerve conduction studies of the legs showed no significant abnormalities except for a predominant cocontraction of the left foot flexors and extensors at 0.6–1.2 Hz in a pattern sometimes seen in painful legs and moving toes. We conclude that there is a condition clinically and electrophysiologically similar to painful legs and moving toes that we call painless legs and moving toes, the etiology of which remains undetermined.
Brain glucose metabolism and dopamine D2 receptor analysis in a patient with hemiparkinsonism‐hemiatrophy syndrome
Authors: Przedborski S. , Goldman S. , Levivier M. , Giladi N. , Bidaut L. M. , Hildebrand J. , Stanus E. , Labar D. , Luxen A. 
Published: December 2004

AbstractWe report findings on brain glucose metabolism and dopamine D2 receptors generated by positron emission tomography (PET) in a 67‐year‐old woman with right hemiparkinsonism‐hemiatrophy syndrome (HP‐HA). PET with [18F]‐fluorodeoxy‐glucose (FDG) showed marked glucose metabolism asymmetry. There were significant reductions in glucose uptake at the level of the basal ganglia and, to lesser extent, in the fronto‐parietal cortex contralateral to the clinically involved side. These changes were different from those found in a patient with hemi‐Parkinson's disease who was scanned under similar conditions. Because the patient with HP‐HA had only minimal response to levodopa therapy, we evaluated post‐synaptic dopaminergic structures using PET with [18F]‐fluoroethylspiperone (FESP). No striatal binding asymmetry was found in FESP/PET, which suggests a sparing of striatal dopamine D2 receptors. The changes in FDG uptake which we found were in brain areas relevant to the clinical features of HP‐HA syndrome. In addition, our study provides evidence that FDG/PET may help to differentiate HP‐HA syndrome from hemi‐Parkinson's disease. In most instances, since HP‐HA is associated with a more benign clinical course than Parkinson's disease, this distinction is of clinical important.
The subthalamic nucleus: A possible target for stereotaxic surgery in parkinson's disease
Authors: Guridi J. , Luquin M. R. , Herrero M. T. , Obeso J. A. 
Published: December 2004

AbstractHyperactivity in the subthalamic nucleus (STN) projections to the globus pallidus medialis (GPM) has been established as a crucial feature of parkinsonism in animal models of Parkinson's disease (PD). Recent experiments blocking the STN glutamatergic output to GPM or lesioning the STN support this concept by showing a dramatic reversal of parkinsonism. We review the role of stereotaxic surgery in the past and the possible future application of subthalamotomy for PD.
Pre‐ and postcentral cortical somatosensory evoked potentials in hemiparkinsonism
Authors: Huttunen J. , Teräväinen H. 
Published: December 2004

AbstractWe recorded cortical frontal, central, and parietal somatosensory evoked potentials (SEPs) in 9 patients with hemiparkinsonism and in a group of 25 healthy volunteers. No differences were observed in the SEPs recorded after stimulation of the asymptomatic and symptomatic sides in the patients. Likewise, comparison with the healthy controls did not reveal significant group differences or abnormal waveforms in the patients. Even frontal N30 deflection, which has been reported to be diminished in Parkinson's disease (PD), was normal and symmetric in the patients. Therefore, no evidence was found for altered sensory input to the motor or premotor and supplementary motor cortices in PD.
Increased striatal glucose consumption in sydenham's chorea
Authors: Weindl A. , Kuwert T. , Leenders K. L. , Poremba M. , GräFin von Einsiedel H. , Antonini A. , Herzog H. , Scholz D. , Feinendegen L. E. , Conrad B. 
Published: December 2004

AbstractPositron emission tomography and 18F‐fluorodeoxyglucose were used to measure the regional cerebral glucose consumption in a 15‐year‐old choreatic girl with classical Sydenham's chorea shortly after the onset of hyperkinetic movements and 5 months later after chorea had resolved and in a 74‐year‐old hemichoreatic woman with long‐standing hyperkinesia as a residuum of Sydenham's chorea in adolescence. Whereas cerebellar, thalamic, and cortical glucose consumption was within normal limits in both patients, lentiform and caudate glucose consumption was significantly increased in both hemispheres of the 15‐year‐old patient and in the hemisphere contralateral to the chorea in the 74‐year‐old patient. In the younger patient, striatal glucose consumption returned to normal after her hyperkinesia had disappeared with antibiotic therapy. The observation of an increase in striatal glucose consumption in Sydenham's chorea, in contrast to the decrease of this variable encountered in the vast majority of other choreatic disorders, leads to questioning the pathophysiology of chorea in humans and suggests the use of emission tomographic measurement of variables related to cerebral energy metabolism for differential diagnosis in choreatic disorders.
Correlation of clinical response in apomorphine test with D2‐receptor status as demonstrated by 123I IBZM‐SPECT
Authors: Schelosky L. , Hierholzer J. , Wissel J. , Cordes M. , Poewe W. 
Published: December 2004

AbstractThe knowledge of functional capacities of postsynaptic dopaminergic receptors in parkinsonian syndromes is important for differential diagnosis and for planning therapeutic approaches. Subcutaneous apomorphine challenges serve as a pharmacological tool in testing dopaminergic responsiveness, but discrepancies between results of the apomorphine test and long‐term levodopa treatment remain. 123I IBZM (I‐123 labeled iodobenzamide) as a dopaminergic receptor ligand allows depiction of D2‐receptors by means of SPECT methods. The correlation between dopaminergic responsiveness and D2‐receptor status as demonstrated by 123I IBZM‐SPECT imaging was assessed by applying an apomorphine test to 41 patients with parkinsonian syndromes. All subsequently underwent an 123I IBZM‐SPECT. Apomorphine responders showed a significantly higher binding of 123I IBZM than nonresponders, and patients with idiopathic Parkinson's disease (IPD) had higher D2‐receptor density as visualized by SPECT than patients with other parkinsonian syndromes. The marked overlap between the groups allowed a reliable prediction only in patients with an abnormally low basal ganglia/frontal cortex ratio of 123I IBZM binding.
Relief of akinesia by apomorphine and cerebral metabolic changes in parkinson's disease
Authors: Broussolle E. , Cinotti L. , Pollak P. , Landais P. , Le Bars D. , Galy G. , Lavenne F. , Khalfallah Y. , Chazot G. , Mauguière F. 
Published: December 2004

AbstractThe cerebral metabolic rate of glucose was measured in 14 Parkinson's disease patients with severe on‐off fluctuations. Two positron emission tomography (PET) scans with [18F]fluorodeoxyglucose were performed, one after a challenge of subcutaneous apomorphine at a dose able to relieve akinesia within 15 min and the other with the vehicle. Apomorphine reduced glucose utilization by 4‐6% in the lenticular nuclei and the occipital cortex and by 6‐9% in the thalamic nuclei, but this effect was not statistically significant. Thus, central stimulation of dopamine receptors by apomorphine in advanced Parkinson's disease is not associated with cerebral methabolic changes as assessed by PET. Despite a dramatic improvement of the motor state, the global neuronal activity in the striatum and its downstream projections remains stable, suggesting an equilibrium between excitatory and inhibitory dopaminergic activities.
Terguride in fluctuating parkinsonian patients: A double‐blind study versus placebo
Authors: Pacchetti C. , Martignoni E. , Bruggi P. , Godi L. , Aufdembrinke B. , Miltenburger C. , Voet B. , Nappi G. 
Published: December 2004

AbstractTerguride (TER), a semisynthetic derivative of lisuride, has been found to display dopamine (DA) agonist and DA antagonist effects in animals, depending on the experimental model used. TER (2 mg/day) was compared to placebo in 41 fluctuating Parkinson's disease patients to test its effect on akinesia and dyskinesia. Mean hours “off” decreased at weeks 6 and 12 (p < 0.05) in the TER group but the overall difference from the placebo group was not significant. Only the TER group displayed a decrease over time in mean Columbia University Rating Scale total score “on” and “off” (p = 0.001 and p = 0.03, respectively). Duration of involuntary movements and resulting disability were not significantly different between patients on TER and those on placebo administration. In the overall evaluation, patients preferred TER (p = 0.01). Tolerance of TER was very good in all but one patient whose wearing‐off increased; no one dropped out because of side effects. This 3‐month doubleblind study showed that TER, added to stable doses of L‐dopa, may have slight antiparkinsonian efficacy.
Reliability of the columbia scale for assessing signs of parkinson's disease
Authors: Hely M. A. , Chey T. , Wilson A. , Williamson P. M. , O'Sullivan D. J. , Rail D. , Morris J. G. L. 
Published: December 2004

AbstractInter‐ and intrarater reliability in scoring the signs of Parkinson's disease using the original Columbia scale and a modified version of this, the Sydney scale, were assessed in five neurologists participating in a long‐term study of Parkinson's disease. Scoring was done on video recordings of 41 patients whose disability ranged from mild to severe. Although all the neurologists were familiar with the scales and had received training designed to produce uniformity of scoring, interrater reliability was poor. The mean score for the Columbia scale varied from 18.6 to 30 and for the Sydney scale from 15.2 to 23.2. By contrast, intrarater reliability was good. This study highlights the limitations of clinical rating scales in Parkinson's disease when more than one rater is used. In designing clinical trials, every effort should be made to ensure that the same patient is always assessed by the same rater.
Reversal of reserpine‐induced catalepsy by selective D1 and D2 dopamine agonists
Authors: Hubbard C. Anthony , Trugman Joel M. 
Published: December 2004

AbstractTo gain insight into the antiparkinsonian effects of selective D1 and D2 dopamine receptor stimulation, we examined the ability of D1 (SKF 38393) and D2 (quinpirole) agonists to reverse catalepsy induced by the combined administration of reserpine and α‐methyl‐p‐tyrosine (AMPT) in rats. Catalepsy, the failure to correct an externally imposed posture, is a measure of akinesia and was assessed using the bar test. Rats injected with reserpine alone (2.5 mg/ kg i.p.) developed akinesia and ptosis within 60‐90 min. The D1 agonist SKF 38393 (30 mg/ kg i.v.) rapidly reversed ptosis and restored near‐normal mobility when administered 24 h after reserpine and AMPT; catalepsy was reversed for 90 min, after which the drug effect wore off. Quinpirole (1 mg/ kg i.v.) reversed catalepsy for the duration of the test period (4 h) but did not consistently reverse ptosis or promote normal mobility; the rats continued to exhibit kyphotic postures with little spontaneous locomotion. These results indicate that selective D1 stimulation is sufficient to reverse reserpine‐induced akinesia and highlight the need for the development of potent selective D1 agonists for clincal traial in Parkinson's disease. In serve dopamine depletion, D2 stimulation alone appears to be insufficient to restore normal movement. Quinpirole, but not SKF 38393, elicited paroxysmal limb/ body jerking in reserpine‐AMPT‐treated rats, providing further evidence that atypical jerking can be elicited by D2 stimulation in the complete absence of D1 stimulation. This laboratory observation suggests that some jerking dyskinesias seen in treated parkinsonian patients may be mediated by an imbalance in D1‐D2 receptor stimulation.
Anxiety and motor performance in parkinson's disease
Authors: Siemers Eric R. , Shekhar Anantha , Quaid Kimberly , Dickson Hal 
Published: December 2004

AbstractPrevious work has suggested that anxiety disorders are common in patients with Parkinson's disease. To study the relationship between anxiety and response fluctuations in Parkinson's patients further, we compared change in Spielberger anxiety state scores with changes in parkinsonian disability as determined by the Parkinson's symptom diary (PSD). Anxiety state and PSD scores were obtained in 19 patients with idiopathic Parkinson's disease during on and off periods. Spielberger anxiety state scores were higher during off periods than during on periods (38.8 ± 12.4 vs. 45.6 ± 12.4, p < 0.03); further, the magnitude of the change in anxiety state scores was correlated with the change in PSD scores (rs= 0.616, p = 0.006). Spielberger anxiety trait scores were also correlated with disease duration. Our findings support existing data suggesting that anxiety can contribute significantly to morbidity in Parkinson's disease and suggest that anxiety varies with fluctuations in motor performance.