ABSTRACT
Twenty-five Parkinson's disease (PD) patients were studied by brainstem auditory evoked potentials (BAEP) with increased stimulus rate (ISR) and compared to a control age and hearing matched group. A second comparison was made between L-dopa-treated and untreated PD patients. The results of the study suggest that there is subclinical involvement of the auditory brainstem in PD patients, possibly due to the dopamine influence upon the blood vessels. Our results also indicate that dopamine is probably not involved in the synaptic transmission along the auditory pathway of the brainstem.
Subject(s)
Brain Stem/physiopathology , Evoked Potentials, Auditory , Parkinson Disease/physiopathology , Aged , Audiometry, Pure-Tone , Female , Humans , Male , Middle AgedSubject(s)
Brain Stem/physiopathology , Evoked Potentials, Auditory , Migraine Disorders/physiopathology , Adolescent , Adult , Child , Female , Humans , Male , Middle AgedABSTRACT
Although the present study is based on a small number of patients, our clinical data clearly show that DFMD is as effective as other peripheral decarboxylase inhibitors in potentiating the action of L-DOPA. In 3 patients, we observed an improvement above that with previous therapy. This may suggest that in some patients DFMD is either more effective than other decarboxylase inhibitors or that it has its own effect. Subjective complaints with DFMD were frequent and 9 of the 10 patients preferred their previous therapy. In 5 patients, we observed an increase in blood pressure while on DFMD plus L-DOPA and 2 had EEG changes. These effects appear to be drug-related. Because of its side effects, DFMD cannot be considered in this form as a useful adjuvant in Parkinson therapy. However, further studies are necessary for the development of selective inhibitors.
Subject(s)
Antiparkinson Agents , Carboxy-Lyases/antagonists & inhibitors , Parkinson Disease/drug therapy , Aged , Antiparkinson Agents/adverse effects , Brain Diseases/chemically induced , Clinical Trials as Topic , Electroencephalography , Female , Humans , Hyperbilirubinemia/chemically induced , Hypertension/chemically induced , Levodopa/administration & dosage , Male , Middle AgedABSTRACT
In two adolescent and two adult patients with Kleine-Levin syndrome, polygraphic sleep recording performed during somnolent and non-somnolent periods revealed various forms of abnormal breathing patterns during sleep. These included periodic breathing and hypopnoeic episodes associated with brief arousals and, in one adult patient, a full blown sleep apnoea syndrome. It is suggested that abnormal breathing in sleep in this syndrome may result from central hypoexcitability.
Subject(s)
Disorders of Excessive Somnolence/etiology , Respiration Disorders/etiology , Sleep Wake Disorders/etiology , Adolescent , Adult , Disorders of Excessive Somnolence/physiopathology , Electroencephalography , Electromyography , Humans , Male , Mental Disorders/complications , Middle Aged , Sexual Behavior , SyndromeABSTRACT
The therapeutic effect of the combination of levodopa and carbidopa ("Sinemet") was compared with that of levodopa alone in 21 patients with Parkinson's disease. Eighteen parameters of the clinical condition and of functional impairment were determined quantitatively and the results satistically evaluated. Changing over from levodopa to the combination preparation resulted in an average improvement of 51.9% within 2 weeks. No relationship was found to exist between the degree of improvement and the severity or the progression of the disease. By the use of the combination preparation, the daily dosage of levodopa could be reduced by 77%. Side-effects connected with the gastro-intestinal tract occurred much less frequently, while hyperkinesia increased. No arrhythmogenic effect was found with the combination product. From the clinical standpoint, combination therapy appeared to be qualitatively superior. By selective maintenance of freshly formed dopamine, it should be possible to assure a directed influence on the disturbed equilibrium of the functional systems of the brain.
Subject(s)
Carbidopa/therapeutic use , Hydrazines/therapeutic use , Levodopa/therapeutic use , Parkinson Disease/drug therapy , Aged , Carbidopa/adverse effects , Clinical Trials as Topic , Drug Combinations , Electrocardiography , Female , Humans , Levodopa/adverse effects , Male , Middle Aged , Parkinson Disease/physiopathology , Time FactorsABSTRACT
The fluctuation in daily performance of Parkinson patients on long-term L-dopa therapy is known as the so called "off-on" phenomenon. Cotzias et al. found that a low protein diet is able to control this phenomenon in patients taking L-dopa alone but not in those receiving a combination of L-dopa and decarboxylase inhibitor. The author's hypothesis was based on the competition between the alimentary aminoacids and L-dopa for transport to the brain ganglia. In our attempt to prove the findings of Cotzias group we tested the influence of a low protein diet on 23 Parkinson patients manifesting the "off-on" phenomenon. All had been pretreated with L-dopa for 5--8 years and taking dopa DI for a minimum of 3 years. The protein intake was limited to 25 g/day (which is less than 0.5 g/kg body weight) for 1--4 months. In 6 cases there was a marked improvment with reduction of the "off-on" effect, and in one it disappeared completely. A distinct improvment of general capability was seen in the other 5 cases, and an objective improvment of the symptoms was noted, except during the "off" period. No response could be observed in the remaining 12 cases. All cases with hyperkinesia showed an augmentation of this symptom during the use of the diet. The diet restriction was not found to be correlated with age, stage, duration of illness or duration of dopa treatment. The possible mechanism of the "off-on" phenomenon and some suggestions to influence it, are presented.
