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Biomedical subjects

F Tison

Publications and source records attributed to F Tison.

At least 73 records · Page 4Linked to original sources
PubMed1997

Survival of patients with pathologically proven multiple system atrophy: a meta-analysis.

A systematic review of the neurologic literature identified 433 cases of pathologically proven multiple system atrophy over a 100-year period. Earlier case reports included patients younger in age with more frequent cerebellar involvement. Mean age of onset was 54.2 years (range 31 to 78) and survival was 6.2 years (range 0.5 to 24). Survival analysis showed a secular trend from a median duration of 4.9 years for publications between 1887 and 1970 to 6.8 years between 1991 and 1994. Older age of onset was associated with shorter survival; the hazard ratio for patients with onset after 60 years was 1.8 (95% CI 1.4 to 2.3) compared with patients between 31 and 49 years. Cerebellar features were associated with marginally increased survival (6.1 years versus 5.4 years; p = 0.04). There were no difference in survival according to gender, parkinsonian, or pyramidal features or whether the patient was classified as striatonigral degeneration or olivopontocerebellar atrophy type. These results demonstrate the poor prognosis for patients with multiple system atrophy but may be biased toward the worst cases. Future research needs to recruit more representative samples.

Adult↗
PubMed1997

Other causes of parkinsonism.

This chapter deals with the 'other causes of parkinsonism with the exclusion of idiopathic Parkinson's disease, multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration. It is a cursory glance over the endless list of 'secondary' causes of parkinsonism or parkinsonism due to acquired and inherited metabolic and neurodegenerative diseases. With the exception of drug-induced parkinsonism and 'vascular' parkinsonism, most such cases are rare. However, single rare causes must not be overlooked as there can be specific therapeutic consequences. Parkinsonism is often present amid a constellation of other symptoms. Careful evaluation of the personal, familial and environmental context, mode of onset and progression, clinical features, and drug response, together with imaging, biochemical and molecular tests, help in determining the underlying disease.

Antipsychotic Agents↗
PubMed1996

Olivopontocerebellar pathology in multiple system atrophy.

Olivopontocerebellar atrophy (OPCA) is widely accepted as part of the neuropathological spectrum of multiple system atrophy (MSA). The distribution of affected sites in the olivopontocerebellar (OPC) system and their interrelationship remain poorly understood due to lack of quantitative studies. To further investigate the OPC pathology in MSA, we performed a morphometric analysis of 20 MSA cases and eight healthy controls. In the MSA cases, mean neuronal cell densities were significantly reduced in (medial and dorsal) accessory and principal inferior olives, pontine nuclei, cerebellar vermis (except nodulus), and hemispheres. Inferior olives and pontine nuclei were more severely affected than cerebellar Purkinje cells in most cases. Cerebellar Purkinje cells were more severely depleted in vermis rather than in hemisphere. There was a poor topographic correlation between neuronal cell loss in inferior olives and cerebellar cortex. These results suggest a primary degeneration of olivopontine nuclei and cerebellar Purkinje cells in OPCA. Inferior olives, pontine nuclei and cerebellar cortex were all significantly more severely affected in cases with a pure or predominating cerebellar syndrome (OPCA type, n = 4) compared to those with pure or predominating parkinsonism (SND type, n = 14). However, although cerebellar signs had been noted in life in only six cases, morphometry revealed OPCA in 17 of the 20 MSA brains.

Adult↗
PubMed1996

Effects of central dopaminergic stimulation by apomorphine on swallowing disorders in Parkinson's disease.

Swallowing disorders are common in Parkinson's disease but are of obscure and complex nature and pathophysiology. The effect of central dopaminergic stimulation on disordered swallowing is not well known. We studied the effects of apomorphine (in combination with domperidone) on buccolinguofacial motoricity and on various swallowing stages by using videofluoroscopy in eight patients with dysphagia. Swallowing abnormalities more frequently encountered were vallecular stasis (n = 7), fragmentation of the bolus (n = 7), and buccal stagnation of the bolus. Apomorphine improved vallecular stasis and fragmentation in about half the cases and improved buccal stagnation in all cases. Direct laryngeal penetration was found in three cases and improved in two of them. The total swallowing duration was improved by apomorphine in a subset of patients (n = 5). This improvement correlated with an improvement of the buccolinguofacial motoricity and was combined with an improvement of pharyngeal transit time. Thus central dopaminergic stimulation by apomorphine improved swallowing in a subgroup of patients, mainly in its early stages.

Aged↗
PubMed1996

Pain in multiple system atrophy.

Pain is a recognized feature of idiopathic Parkinson's disease (IPD) but has never been studied in multiple system atrophy (MSA), the commonest cause of atypical parkinsonism. We retrospectively analysed histories of pain in 100 consecutive cases of clinically probable MSA. Details were obtained from the medical records of 100 patients with MSA, comprising 82 with the striatonigral degeneration (SND) type and 18 with the olivopontocerebellar atrophy (OPCA) type of MSA. Pain was reported in 47% of the MSA patients. It was classified as rheumatic in 64% of MSA patients reporting pain, sensory in 28%, dystonic in 21%, and levodopa-related in 16%, mostly related to off-period or diphasic dystonias. There was a mixed pain syndrome in 19% of these patients. Pain was significantly more commonly reported by females (P = 0.02), and by patients with levodopa-induced dyskinesias (P = 0.02). No other clinical feature differentiated MSA patients who reported pain from those who did not. The mean delay between disease onset and onset of pain was 2.9 years, but pain was reported at the time of, or before, disease onset in about 30% of patients. The overall prevalence of pain in MSA was similar to that reported in IPD, but the distribution of pain categories was different.

Adult↗
PubMed1996

Clinical drug monitoring by microdialysis: application to levodopa therapy in Parkinson's disease.

1. We describe the first application of microdialysis to monitor the pharmacokinetics of a drug in the blood of man. 2. The aims of the study were to ascertain patient acceptability and tolerability of a new microdialysis probe and to assess its accuracy in determining the pharmacokinetics of levodopa and its principal plasma metabolite 3-O-methyldopa (3-OMD). 3. Eight patients with parkinsonism on chronic levodopa therapy were investigated. 4. After an overnight fast, a flexible microdialysis probe, perfused with isotonic saline, was inserted into a forearm vein and a blood sampling cannula was inserted in a forearm vein of the other arm. After ingestion of a levodopa preparation (Madopar Dispersible), dialysate was collected over 5 or 10 min periods and blood samples were taken every 15 or 30 min for 2-6 h. 5. Dialysate drug profiles were similar to those of plasma, and levodopa and 3-OMD concentrations exhibited significant (P < 0.001) correlation with those observed in the corresponding plasma samples. 6. The mean (+/- s.d.) blood dialysate concentrations for levodopa and 3-OMD were 36.1 +/- 9.2% and 43.4 +/- 8.4% respectively of the plasma content. 7. The tolerability of the probe was excellent, and all eight patients found it preferable to conventional blood sampling. 8. Microdialysis of blood is less invasive than frequent intermittent direct blood sampling, and can readily be used to continuously monitor levodopa pharmacokinetics. In a clinical setting, a combination of drug monitoring by this technique together with clinical evaluation of motor function can be used to optimize levodopa treatment in patients with Parkinson's disease.

Antiparkinson Agents↗
PubMed1995

Dementia in Parkinson's disease: a population-based study in ambulatory and institutionalized individuals.

We examined the frequency of dementia and depressive symptomatology in 60 Parkinson's disease (PD) patients, identified in a large representative sample of the population, aged 65 years and older, living at home or in institutions in Gironde, France. Dementia, diagnosed according to DSM-III-R criteria, was present in 17.6%, and depressive symptomatology, assessed by the Center for Epidemiologic Studies-Depression Scale, was present in 32.7%. The frequency of dementia in PD increased strongly with age and was higher in institutionalized PD patients than in those living at home. PD was significantly associated with dementia for individuals living at home (odds ratio = 8.2, adjusted for age and symptoms of depression.

Aged↗
PubMed1994

Prenatal ontogeny of D2 dopamine receptor and dopamine transporter gene expression in the rat mesencephalon.

This work demonstrates the early prenatal expression (by gestational day 14) of dopamine D2 receptor and dopamine transporter mRNAs by immature dopaminergic cells of the rat mesencephalon using in situ hybridization. Our results indicate that mRNAs are detectable 3 days before the appearance of functional D2 presynaptic receptors and detectable dopamine release at striatal terminals.

Animals↗
PubMed1994

Differential influence of haloperidol and sulpiride on dopamine receptors and peptide mRNA levels in the rat striatum and pituitary.

We examined the effect of chronic administration (14 days) of haloperidol (2 mg/kg/day) or sulpiride (100 mg/kg/day), on the mRNA levels of various genes in the rat striatum and pituitary by quantitative in situ and Northern blot hybridizations. In the pituitary, haloperidol and sulpiride induced similar increases of mRNAs of pro-opiomelanocortin (POMC) (+65% and +73%), prolactin (PRL) (+821% and +840%) and growth hormone (GH) (+32% and +47%), but sulpiride induced a greater increase of D2R mRNA (+125%) than haloperidol (+92%). In the striatum, sulpiride and haloperidol had different effects: sulpiride induced a higher increase than haloperidol of both preproenkephalin A (PPA) mRNA (+67% versus +47%) and D2 dopamine receptor (D2R) mRNAs (+72% versus +40%). Moreover, haloperidol and sulpiride had opposite effects on substance P (SP) mRNA. Haloperidol decreased the amount of SP mRNA by 20% while sulpiride increased it by 20%. The D1 dopamine receptor (D1R) mRNA level was not significantly modified after either treatment. Our results demonstrate that the effect of a chronic haloperidol treatment on striatal dopamine receptors and neuropeptide mRNA levels is different to that of sulpiride, whereas it is similar on pituitary hormones mRNA levels.

Animals↗
PubMed1994

[Cerebrovascular complications of non-bacterial thrombotic endocarditis: value of transesophageal echocardiography].

Non bacterial thrombotic endocarditis is a frequent cause of cerebrovascular complications in patients with cancer. Clinical features are often misleading and symptoms are hardly linked to valvular thrombosis in the absence of systemic embolism. We describe here a case mainly illustrating two aspects: clinical and neuroradiological manifestations of multiple distal brain infarcts and the value of transoesophageal echocardiography for the diagnosis.

Cerebral Infarction↗
PubMed1994

Prevalence of Parkinson's disease in the elderly: a population study in Gironde, France.

We investigated the prevalence of Parkinson's disease in a representative sample of the elderly population living in the Gironde département, France. Among 3149 people over age 65, the prevalence ratio for Parkinson's disease was 1.4%, without significant difference between men and women. We found that age-specific prevalence ratios increased with age from 0.5% in the age group 65 to 69 to 6.1% in individuals over age 90. This age pattern is consistent with that found in other population-based studies. Interestingly, the slope of age-specific prevalence ratios for Parkinson's disease was similar to that previously reported for Lewy bodies. Our study showed that a high proportion (42%) of Parkinson's disease cases in elderly subjects living in institutions were undiagnosed.

Aged↗