Wilfried Kuhn

Leopoldina Hospital, Schweinfurt · Department of Neurology

The role of immune mechanisms in the pathogenesis of Parkinson's disease is still a matter of controversy. Immunological abnormalities have been reported in various brain areas and in peripheral immune parameters. Beside antigen specific findings which might indicate an autoimmune process directed against dopaminergic neurons, non-antigen specific...

Failures in clinical studies that were aimed to prove disease-modifying effects of treatments in Parkinson's disease (PD) raise the question as to whether basic sciences have had an impact in clinical practice. This question implies that despite well-publicized results obtained by intensive genetic and pathogenetic research, e.g. the identification...

Colour discrimination and visual contrast perception were investigated in 18 patients with Huntington's disease (HD) and in 18 age- and sex-matched healthy volunteers using the Farnsworth-Munsell 100 Hue test (FM) and stationary contrast targets. The mean total error score (MTES) and the partial scores for the “red-green” and the “blue-yellow” axes...

Parkinson's disease (PD) is a neurodegenerative movement disorder affecting about 2% of the human population in old age. L-3,4-Dihydroxyphenylalanine (L-DOPA) in combination with a peripheral aromatic amino acid decarboxylase inhibition has been the most frequently prescribed drug for alleviating symptoms of PD, but a potential contribution of L-DO...

Several lines of evidence suggest that endogenous and exogenous toxins may play a major role in the pathogenesis of Parkinson's disease (PD). In vivo aromatic β-carbolines, like harman or norharman, may easily be formed by cyclization of indoleamines with e.g. aldehydes. Because of the structural similarity to MPTP, β-carbolines have been proposed...

Introduction - Several lines of evidence suggest that neuroimmune mechanisms may also be involved in neurodegeneration in Parkinson's disease (PD). The potential role of cytokines such as interleukin 6 (IL-6), in the interaction between neurons and immune system has been emphasized by recent findings. IL-6 induces acute phase protein synthesis, dif...

Levodopa (L-dopa) administered with a dopadecarboxylase inhibitor (DDI) increases homocysteine plasma levels. This may support the onset of atherosclerosis-related disorders and neuropsychiatric complications in patients with Parkinson's disease (PD). This homocysteine elevation is considered as long-term effect of chronic L-dopa/DDI treatment. Lit...

In recent studies disorders of chromatic and achromatic vision in Parkinsonian patients have been demonstrated, which were partially reversible after application of L-dopa. Up to now the origin of visual disorders in Parkinson's disease (PD) and the effect of further anti-Parkinsonian drugs are unclear. In this study, the authors evaluated the effe...

Homocysteine, cysteine, and cysteinyl-glycine are all metabolically interrelated. Levodopa/decarboxylase inhibitor (LD/DCI) administration increases total homocysteine (tHcy) plasma levels. Objectives were to investigate associations between LD/DCI intake, concentrations of tHcy, cysteine, and cysteinyl-glycine in PD patients and healthy controls....

Parkinson’s disease (PD) is characterized by its motor impairment. However, non-motor symptoms such as psychiatric disorders, autonomic disturbances and sleep disorders frequently complicate the course of the disease. In particular, psychiatric disturbances including cognitive impairment, depression and psychosis impact these patients considerably....

Alpha-synuclein (alpha-syn) has been implicated in the pathogenesis of many neurodegenerative disorders, including Parkinson's disease. These disorders are characterized by various neurological and psychiatric symptoms based on progressive neuropathological alterations. Whether the neurodegenerative process might be halted or even reversed is prese...

Major hallmarks in the pathophysiology of Parkinson disease are cellular energy depletion and oxidative stress leading to cellular dysfunction and death. Coenzyme Q(10) (CoQ(10)) is an electron acceptor bridging mitochondrial complexes I and II/III and a potent antioxidant that consistently partially recovers the function of dopaminergic neurons. T...

Arising from: Weiner WJ (2006) Levodopa—toxic or neuroprotective? Nat Clin Pract Neurol 2: 518–519 doi:10.1038/ncpneuro0293

Gegenwärtige medikamentöse Therapien sind in frühen Krankheitsstadien des Morbus Parkinson wirksam. Die Behandlung im fortgeschrittenen Stadium des Morbus Parkinson bleibt jedoch für Arzt und Patient eine Herausforderung. Trotz großem Nutzen der dopaminergen Therapie ist die Langzeitbehandlung bei der Mehrzahl der Patienten sowohl mit motorischen a...

Elevated plasma total homocysteine (tHcy) appeared in levodopa/dopadecarcoxylase inhibitor (DDI) treated patients with Parkinson's disease (PD). One therapeutic approach for tHcy reduction is vitamine supplementation, since folic acid and cobalamine catalyse and enhance metabolism of tHcy to methionine. A further therapeutic alternative is inhibiti...

Available immunomodulatory and conventional steroid treatment regimens provide a limited symptomatic benefit for patients with progressive multiple sclerosis (MS). We performed an open trial on the short-term efficacy of repeated intrathecal application of the sustained release steroid triamcinolone acetonide (TCA) in 27 progressive MS patients. Si...

Epilepsies and psychiatric disorders such as psychoses are known to have reciprocal influence. There are problems in patient compliance and pharmacological interactions between the drugs used for treatment. We report an unusual, self-induced, focal, symptomatic epilepsy in a hitherto unrevealed schizophrenic psychosis. The interdisciplinary treatme...

Epilepsien und psychiatrische Erkrankungen können sich in unterschiedlicher Weise gegenseitig beeinflussen. In der klinischen Praxis ist die Behandlung einer Epilepsie bei einem Patienten mit zusätzlich vorliegender Psychose durch das Auftreten von Wechselwirkungen der eingesetzten Medikamente und Complianceprobleme häufig erschwert. Wir schildern...

Metabolism of levodopa via the enzyme catechol-O-methyltransferase requires S-adenosylmethionine (SAM) as a methyl donor. SAM caused Parkinson disease (PD)-like symptoms in rodents. Therefore, SAM could contribute to a decreased efficacy of levodopa in the long term. SAM levels were significantly reduced in levodopa-treated PD patients, but they sh...

The presynaptic protein alpha-synuclein has been implicated in the pathophysiology of many neurodegenerative disorders, including Parkinson's Disease and dementia with Lewy bodies, collectively referred to as synucleinopathies. To advance the study of the function of alpha-synuclein in these diseases, we have used the tTA-system to generate transge...

Die symptomatische Therapie des Morbus Parkinson wird in Abhängigkeit von Erkrankungsdauer und kumulativer L-Dopa-Dosis zunehmend schwieriger. Spätkomplikationen betreffen einerseits die Motorik in Form von Fluktuationen der Beweglichkeit und Dyskinesien. Zudem kann es zu kognitiven Störungen mit Beeinträchtigung vor allem exekutiver Funktionen und...

Previous studies demonstrated the efficacy of budipine on motor symptoms of treated patients with Parkinson's disease (PD) with rating scales. However rating procedures may be subjective and variable. Therefore additional use of instrumental motor tests are helpful to reflect therapeutic benefits. Objective was to test the efficacy of 20 mg budipin...

Levodopa metabolism via catechol O-methyltransferase increases levels of the neurotoxin homocysteine, which induces an axonal-accentuated degeneration in sensory peripheral nerves in vitro. To demonstrate associations among daily levodopa/dopa decarboxylase inhibitor intake, total homocysteine plasma (tHcy) levels, and electrophysiologic sural nerv...

Significantly increased plasma total homocysteine levels (t-Hcys) appeared in treated Huntington disease (HD) patients compared to controls and untreated HD subjects. Because the protein Huntingtin interacts with the homocysteine metabolism modulating enzyme cystathionine beta-synthase, we hypothesize that homocysteine promotes neurodegeneration in...

Certain mutations (TT homozygous; CT heterozygous; CC wild-type) of the methylenetetrahydrofolate (MTHFR) gene and long-term levodopa application in patients with Parkinson's disease (PD) support onset of hyperhomocysteinemia. Total plasma homocysteine (t-hcys) depends on B6, B12, folic acid, all of which support remyelination from t-hcys to methio...

Mitochondrial dysfunction contributes to the neurodegenerative process in Huntington's disease (HD). Coenzyme Q10 (CoQ10) enhances mitochondrial complex I activity and may therefore provide a therapeutic benefit in HD. We compared serum CoQ10 levels of previously untreated-and treated HD patients with those of healthy controls. CoQ10 did not signif...

According to the excitotoxicity hypothesis, neurotoxicity due to glutamate is regarded as potential factor in the progredient neurodegeneration of Huntington's disease (HD). Memantine, as a glutamate receptor antagonist, should counteract this mechanism. Its effectiveness (up to 30 mg/day) with regard to retardation of progression was thus examined...

Mitochondrial dysfunction contributes to the neurodegenerative process in Huntington's disease (HD). Coenzyme Q(10) (CoQ(10)) enhances mitochondrial complex I activity and may therefore provide a therapeutic benefit in HD. We compared serum CoQ(10) levels of previously untreated - and treated HD patients with those of healthy controls. CoQ(10) did...

The presynaptic protein alpha-synuclein has been implicated in the pathophysiology of many neurodegenerative disorders, including Parkinson's Disease and dementia with Lewy bodies, collectively referred to as synucleinopathies. To advance the study of the function of alpha-synuclein in these diseases, we have used the tTA-system to generate transge...

Features of Parkinson's disease (PD) include oxidative stress, nigral mitochondrial complex I deficiency and visual dysfunction, all of which are also associated with coenzyme Q(10) (CoQ(10)) deficiency. The objective of this monocenter, parallel group, placebo controlled, double-blind trial was to determine the symptomatic response of daily oral a...

We read with interest the recent excellent review by Reynolds on the role of folic acid and the risks and benefits of its supplementation in the nervous system.1 It emphasises the beneficial importance of folate on the numerous methylation processes in combination with S-adenosylmethionine (SAM), which donates its methyl group to prevent hyperhomoc...

Intravenous application of amantadine sulphate induces a rapid improvement of motor symptoms in Parkinson's disease (PD), but there are no trials on the efficacy of this compound on bradykinesia, rigidity and tremor in detail in combination with standardized instrumental measurement of tapping and peg insertion abilities. We treated 31 stable non f...

Recognition of facial expressions of emotion was investigated in people with medicated and unmedicated Parkinson's disease (PD) and matched controls (unmedicated PD, n=16; medicated PD, n=20; controls, n=40). Participants in the medicated group showed some visual impairment (impaired contrast sensitivity) and performed less well on perception of un...

Subjects with high levels of daily stress suffer from an increased risk of coronary heart disease. Increased concentrations of the intercellular adhesion molecule-1 (ICAM-1) contribute to atherosclerosis. Cell adhesion molecules may be activated by psychological stress exposure, depending on their interaction with the interleukin network, sex hormo...

Human cerebrospinal fluid is an ultrafiltrate of plasma that is largely produced by the choroid plexus. It consists of a mixture of anorganic salts, various sugars, lipids and proteins from the surrounding brain tissues. The predominant proteins in cerebrospinal fluid are isoforms of serum albumin, transferrin and immunoglobulins, representing more...

One main metabolizing pathway of levodopa is O-methylation to 3-O-methyldopa (3-OMD) by catechol-O-methyltransferase (COMT). Since COMT requires Mg2+ and S-adenosylmethionine as methyl donor for this transmethylating process, COMT converts S-adenosylmethionine to S-adenosylhomocysteine and subsequent homocysteine. Objective of this study was to dem...

Mutations in the alpha-synuclein gene are responsible for an autosomal-dominantly inherited form of Parkinson's disease (PD) and alpha-synuclein was found to be the major component of Lewy bodies in PD. Because of the high homology to alpha-synuclein and the abundance in neuronal tissues, we investigated the gamma-synuclein gene in PD. We analyzed...

Levodopa is administered with dopa decarboxylase inhibitors (DDI) to prevent its peripheral degradation. This increases conversion of levodopa to 3-O-methyldopa (3-OMD) by catechol-O-methyltransferase (COMT). S-adenosylmethionine (SAM), which is synthesized from adenosintriphosphate and methionine (MET), serves as methyl donor for this O-metabolisa...

The authors identified the second known mutation in the alpha-synuclein(SNCA) gene, an alanine-to-proline exchange in amino acid position 30 (A30P), that cosegregates with the disease in one German family with autosomal dominantly inherited parkinsonism (ADP). The authors studied carriers of the A30P mutation to compare the phenotype of this mutati...

Dysfunction of the blood-cerebrospinal fluid barrier (BCB) has been implicated in the pathogenesis of Parkinson's disease (PD) and other neurodegenerative disorders. Therefore, we assayed serum and cerebrospinal fluid (CSF) from 30 parkinsonian patients and 30 controls for concentrations of albumin and IgG. The CSF/serum ratio for albumin (AQ), IgG...

Inhibition of catechol catechol-O-methyltransferase (COMT) in the brains of subjects treated with L-DOPA (L-3,4-dihydroxylphenylalanine) and an aromatic amino acid decarboxylase (AADC) inhibitor is suggested to cause an increase of L-DOPA, which might lead to oxidative damage through enhanced formation of free radicals. To investigate this hypothes...

2and our unpublished findings (table). It also shows that patients with the TT-genotype of the C677T polymorphism of methylenetetrahydrofolate reductase (MTHFR) have especially high homocysteine levels. These findings have to be related to the metabolism of levodopa and methyl groups and may have importance in the future treatment of PD with levodo...

Various investigators have developed complex quantitative instrumental procedures for objective assessment of parkinsonian motor impairment, since drawbacks of rating scales are interrater variability, subjective impression, and insensitivity to subtle modifications. To determine whether performance of inserting of pegs and tapping (i) correlates w...

Recent association studies investigating polymorphisms in the alpha2-macroglobulin (A2M) gene provided evidence for an involvement of this protease inhibitor in the pathogenesis of Alzheimer's disease (AD). The partially overlapping pathology between AD and Parkinson's disease (PD) led us to investigate the role of A2M in PD. We performed associati...

Recently, an Ile93Met substitution has been identified in the ubiquitin carboxy-terminal hydrolase L1 (UCHL1) gene in a single German PD family with autosomal dominant inheritance. To determine whether mutations in the UCHL1 gene are causative for Parkinson's disease (PD) a detailed mutation analysis was performed in a large sample of German sporad...

Background: Antiparkinsonian comedication and/or altered gastrointestinal motility and absorption influence plasma levels of levodopa. Another putative factor may represent body weight. The objective of our study was to examine the relationship between body weight and levodopa in plasma of parkinsonian patients.Methods: We enrolled 26 individuals i...

The aim of this work is to display the protein composition of the cerebrospinal fluid by two-dimensional (2-D) gel electrophoresis and identify it using different mass spectrometric techniques. This will enable us to present an overview of the proteins in human cerebrospinal fluid. The comparison of 2-D gels will help us to analyze the normal prote...

Several case reports with dystonia and homocysteinuria suggest a putative pathogenetic importance of homocysteine for the development of dystonia. We investigated relations between plasma homocysteine, age, severity and duration of primary idiopathic torsion dystonia. We measured homocysteine levels in blood samples drawn from 24 subjects with dyst...

In the last few years, the genetic contribution to Parkinson's disease has gained major attention and resulted in the identification of four gene loci in autosomal dominant and autosomal recessive Parkinson's disease. Several mutations in two genes have been shown to be responsible for neuronal cell death in Parkinson's disease. One of the gene pro...

Glutathione S-transferases (GSTs) are involved in the detoxification of endogenous or exogenous toxins, which may play a role in the pathogenesis of Parkinson's disease. We genotyped the Glutathione-S-Transferase isoenzymes GSTM1 and GSTT1 by polymerase chain reaction in order to evaluate different gene polymorphisms of these isoenzymes in 149 park...

Immunomodulating factors have been shown to play a role in the pathogenesis of Parkinson's disease (PD) by biochemical methods. In order to investigate functionally important genes of the tumor necrosis factor alpha (TNFalpha) pathway we studied the frequency of DNA polymorphisms in the interleukin 6 (IL6), the TNFalpha, and the TNFalpha receptor 1...

The reduced form of coenzyme Q10 (CoQ10) acts as a lipophilic antioxidant and participates in electron and proton transport of the respiratory chain in the inner mitochondrial membrane. An alteration in CoQ10 redox state may thus reflect a change in membrane electron transport and the effectiveness of defense against toxic reactive oxygen species s...

The effect of apomorphine on visual functions in Parkinson's disease (PD) was evaluated by use of a static contrast sensitivity test (VCTS charts), a colour discrimination test (Farnsworth-Munsell 100 Hue test) and the examination of achromatic and chromatic contour perception. 31 patients (14 male, 17 female; mean age 60.9 +/- 9.2 years) with idio...

Motor fluctuations complicate therapy in Parkinson's disease (PD). The mechanisms responsible for motor fluctuations such as the on-off type, are poorly understood. Differences of activity of various enzymes, such as Catechol-O-Methyltransferase (COMT, E.C.2.1.1.6.) may influence the appearance of motor fluctuations and the quantity of metabolic pr...

No significant increase of the maximum concentration (Cmax) of levodopa after addition of catechol-O-methyltransferase inhibitor tolcapone occurred in previous pharmacokinetic studies predominantly on healthy volunteers. We compared pharmacokinetics of levodopa in plasma before and after addition of tolcapone in 13 treated parkinsonian subjects und...

Visual system dysfunction has been reported in Parkinson's disease (PD). The objective of the present study was to evaluate a putative association of distorted colour vision and delayed initiation and execution of movement in PD. We performed the Farnsworth-Munsell 100-hue test and estimated the total error score in 30 previously untreated parkinso...

The cerebral availability of the peripherally and centrally acting catechol-O-methyltransferase (COMT) inhibitor tolcapone is not known in humans. Therefore, we determined the concentration of tolcapone in cerebrospinal fluid (CSF) of 12 parkinsonian subjects 1-4 h after oral application of 200 mg of the drug. The mean concentration was 56.4+/-35.5...

Studies on reaction time have suggested a selective deficit of slowness in motor readiness and motor programming in Parkinson's disease (PD). Objective of this study was the putative relation between delayed initiation and execution of movement and the striatal dopamine deficiency in PD. We investigated 32 idiopathic, previously untreated parkinson...

Transcranial real time sonography (TCS) was applied to 49 patients with Huntington's disease and 39 control subjects to visualise alterations in the echotexture of the basal ganglia. For comparison T1 weighted, T2 weighted, and fast spin echo MRI was performed in 12 patients with Huntington's disease with and in nine patients without alterations of...

We found increased levels of atherosclerosis-inducing homocysteine in parkinsonian patients with long-term application of levodopa compared with previously untreated parkinsonian patients and controls. We conclude that antiparkinsonian treatment with levodopa promotes occurrence of vascular disease in Parkinson's disease.

Serum neuron-specific enolase (s-NSE) and s-100 protein (s-100) are sensitive markers of various brain diseases. We investigated both of these markers in nine patients within 5 min, 6 h, 12 h, and 48 h after a single tonic-clonic seizure. The mean peak s-NSE level was significantly higher after 5 min (11.97 +/- 8.56 microg/l) and 48 h (10.31 +/- 8....

Various investigators address an augmented synthesis of tetrahydroisoquinolines, such as salsolinol (SAL), or an increased N-methylation of these compounds as putative pathophysiologic mechanisms in Parkinson's disease (PD). Objectives of this study were (1) the evaluation of a putative elevation of enantiomers (R-, S-) of SAL and (2) the investiga...

Parkinson's disease (PD) is one of the most common neurodegenerative disorders affecting about 1% of Western populations older than age 50. The pathological hallmark of PD are Lewy bodies, that is, intracytoplasmic inclusion bodies in affected neurons of the substantia nigra. Recently, alpha-synuclein (alpha-SYN) has been identified as the main com...

Parkinson's disease (PD) is one of the most common neurodegenerative disorders affecting about 1% of Western populations older than age 50. The pathological hallmark of PD are Lewy bodies, that is, intracytoplasmic inclusion bodies in affected neurons of the substantia nigra. Recently, α-synuclein (α-SYN) has been identified as the main component o...

Recently a mutation in the parkin gene has been identified as the cause for an autosomal-recessively inherited form of early onset Parkinson's disease (EOPD). The disease causing minimal deletion has been defined as a homozygous exon 4 loss in the parkin gene among Japanese patients. We investigated 140 sporadic and familial EOPD patients of German...

Hallervorden-Spatz disease (HS) is a rare neurologic disorder characterized by clinical symptoms such as progressive dystonia, mental deterioration, rigidity and retinal degeneration [1–3]. Characteristic neuropathologic findings are deposition of iron-staining pigments in both globi pallidi, substantia nigra, and red nuclei associated with pallida...

Recently a mutation in the parking gene has been identified as the cause for an autosomal-recessively inherited form of early onset Parkinson's disease (EOPD). The disease causing minimal deletion has been defined as a homozygous exon 4 loss in the parkin gene among Japanese patients. We investigated 140 sporadic and familial EOPD patients of Germa...

Electroencephalographic (EEG) generators were investigated in 13 patients suffering from hepatolenticular degeneration with and without neurological symptoms and in 13 healthy subjects for comparison by the use of FFT approximation. Quantitative assessment of motor deficits and psychiatric disturbances was correlated with EEG features. We found mai...

Visual dysfunctions have previously been reported in Parkinson's disease and Huntington's chorea. To further characterize the pathophysiology of vision in basal ganglion diseases, we studied visual functions in focal dystonic syndromes. Colour discrimination and visual contrast perception were investigated in 37 patients with focal idiopathic dysto...

Acetylcholin als zerebraler Neurotransmitter kommt vor allem im Nucleus caudatus, Putamen, Nucleus interpeduncularis, Tuber-culum olfactorium, Nucleus accumbens, Nucleus basalis Meynert, in der Amygdala und in den motorischen Hirnnervenkernen vor. Peripher erscheint Acetylcholin in der glatten Muskulatur im Bereich der motorischen Endplatte, in den...

Die Pharmakokinetik der Antimuskarinergika ist im allgemeinen schlecht belegt, da die meisten Anticholinergika vor etwa 30 Jahren in die Klinik eingeführt wurden und zur damaligen Zeit hauptsächlich die Wirksamkeit dieser Substrate an klinischen Studien belegt wurde. Es kommt weiterhin hinzu, daß eine Reihe von pharmakokinetischen Studien mit radio...

Trotz der hohen Wirksamkeit von L-Dopa als Monotherapeutikum erscheint beim idiopathischen Parkinson-Syndrom unter dem Eindruck der durch das L-Dopa-Langzeitsyndrom bedingten klinischen und therapeutischen Probleme, wie z.B. verstärktes Auftreten von motorischen Fluktuationen, Hyperkinesen und psychotischen Ereignissen nach ca. 5–7 Jahren L-Dopa-Th...

Die erste Generation der COMT-Hemmer, wie z. B. Pyrogallol, Tropolon, Ascorbinsäure, war entweder zu toxisch oder unspezifisch oder nur kurz und zu wenig klinisch wirksam. Die notwendigen Konzentrationen für eine 50% Hemmung der COMT (IC 50) lagen im mikromolaren Bereich oder höher (Männistö et al. 1988, 1992c, Männistö und Kaakkola 1990).

Die Umwandlung der Aminosäure Tyrosin in L-Dopa durch das Enzym Tyrosinhydroxylase ist der geschwindigkeitsbestimmende Schritt der Biosynthese von Dopamin. Ein verminderter Gehalt an Tyrosinhydroxylase als auch eine erniedrigte Konzentration des Co-Enzyms Tetrahydrobiopterin (BH4) ist bei Parkinson-Patienten im nigrostriatalen System aufgrund der D...

Hinsichtlich der klinischen Anwendbarkeit hat Tolcapon bei alleiniger Applikation den Vorteil der dreimaligen Gabe, während Entacapon bzw. Nitecapon mit jeder Levodopa-Dosis kombiniert werden sollte. (Auf Empfehlung der Arzneimittelkommission der Europäischen Union wurde am 17. 11. 1998 wegen des Verdachtes der Lebertoxizität Tolcapon in Europa vom...

Die COMT ist ein im Körper ubiquitär, aber besonders in Leber, Niere und Intestinum vorkommendes Enzym, das neben Levodopa auch Dopamin, Dihydroxyphenylessigsäure (DOPAC) und andere auch exogen zugeführte Katechole peripher metabolisiert (Abb. 4.2.1). Dabei transferiert die COMT die Methylgruppe von S-Adenosyl-Lmethionin an eine der Hydroxylgruppen...

Präparationen des Nachtschattengewächses Atropa belladonna wurden bereits seit 2000 Jahren entweder als Medikament, als Gift oder als Kosmetikum appliziert. In Indien behandelte man hiermit das Asthma bronchiale. In Europa dienten Atropa belladon-na-Tinkturen einerseits als Gift, andererseits wurden Extrakte von Atropa belladonna-Tinkturen zu kosme...

Significantly elevated plasma levels of homocysteine, but not cysteine and cysteinylglycine, were found in treated parkinsonian patients compared to controls. Elevated levels of homocysteine may be either caused by an unknown endogenous metabolic disturbance or by antiparkinsonian treatment, because no association to severity or duration of disease...

Durch Hemmung der Catechol-O-Methyl-transferase (COMT) kann die Bildung von 3-O-Methyldopa verringert und die Bioverfügbarkeit von L-Dopa erhöht werden. Aufgrund experimenteller Daten sowie theoretischer Überlegungen ist insbesondere die Gabe von zentral wirksamen COMT-Hemmern mit potentiellen Risiken im Sinne einer vermehrten Neurotoxizität verbun...

Bromocriptin wirkt stark D2-rezeptoragonistisch und hat eine schwache D1-antagonistischen Komponente. Deshalb soll Bromocriptin seine volle klinische Wirksamkeit nur in Gegenwart von endogenem Dopamin entfalten können. Die Wirksamkeit von Bromocriptin als Monotherapeutikum wurde jedoch in mehreren Studien in den letzten 15 Jahren bei Morbus Parkins...

The long-standing consultant service for neurological patients in a general hospital requires questions to about the dimensions and efficiency of being answered cooperation between a general hospital and a neighbouring neurological clinic with a casualty ward and neuroradiology. From 1987 to 1995, 1471 patients with neurological diagnoses were obse...

Die jahrelange konsiliarische Betreuung von neurologischen Patienten eines Krankenhauses der Grund- und Regelversorgung wirft Fragen nach Umfang und Effizienz dieser Zusammenarbeit zwischen einem Allgemeinkrankenhaus und einer benachbarten neurologischen Klinik mit Ambulanz und Neuroradiologie auf. 1471 Patienten mit neurologischen Diagnosen wurden...

Sensory disturbances such as olfactory or visual dysfunctions are common in Parkinson's disease (PD). A possible relationship between distorted colour discrimination and the nigrostriatal dopamine deficit is still a matter of debate. We examined 31 de novo Parkinsonian patients with [123I]beta-CIT single photon emission tomography (SPECT). We used...

Several lines of evidence suggest that neuroimmune mechanisms may also be involved in neurodegeneration in Parkinson's disease (PD). The potential role of cytokines such as interleukin 6 (IL-6), in the interaction between neurons and immune system has been emphasized by recent findings. IL-6 induces acute phase protein synthesis, differentiation of...

Previous studies demonstrated controversial results regarding monoamine oxidase B (MAO-B) activity in platelets in the periphery in parkinsonian patients (PD). Therefore we determined platelet MAO-B activity in three age- and sex-matched groups of 17 untreated, so called "de novo" patients with Parkinson's disease (PD), 17 parkinsonian patients, re...