Clinical Neuroscience

[NMDA antagonists: possible kinetic and neuroprotective effect with special regard to parkinson's disease]

TAKÁTS Annamária1

MAY 20, 1993

Clinical Neuroscience - 1993;46(05-06)

[The role of excitatory amino acids in the pathomechanism of several neuropsychiatric disorders became known in the last few years. Special attention is paid to glutamate, since this has proved to be an excitotoxin under certain pathological conditions. It acts through the ion-channel of the NMDA receptors via enormous Ca++ ion flow into the cell. NMDA antagonists may be of importance in the treatment of Parkinson's disease, which is characterized by increased glutamate hyperactivity. The clinical use of adamantane derivatives might be suggested because of their possible symptomatic and neuroprotective effect.]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem Neurológiai Klinika

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

[New data in the classification, diagnostic and in the therapy of cerebrovascular diseases]

NAGY Zoltán

[High stroke morbidity and mortality in Hungary have focused to attention on stroke prevention and the organization of adequate therapy. Up till 1990 both cardiovascular and the cerebrovascular mortality had increased. The Precise analysis risk factors' determines the primary and secondary stroke prevention. The most important issues in of prevention are: proper care of hypertension, gradual change of dietary habits of the Hungarian population, and reduction of smoking. The revised stroke classification, published in 1990 suggested the further breakdown of ischemic strokes into embolic, atherothrombotic and lacunar forms. The new categories reflect the pathomechanism, and thus help in planning more successful treatment. The early treatment of embolic stroke with thrombolysis looks promising, thrombolysis in lacunar stroke implies a certain amount of risk. Hemodilution and dehydration therapy in the treatment of different forms of ischemic strokes need to be evaluated differently. Both invasive and non-invasive diagnostic examinations follow a well thought out algorithmic pattern. Since thrombolysis is a possible therapeutic choice, laboratory tests, especially the analysis of hemostatic factors have gained more significance.]

Clinical Neuroscience

[Arteriovenous malformation and occlusive cerebrovascular disease]

BODOSI Mihály, KUNCZ Ádám, DÓCZI Tamás, BARZÓ Pál, VÖRÖS Erika

[Five rare case histories of intracranial occlusive cerebrovascular disease with arteriovenous malformation are presented. In 2 cases the middle cerebral artery and in a further 2 cases the internal carotid artery were occluded (3 ipsilateral frontal and 1 parietal angiomas). In the fifth case a temporal angioma and ipsilateral posterior cerebral artery occlusion was detected. In the first 4 cases extra-intracranial arterial bypass was performed before the excision of the malformation. ]

Clinical Neuroscience

[The role of PCR in the diagnosis of duchenne/becker muscular dystrophy]

FODOR Flóra, MECHLER Ferenc, DIÓSZEGHY Péter, ÁDÁNY Róza

[The majority of Duchenne/Becker muscular dystrophy (DMD/BMD) cases are caused by deletions affecting exons of the dystrophin gene, which results in defective protein synthesis. In order to detect deletions the multiplex PCR method was utilized on the DNA of 15 DMD/BMD patients by amplifying 9 deletion-prone exons as a first step followed by a further 5 exons when necessary. Delection were found in more than 50% of patients by this method which correlates well with that expected from the literature data. This rapid and reliable method is an important diagnostic tool in the precise characterization of muscular dystrophies.]

Clinical Neuroscience

[Fibrinogen as a general risk factor in stroke ]

SZIRMAI Imre, KAMONDI Anita

[Fibrinogen and other laboratory variables of 348 patients with various types of stroke were statistically analysed in the acute, subacute and chronic stage of the disease. Seventy two patients with non-vascular disease served as control. The actual level of plasma fibrinogen in cerebrovascular patients was attributed to the following factors: 1. presence of atherosclerotic plaques in extra and intracranial arteries, 2. the time lag between the onset of stroke and laboratory testing, 3. degre of post stroke mobility of the patients. Initial level of fibrinogen is a predictive value of death both in hemorrhagic and ischemic patients. The highest plasma concentration of fibrinogen was found in the atherothrombotic stroke group, in which was a significant negative correlation between the plasma fibrinogen and high density lipoprotein level. It was concluded that fibrinogen is a risk factor in cerebrovascular diseases.]

Clinical Neuroscience

[Solitary osteochondroma presenting as a neck mass with spinal cord compression and central cervical cord syndrome]

BALÁS István, VARGA Sabján Márta, DÓCZI Tamás

[Osteochondromas are rarely the cause of spinal pathology and neurological dysfunction. A case of cervical osteochondroma with spinal cord compression and central cord syndrome is reported, and the pathological, clinical and radiological features are discussed with a brief review of the literature.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Pharmacotherapy of dementia ]

PÁKÁSKI Magdolna, KÁLMÁN János

[The goal of treatment of dementia-related disorders is to reserve cognitive and functional ability, minimize behavioral and psychological disturbances, and slow disease progression, since currently available therapies can not reverse the pathologic processes. Among them, the most common is Alzheimer’s disease and vascular dementia. The authors review the therapeutic guidelines of these dementia types adapted to Hungarian conditions. Cho­li­nesterase inhibitors represent first-line therapy for patients with mild to moderate Alzheimer’s disease, whereas a glutamate N-metil-D-aspartate antagonist is used in the treatment of moderate to severe Alzheimer’s disease. In milder stages, phar­macotherapy may be supplemented by the use of nootropics. The progression slowing drugs have not only impact on cognitive symptoms but also affect behavioral and psychological symptoms. De­pen­ding on the severity of dementia and the existence of behavioral and psychological symptoms, these medicines may be re­commended as monotherapy or in combination. To further alleviate behavioral and psychological symptoms a variety non-pharmacological methods are known, at present their effectiveness has not been proven. Antipsychotics may be used to reduce agitation and aggression. Taking into account the side effects profile of antipsychotics, tiapride or risperidon ad­mi­nistration can be considered. In the case of their ineffectiveness, haloperidol may be used. ]

Lege Artis Medicinae

[Depression in Parkinson's disease, experiences with PK-MERZ infusion]

TAKÁTS Annamária, BERGHAMMER Rita, THOMKA Magdolna, SZOMBATHELYI Éva

[It is accepted that depression is the most frequent psychopathological finding in Parkinson's disease. Recently has been proved that this depression is mostly of major nature according to DSM-III criteria. It may be due to the altered serotonin metabolism. A possible subgroup of Parkinson's disease has been suggested including the decreased serotonergic activity. So it seemed to be evident that drugs of serotonergic activity – like amantadine - may influence the depression in Parkinson's disease. 27 patients of Parkinson's disease with depression were given PK-Merz infusion. After the infusion treatment over 3 weeks – without changing the previous antiparkinson therapy – 18 of 27 patients improved, and this improvement was mathematically significant in all the depression scores. Amantadine results in inhibition of storage and endogenous release of biogen amines, that of serotonin, too, further the serotonin binding capaticy changes, as well.]

Clinical Neuroscience

[Assessment of the role of multidrug resistance-associated proteins in MPTP neurotoxicity in mice]

PLANGÁR Imola, ZÁDORI Dénes, SZALÁRDY Levente, VÉCSEI László, KLIVÉNYI Péter

[Goals - The available scientific data indicate that the pathomechanism of Parkinson's disease (PD) involves the accumulation of endogenous and exogenous toxic substances. The disruption of the proper functioning of certain transporters in the blood-brain barrier and in the blood-cerebrospinal fluid barrier in PD would accompany to that accumulation. Although there is an emerging role of the dysfunction of multidrug resistance-associated proteins (MRPs), members of ATP-binding cassette (ABC) transporter superfamily, in neurodegenerative disorders, there is only a few available data as regards PD. So the aim of our study was the assessment of the role of certain MRPs (1,2,4 and 5) in neurotoxicity induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Methods - Following the intraperitoneal administration of silymarin (with MRP1, 2, 4 and 5 inhibitory effects), naringenin (with MRP1, 2 and 4 stimulatory effects), sulfinpyrazone (with MRP1, 4 and 5 inhibitory and MRP2 stimulatory effects) and allopurinol (with MRP4 stimulatory effect) in doses of 100 mg/kg, 100 mg/kg, 100 mg/kg and 60 mg/kg, respectively, for one week before and after the administration of MPTP in C57B/6 mice in acute dosing regimen, the striatal concentrations of dopamine, 3,4-dihydroxyphenylacetic acid and homovanillic acid has been measured using high-performance liquid chromatography. Results - Although the results of these experiments showed that neither of these substances exerted significant influence on MPTP-induced striatal depletion of dopamine and its metabolites, naringenin exerted a slight prevention of dopamine decrease, while allopurinol considerably enhanced the MPTP-induced lethality in mice. The explanation of these findings would be that the stimulation of MRP1- and MRP2-mediated transport of glutathione conjugates of toxic substances may have slight beneficial effects, while stimulation of MRP4-mediated efflux of brain urate, which has an important antioxidant potency, may worsen the effects of oxidative stress.]

Lege Artis Medicinae

[P300 wave evoked by visual and acustic stimuli in parkinsonian patients with or without dementia]

MOGYORÓS Ilona, SZOMBATHELYI Éva

[Authors analysed the relationship between cognitive function disturbance observed in patients with Parkinson's disease and clinical features of the disease. Relationship between the latency prolongation of the P 300 wave and the duration of substitution therapy, clinical form and severity of the disease (the Hoehn-Yahr stage) was examined. 75 randomly selected young patients with Parkinson's disease were divided in to two groups: one with and the other without dementia as determined by the Wechsler. Hunt and Mini Mental State tests. The latency of the P 300 wave using visual and acoustic stimuli was determinated. Significant prolongation of the latency of P 300 wave evoked both by visual and acoustic target stimuli was found in parkinsonian patients with dementia. Patients with dementia have longer duration of disease and substitution therapy. The akinetic-rigid form of the disease was more frequent in this group as well. A significant part of younger patients are chacarterised not only with motor but with cognitive function disturbance, too. Determination of the latency of P 300 wave helps to select these patients and to choose the adequat therapy. ]

Clinical Neuroscience

[GLUTAMATERGIC PHENOTYPE OF HYPOTHALAMIC NEUROSECRETORY SYSTEMS: A NOVEL ASPECT OF CENTRAL NEUROENDOCRINE REGULATION]

HRABOVSZKY Erik, LIPOSITS Zsolt

[While three decades ago, the co-existence of classical neurotransmitters and peptide neuromodulators in a single neuronal cell was considered to be rather exceptional, the phenomenon that neurons have a complex transmitter phenotype now appears to be the general rule. Parvicellular and magnocellular neurosecretory systems consist of neuronal cells which are specialized in secreting peptide neurohormones into the blood-stream to regulate hypophyseal functions. This mini-review, dedicated to the memory of Mariann Fodor, summarizes the current knowledge about the classical neurotransmitter content of different hypothalamic neurosecretory systems, with a special focus on the occurrence and putative functions of glutamate in parvicellular and magnocellular neurosecretory cells.]