Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A dopamine agonist (apomorphine) and a cholinomimetic drug (physostigmine) were administered to five patients with blepharospasm and oromandibular dystonia (Meige disease). The effects of haloperidol and levodopa were also assessed. Apomorphine lessened and physostigmine aggravated the facial dyskinesias in all patients, while placebo injections had no consistent effect. Levodopa did not modify the symptoms, but haloperidol attentuated the facial dystonia. Dysfunction of the basal ganglia, characterized by a state of striatal dopamine preponderance, probably underlies the dystonic spasms in Meige disease. The prominent cholinergic enhancement of facial dyskinesias may distinguish this disorder pharmacologically from tardive dyskinesia, a differentiation which has practical therapeutic implications.
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PMID:Meige disease: striatal dopaminergic preponderance. 37 89

Studies are reported of the variation of melatonin in serum, plasma urine and cerebrospinal fluid in normal subjects and in patients with various diseases. The diurnal variation of plasma and urine melatonin found in healthy controls on a regular dark-sleep pattern persisted when the subjects slept in light. The effect of sleep deprivation and of rapid light exposure at night is reported. There was a correlation between melatonin in morning urine and plasma at 2 a.m. Four hours of extended darkness in the morning as well as a 9-hour shift of sleep and activity cycles following travel affected the melatonin rhythm. The night increase in plasma melatonin preceeded both the cortisol and prolactin rise. A single oral dose of 4.3 X 10(5) nmol of melatonin given to a 44-year-old healthy male gave a peak plasma value of 624 nmol/l after 30 min. Plasma melatonin was not affected by electroconvulsive therapy, TRH-injection, L-Dopa or bromoergocryptine orally. Patients with alcoholism, migraine, postoperative pinealoma, panhypopituitarism, hereditary dystonia and schizophrenics on propranolol exhibited a decreased amplitude of their diurnal rhythm of melatonin. Two patients with pituitary tumors had occasional high levels of plasma melatonin. The change in melatonin secretion in human is apparently controlled by a mechanism which is at least party influenced by environmental lighting conditions, drugs and different disease states.
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PMID:Melatonin in humans physiological and clinical studies. 38 89

The author examined the catecholamine metabolism in 78 children with polyetiological extrapyramidal lesions of the nervous system. Most of the cases were with the pallidnigral syndrome. A sharp drop in the catecholamine excretion, especially of the dopamine and DOPA were detected in the akinetico-rigid forms. In torsion muscular deformant dystonia there was the most expressed drop in the DOPA excretion. Under the impact of a pathogenetical treatment by L-DOPA in most of the cases there was an improvement of the clinical state and in the indices of the catecholamine metabolism. A study of the catecholamine metabolism permitted to detect certain aspects in the pathogenesis of different forms of extrapyramidal lesions in children.
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PMID:[Catecholamines metabolism in extrapyramidal disorders in children]. 93 Apr 91

The authors describe 14 personal cases of progressive supranuclear palsy, 8 of them including a neuropathological study. The analysis of this material confirms the characteristics of this nosological entity, which is now well individualized amongst the apparently idiopathic degnerative diseases of the CNS. The clinical picture was characterized in all cases by a supranuclear opthalmoplegia, a pseudo-bulbar syndrome, an axial dystonia and a 'subcortical' dementia of a particular type. The average duration of the disease was 4 years for the 12 patients followed until death; the first symptoms appeared at a slightly older age than the average reported in the literature. Males are not predominantly affected in our material. Lesions are remarkably homogeneous as to their localisation in all cases but one. The nuclei of cranial curves are moderately involved, the reticular substances throughout the brain stem is more severely effected. In two cases, senile degenerative lesions of the cerebral cortex are associated with subcortical lesions of the progressive supranulcear palsy. No anamnestic or histologic feature is suggestive of any etiology of this disease. L-Dopa with or within a Dopa-decarboxylase inhibitor did after alter neither the patients condition nor the course of the disease.
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PMID:[Supranuclear progressive paralysis (or oculo-facial-cervical dystonia)]. 115 60

The present report discusses two patients of a same family who have "familial progressive dystonia with diurnal fluctuation" (Segawa). One of them, a severely handicapped nine year-old girl was successfully treated with L-Dopa.
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PMID:[Familial progressive dystonia with diurnal fluctuation. Case report. Remarkable therapeutic effect of 1-dopa (author's transl)]. 116 24

We have demonstrated that injection of manganese into one caudate nucleus in rats results in a predominant ipsilateral turning behavior, accompanied at higher doses by an intermittent, alternating and dose-related incidence of contralateral turning and stereotypies. Although the pharmacological evidence produced (effect of alpha-MT, L-DOPA, pargyline) indicates a definite participation of the dopaminergic system in the latter two phenomena, it is probable that ipsilateral turning is the result of involvement of other transmitter systems as well. Tegmental serotoninergic and intrastriatal cholinergic pathways appear to be involved in the production of the basic postural asymmetry resulting in turning. The amount of interference with the nigrostriatal and mesolimbic dopaminergic pathways may determine the speed of circling, and the concurrent inhibition of locomotion. This is more evident with bilateral injections. Manganese appears to act at presynaptic levels within the striatum by blocking release of the transmitter, thus creating a localized, relative deficit in caudate function. The end result is the release of the dominant "ipsilateral syndrome-inducing system' from its inhibitory control. Repeated or chronic administration of this metal in man or animals is known to result in a brain dopamine and/or serotonin deficit commensurate with the clinical manifestations of bradykinesia and dystonia. Our results are compatible with the anatomical findings of Poirier and collaborators and tend to support the dual ipsilateral and contralateral syndrome-inducing systems in the caudate postulated by Cools, and the complementary roles of dopamine, serotonin and acetylcholine within that nucleus. No one transmitter is involved alone in the experimental production of the manganese syndrome, or of its component symptoms.
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PMID:Behavioral effects in rats following intrastriatal microinjection of manganese. 117 15

Dystonia is a term used to describe a specific set of abnormal movements that can occur as a symptom of a variety of neurologic disorders, but also as a disease entity in its own right. This review focuses on the primary dystonias and delineates the genetic contribution to these disorders. Included is a description of the well recognized forms of primary dystonias which manifest autosomal dominant inheritance, especially the "classic" type of early onset, generalized torsion dystonia, but also other clinically distinct forms such as myoclonic dystonia, paroxysmal dystonia, and DOPA-responsive dystonia. Also, a summary of the molecular genetic studies pertinent to these disorders and a discussion of the implications of recent genetic research for delineating the wide spectrum of this phenotypically and genetically heterogeneous group of diseases are forthcoming.
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PMID:The autosomal dominant dystonias. 134 64

Levodopa-induced dyskinesias (LID) in Parkinson's disease (PD) may be classified into three main categories: "On" dyskinesias, diphasic dyskinesias (DD), and "off" periods. The study of 168 parkinsonian patients showed that about half (n = 84) showed one pattern of LID only. A combination of two was present in 68, and 16 had the three presentation patterns. A fairly good correlation between type of dyskinesia and presentation pattern was established. Chorea, myoclonus, and dystonic movements occurred during the "on" period. Dystonic postures, particularly affecting the feet, were mainly present in the "off" period, but a few patients had a diphasic presentation. Repetitive stereotyped movements of the lower limbs always corresponded to DD. Acute pharmacological tests using dopamine agonists (subcutaneous apomorphine 3-8 mg; intravenous lisuride 0.1-0.15 mg) and dopamine antagonists (intravenous sulpiride 200-400 mg and intravenous chlorpromazine 25 mg) were performed in 40 patients. Dopamine agonists enhanced "on" dyskinesias and markedly reduced or abolished "off" period dystonia and DD. Dopamine antagonists reduced all types of LID but usually aggravated parkinsonism. These clinical and pharmacological results indicate that LID in PD are a heterogeneous phenomenon difficult to explain on the basis of a single pathophysiological mechanism.
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PMID:Levodopa-induced dyskinesias in Parkinson's disease: clinical and pharmacological classification. 135 58

Pramipexole (SND 919; 2-amino-4,5,6,7-tetrahydro-6-propyl-amino-benzthiazole- dihydrochloride) was tested for its agonistic activity at pre- and postsynaptic dopamine (DA) receptors. L-Dihydroxyphenylalanine (L-dopa) accumulation in the rat striatum and limbic system and the alpha-methyltyrosine-induced reduction of DA were inhibited. Both effects were fully antagonized by haloperidol but not by the selective DA D1 receptor antagonist SCH 23390. Pramipexole decreased the levels of DA metabolites dose dependently, whereas striatal DA levels remained unchanged. In mice, pramipexole (0.001-1 mg/kg s.c.) reduced exploratory locomotor activity. In rats with unilateral striatal lesions, only weak ipsilateral rotation was produced by pramipexole at the highest dose. However, in rats with unilateral lesions of the medial forebrain bundle, pramipexole potently induced contralateral circling (ED50 0.026 mg/kg s.c.). In the N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) monkey model, pramipexole also had potent stimulatory effects. Finally, in haloperidol-sensitized monkeys, the substance did not elicit dyskinesia/dystonia when given alone, but rather inhibited those symptoms which had been induced by haloperidol (ED50 0.116 mg/kg i.m.). It is concluded that pramipexole has therapeutic potential for schizophrenic patients, as a result of its autoreceptor agonistic effects and its weak effects at normosensitive postsynaptic DA receptors. Furthermore, its potent stimulatory effects in DA-depleted animals suggest a possible use in the treatment of Parkinson's disease.
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PMID:Biochemical and pharmacological studies on pramipexole, a potent and selective dopamine D2 receptor agonist. 135 88

Transcranial magnetoelectrical stimulation (TMS) is now widely used as a diagnostic tool in adults. In this study we report our experiences with this technique in children with central motor disturbances. We used a Cadwell MES10 magnetoelectrical stimulator with a maximal magnetic field of 2 tesla. The stimulation procedure followed a standardized protocol, with the patients being as relaxed as possible in order to avoid contamination of parameters with different preinnervational levels. Stimulation data were compared to a data base obtained in 58 normal children. The first group of patients consisted of 20 children aged from 7 months to 16 years with hemiparesis of different etiologies. Neuroimaging data were correlated with the results of magnetoelectrical stimulation. In 13 patients a pathological pattern of TMS could be detected, and in 7 of these a corresponding lesion of the cortico-spinal tract was found in CT or MRI scans. In 7 children TMS was normal, in spite of a clear-cut lesion of the cortico-spinal tract in CT or MRI scans in 4 of them. The second group of patients consisted of 16 children with extrapyramidal disease, mostly of hereditary origin, such as DOPA-responsive dystonia or benign hereditary chorea. TMS showed a normal response pattern in this group. We discuss problems and possible pitfalls in TMS in childhood in evaluating the diagnostic value of TMS. At the moment the diagnostic usefulness of TMS in children with motor disturbances appears limited and calls for careful interpretation.
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PMID:Magnetoelectrical stimulation of motor cortex in children with motor disturbances. 137 70


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