Dementia and behavioral neurology: recent advances

In this review, progress in dementia and behavioral neurology research published in the Journal of Neurology during the past year is summarized

Clozapine Treatment in Oromandibular Dystonia

Oromandibular dystonia (OMD) is a form of focal dystonias, which can be associated with substantial disability and is frequently refractory to all antidystonic therapies. Clozapine is a dibenzodiazepin derivative atypical neuroleptic that has been reported to be effective in the treatment of primary or symptomatic dystonia. We report here two patients with severe OMD refractory to other antidystonic therapies, who had substantial improvement with clozapine. We suggest that clozapine should be considered in patients with OMD who fail to response to other treatments

Psychometric Properties of Turkish Version of Survey of Activities and Fear of Falling in the Elderly Among Patients with Parkinson's Disease

Objective: Fear of falling (FOF) is one of the important risk factors for falling, is higher in patients with Parkinson's disease (PD). The Survey of Activities and Fear of Falling in the Elderly (SAFFE) differs from other scales in terms of considering the accompanying activity limitation. The aim of the study was to show the psychometric properties of the Turkish version of SAFFE (SAFFE-T) in PD, and to correlate SAFFE FOF subscale scores with age, disease duration, and the Turkish version of Movement Disorder Society Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-TR-III) motor score

Therapeutic effects of an acetylcholinesterase inhibitor (Donepezil) on memory in Wernicke-Korsakoff's disease

Wernicke-Korsakoff's disease (WKD) is cognitively an amnestic state resulting from strategic lesions in the limbic system and resulting from thiamine deficiency. Neurochemical deficits have been implicated in the pathophysiology of amnesia based on the pathologic observations that various brainstem and basal forebrain nuclei are also affected. Previous treatment attempts with serotoninergic, noradrenergic, and cholinergic drug, hake given controversial results, The objective of this study was to assess the effects of a cholinesterase inhibitor, donepezil. on memory. attention, and executive C functions in patients with nonalcoholic WKD. Seven patients who developed WKD after a hunger strike were included in this single. blind, placebo-controlled. one-ay, crossover study. The patients were administered donepezil during the first 30 days, and were administered placebo during the 1,following 30 days. Neuropsychological tests to evaluate herbal and visual memory, and attention and executive function were performed on days 0, 3 1, and 6 1, All patients completed both phases of the study. There were no statistically significant differences between the three evaluations, except For a difference between active treatment and the placebo phase during recall of the Rey-Osterrieth complex figure, which as in favor of the placebo phase. There were no significant changes in favor of the active treatment. Cholinergic treatment with the cholinesterase inhibitor donepezil doe,,, not seem to provide marked beneficial effects in patients with WKD in this small. descriptive Study. This may be because pathways mediating channel and state-dependent functions are impaired in this disease, and enhancement of state-dependent cholinergic transmission may not be sufficient, Subtle benefits, however, cannot be excluded because of the small sample size and the relatively short duration of the treatment

An assessment of Movement Disorder Society Task Force diagnostic criteria for mild cognitive impairment in Parkinson's disease

Background and purposeCognitive impairment is one of the most disabling non-motor symptoms of Parkinson's disease. Mild cognitive impairment constitutes a major risk for the development of Parkinson's disease dementia in the course of the disease. A Movement Disorder Society Task Force proposed diagnostic criteria for mild cognitive impairment in Parkinson's disease (PD-MCI), comprising two operational levels: Level I and Level II. The objective of our study was to test the accuracy of Level I versus Level II diagnostic criteria