Is Parkinson's disease of early onset a separate disease entity?

Two groups of patients suffering from Parkinson's disease were studied. The first group consisted of 23 patients with an onset age before 40 years; in the second group of 21 patients the onset was after age 50. The clinical findings and the course of the disease were very similar in each group. In spite of a longer disease duration in the patients with early onset of the disease there was no difference in motor impairment; the younger patients did better in mental testing and they were taking less dopaminergic medication. These differences are thought to be due to the age difference rather than to the existence of different disease entities. In the early onset group more familial cases (mostly affecting siblings) were found than in the older ones. The points in favour of there being a hereditary subgroup of early onset Parkinson's disease or of environmental factors causing the disease are reviewed

The L-Dopa Story: Translational Neuroscience Ante Verbum

Since almost 50 years L-Dopa is the gold standard for the treatment of patients with Parkinson’s disease (PD). For the first time, a specific chemical abnormality was found in a specific brain disorder. It has been shown that the striatal dopamine (DA) content is greatly reduced in PD patients. The substitution of DA by its precursor L-dopa greatly enhanced the quality of life of PD patients

Autonomic disturbances and cardiovascular reflexes in idiopathic Parkinson's disease

A total of 22 patients suffering from idiopathic Parkinson's disease and 20 age-matched volunteers were questioned about autonomic disturbances and all underwent four non-invasive tests examining cardiovascular reflexes. Significantly more autonomic disturbances were reported by the patients than by the controls. Resting blood pressure was significantly decreased in patients taking dopamine agonists, whereas it was normal in those patients who only received levodopa and anticholinergics. Resting heart rate and resting beat-to-beat variation were normal in the patients, as were the blood pressure response to standing and the postural heart rate response. No pathological response to the Valsalva manoeuvre could be detected. On the other hand, the heart rate variation evoked by deep breathing as well as the blood pressure response and the heart rate response to sustained isometric exercise were significantly diminished in the patients with idiopathic Parkinson's disease. These findings indicate a central disturbance of cardiovascular reflex control, whereas the corresponding peripheral pathways seem to be normal

A 110-Year History of the Swiss Neurological Society (SNG) through the Biosketches of Its First 42 Presidents

The Swiss Neurological Society (SNG) was founded in 1908. In the 1930s, a pre- and postgraduate neurological curriculum and the recognition of neurology as medical specialty followed. In the 1950–1960s, first independent university departments were created in the country. On the occasion of the 110th anniversary of the SNG, the biosketches of its first 42 presidents (including C. von Monakow, R. Bing, M. Minkowski, H. Krayenbühl and M. Mumenthaler) are presented. The multidisciplinary and international influences that contributed to the development of neurology in Switzerland are discussed in the context of the national and international scientific, medical and political history