ECT and Parkinson's disease revisited: a "naturalistic" study

Article Abstract:

Parkinson's disease is characterized by neurological symptoms including tremor, muscular rigidity, and hypokinesia (abnormally reduced movement). One percent of persons over age 50 have Parkinson's disease, and two-thirds become severely disabled within the first ten years of the illness. Electroconvulsive shock therapy (ECT) may prove to be a promising treatment for Parkinson's disease. Patients with Parkinson's disease and concurrent depression or mania (periods of extreme excitement) first received ECT for their emotional disorder, and their physicians noted a clear improvement in motor abilities as well. The neurophysiology of Parkinson's disease suggested that it would improve with ECT. Seven patients with concurrent major depression and Parkinson's disease, aged 61 to 73, participated in a trial of ECT. All patients were recommended because they had not responded to antidepressant medications. Each subject received approximately seven sessions of ECT in which electrical charges were given to induce brief seizures. Five of the seven patients had significantly improved motor function after two treatments; one subject responded well after more treatments and one subject had only minimal improvement. All the motor abnormalities of Parkinson's disease responded equally to ECT. The duration of symptomatic relief varied from one month to over six months. Two other studies have reported that benefits lasted for brief periods and three to eight years. Patients whose symptoms return more quickly than others should be studied to develop maintenance schedules for ECT. The subjects in this study also experienced improved mood and reduced depression from ECT. Both depressed and nondepressed Parkinson's disease patients may benefit from ECT; further research is needed.

Health aspects, Care and treatment, Case studies, Evaluation, Parkinsonism, Electric shock, Electric shock injuries, Antiparkinsonian agents, Antiparkinson agents

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Olfactory identification deficits in HIV infection

Article Abstract:

Olfactory deficits (impairments in the ability to identify odors) have been noted at the onset of several central nervous system (CNS) disorders, such as Alzheimer's and Parkinson's diseases. Since the human immunodeficiency virus (HIV) infects the CNS in the majority of patients, odor identification was measured in 42 HIV-infected patients and 37 healthy age- and sex-matched controls to ascertain whether impaired olfaction might serve as a marker for early HIV CNS involvement. Ten of the HIV-infected (seropositive) patients had no symptoms of the disease; 24 demonstrated clinical evidence of immunocompromise, while eight had HIV-related dementia. Patients and controls were all given the Smell Identification Test, which is a standardized, 40-item odor identification instrument based on a scratch-and-sniff method. All patient groups scored significantly lower on the odor identification test than controls. Patients with HIV-related dementia had significantly lower test scores than the nonsymptomatic or clinically immunocompromised patients. No differences were found between scores of the nonsymptomatic and immunocompromised patients. Although diminished olfaction can reflect pathology related to nasal mucosa, these study results suggest that impaired odor identification may reflect alterations of the CNS and that olfactory changes may indicate early HIV-related CNS involvement. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, HIV infection, HIV infections, Smell

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