Abstract:
:In vitro and in vivo studies of striatal dopamine receptor changes have been reviewed in this article. A background of receptor pharmacology methods has been included to assist the reader in assessing the merits of the published studies. Overall the literature is not consistent in the relevant observations in parkinsonian brains. D2 receptors are increased in the striatum of parkinsonian patients who have not been exposed to L-dopa therapy. This has been confirmed by both in vivo and in vitro experiments. This supersensitivity is reversed with L-dopa treatment, but it is unclear as to the time sequence of this reversal and the clinical correlation that this has. D1 receptors have also been shown to be up-regulated in postmortem tissues from nontreated patients. The density seems to be normal compared with controls after treatment is initiated. A single PET study, however, did not find any differences in D1 binding between untreated parkinsonian patients and controls, and we must await further studies before conclusions may be reached. There are a number of new receptor subtypes that were recently identified with molecular biology techniques. Their relevance to Parkinson's disease is currently unknown, and we await reports of potential changes in these sites in this condition. In addition to these new subtypes, there has been tremendous progress in molecular techniques to understand the regulation of receptor protein formation in different brain regions in response to dopaminergic denervation. In the near future, we may encounter reports of changes in receptor regulation that may help us in understanding the changes that occur in Parkinson's disease.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Guttman Msubject
Has Abstractpub_date
1992-05-01 00:00:00pages
377-86issue
2eissn
0733-8619issn
1557-9875journal_volume
10pub_type
杂志文章,评审abstract::Echocardiography is an established technology encompassing an increasingly wide variety of clinical situations including cardioembolism and the detection of CAD in patients with cerebral ischemia and in patients undergoing neurovascular surgery. Echocardiography will continue to occupy a pivotal role in clinical manag...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-05-01 00:00:00
abstract::Infantile spasms are a seizure disorder in young infants with diverse etiologies, suggesting that they arise from any disturbance of central nervous system function during susceptible periods of development. The prognosis for normal intellectual and neurologic development parallels that of the underlying etiology. Ear...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 00:00:00
abstract::In a recent trial limited to arteriovenous malformations discovered not to have bled, medical management was superior to medical management plus intervention. The trial was halted after 226 randomizations and a mean follow-up of 3.3 years owing to a disparity favoring the medical arm. Eligible patients were selected a...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2014.12.006
更新日期:2015-05-01 00:00:00
abstract::The epidemiology of vasculitis has witnessed extraordinary advances in the past decade influenced by the worldwide increased recognition and accurate classification and diagnosis of the vasculitides, and insights brought by genome-wide association studies and other genetic investigations that contribute to the underst...
journal_title:Neurologic clinics
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.ncl.2016.06.006
更新日期:2016-11-01 00:00:00
abstract::The oldest-old represent the fastest growing segment of society, and the risk of developing dementia continues to increase with advancing age into the 9th and 10th decades of life. The most common form of dementia in the oldest-old is Alzheimer disease (AD), although there are often mixed pathologies contributing to d...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2017.01.006
更新日期:2017-05-01 00:00:00
abstract::Many substances, organic and manufactured, may induce peripheral nerve damage when exposed to them. The expected clinical phenotype is of a distal, sensory or sensorimotor polyneuropathy, often painful, with axonal characteristics on electrodiagnostic and histopathologic analysis. Treatment is limited; often, the only...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2004.12.003
更新日期:2005-05-01 00:00:00
abstract::Selecting appropriate laboratory tests in diagnosing peripheral neuropathies is important because it increases the yield of correct diagnoses and is cost effective. A large number of tests are available. This article provides a guide to selecting appropriate tests and reviews the clinical situations that suggest speci...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70246-2
更新日期:1996-02-01 00:00:00
abstract::Parkinson disease (PD) is well recognized by its motor features of bradykinesia, tremor, rigidity, and gait and balance difficulties. However, PD is also characterized by a myriad of nonmotor symptoms, which may occur even before motor symptoms, early in the course of disease, and throughout the advancing disease. The...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2019.12.003
更新日期:2020-05-01 00:00:00
abstract::This article defines the evolving role of the neurologist as a provider of palliative care. As neurologists care for chronically and critically ill, dying patients, and individuals whose diseases are incurable at the time of diagnosis, clinical competence requires expertise in the principles and practice of palliative...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:10.1016/s0733-8619(05)70047-5
更新日期:2001-11-01 00:00:00
abstract::Classifications and definitions are essential to facilitate communication; promote accurate diagnostic criteria; develop, test, and use effective therapies; and specify knowledge gaps. This article describes the development of the International Classification of Vestibular Disorders (ICVD) initiative. It describes its...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2015.04.010
更新日期:2015-08-01 00:00:00
abstract::Neurologists frequently evaluate patients complaining of vision loss, especially when the patient has been examined by an ophthalmologist who has found no ocular disease. A significant proportion of patients presenting to the neurologist with visual complaints have nonorganic or functional visual loss. Although there ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:10.1016/j.ncl.2010.03.012
更新日期:2010-08-01 00:00:00
abstract::As I have indicated in the foregoing discussion, there are several syndromes that with various degrees of proof seem to be caused by unilateral vascular compression of a cranial nerve at the brain stem. Jannetta has summarized this concept as follows: "As we age, our arteries elongate and our brains 'sag'. As a conseq...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1985-05-01 00:00:00
abstract::Cerebellar ataxia can be caused by a variety of disorders, including degenerative processes, autoimmune and paraneoplastic illness as well as by gene mutations inherited in autosomal dominant, autosomal recessive, or X-linked fashions. In this review, we highlight the treatments for cerebellar ataxia in a systematic w...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2020.01.008
更新日期:2020-05-01 00:00:00
abstract::Vasculitis or angiitis refers to a group of inflammatory disorders of the blood vessels that cause structural damage to the affected vessel, including thickening and weakening of the vessel wall, narrowing of its lumen, and, usually, vascular necrosis. Systemic vasculitis is classified according to the vessel size and...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2009.09.015
更新日期:2010-02-01 00:00:00
abstract::SEPs may be recorded over the spine and scalp to stimulation of any accessible mixed or sensory nerve in the extremities. SEP abnormalities are useful in detecting lesions in central somatosensory pathways. They do not establish a specific diagnosis, but they may suggest or support a diagnosis made on clinical grounds...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-11-01 00:00:00
abstract::Dramatic progress has been made recently in diagnosing and treating herpes simplex virus encephalitis (HSVE). Advances in imaging technology have greatly enhanced our ability to diagnose the illness noninvasively. Acyclovir is of proven efficacy and is generally well-tolerated. The major clinical management problem is...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2008.03.005
更新日期:2008-08-01 00:00:00
abstract::The nervous system is involved in approximately 25% of patients with classical Wegener's granulomatosis. The spectrum of this disease has been broadened with the discovery of the anti-neutrophil cytoplasmic antibodies, which are found in diseases sharing many clinical features. The ANCA testing may indicate a common m...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70353-4
更新日期:1997-11-01 00:00:00
abstract::The diagnostic approach to the patient with cancer with suspected CNS infection depends on an analysis of the patient's immune defect, the time course of development of manifestations of infection, and the type of clinical syndrome with supportive evidence for a specific diagnosis coming from laboratory and neuroradio...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(02)00075-0
更新日期:2003-02-01 00:00:00
abstract::Mortality and morbidity from kidney disease and the spectrum of renal-associated neurologic disease have changed markedly since the introduction of renal dialysis and with the advent of renal transplantation. This article includes historical studies of the neurologic complications of acute uremia, now fairly uncommon,...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(03)00052-5
更新日期:2002-02-01 00:00:00
abstract::The adverse effects of fetal drug exposures are well documented. Evidence for FAS, impaired intrauterine growth, birth defects, and mental retardation related to alcohol is compelling; evidence for alcohol-induced adverse behaviors and impaired speech is tenuous. Teratogenic, cognitive, or behavioral effects associate...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-08-01 00:00:00
abstract::The anatomic and physiologic changes that occur during pregnancy are unique. A neurologist needs to be aware of normal pregnancy-induced physiologic changes in the cardiovascular, renal, hematologic, and autoimmune systems, and the local anatomic changes, which include alteration of body habitus and pelvic ligaments. ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2016.04.009
更新日期:2016-08-01 00:00:00
abstract::The presence of a monoclonal protein in the serum of a patient with peripheral neuropathy raises the suspicion of systemic amyloidosis, POEMS syndrome, macroglobulinemia, multiple myeloma, or lymphoma. If these conditions are excluded, the patient is classified as having a monoclonal gammopathy of undetermined signifi...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Epilepsy affects over one percent of the population, including nearly one million women of childbearing potential. Women with epilepsy represent a particularly challenging group for neurologists and other health care professionals. Affected women are unaware of many of the unique issues they face, including the relati...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70024-4
更新日期:2001-05-01 00:00:00
abstract::"Deep brain stimulation is a safe and effective therapy for the management of a variety of neurologic conditions with Food and Drug Administration or humanitarian exception approval for Parkinson disease, dystonia, tremor, and obsessive-compulsive disorder. Advances in neurophysiology, neuroimaging, and technology hav...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2020.09.004
更新日期:2021-02-01 00:00:00
abstract::Progressive muscular atrophy (PMA) is a rare, sporadic, adult-onset motor neuron disease, clinically characterized by isolated lower motor neuron features; however, clinically evident upper motor neuron signs may emerge in some patients. Subclinical upper motor neuron involvement is identified pathologically, radiolog...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2015.07.005
更新日期:2015-11-01 00:00:00
abstract::Different types of conduction defects, avenues available for functional recovery after demyelination, therapeutic and diagnostic measures, and electrophysiologic testing are covered. ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract::In the current era of escalating globalization with rapid transport, changing climate, and an ever growing human population with associated changes in lifestyle, poverty, and war, the emergence of new neurologic infections is accelerated. Understanding their origins using epidemiologic and molecular tools will contrib...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2008.04.003
更新日期:2008-08-01 00:00:00
abstract::Traditionally, diseases affecting the motor unit had been subdivided based on anatomic criteria into diseases of the anterior horn cell, the peripheral nerve, the neuromuscular junction, and the muscle itself. For therapeutic considerations, however, a more precise cellular and clinicopathologic characterization of th...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-02-01 00:00:00
abstract::What the study of EAE has taught us that has relevance to human demyelinating diseases is discussed. ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract::A large body of medical and ethical opinion holds that it is justifiable to terminate medical treatment for permanently unconscious persons. But opponents of particular decisions to withhold or withdraw treatment may argue that the decisions violate laws against homicide, pose a threat to the lives of other less sever...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00