Last December my wife died of Multiple Systems Atrophy with Lewys bodies
after having been misdiagnosed Parkinsonian some nine years previously.
We had been married just 18 months and after several months asking I had
to be tough with her GP before he referred her for second opinion, which
confirmed my growing suspicion of misdiagnosis. Her death was
horrendous for us both since I cared for her at home until the end

I'm aware of the difficulties but new specialists confirmed such
misdiagnosis to be quite common. Hence I urge all involved with
Parkinson's Disease to be most careful since the penalty for patients
and their families is high indeed

dixie
----

Robert Karl Stonjek wrote:
>
>
> L-Dopa Medication in Parkinson's Disease Restores Activity in the
> Motor Cortico-Striatal Loop but Does Not Modify the Cognitive Network
>
> Thomas Jubault ^1 ^, ^2 , Laura Monetta ^1 ^, ^2 , Antonio P.
> Strafella ^3 , Anne-Louise Lafontaine ^4 , Oury Monchi ^1 ^, ^2
>
> *1* Unité de Neuroimagerie Fonctionnelle, Institut Universitaire de
> Gériatrie de Montréal, Montreal, Québec, Canada, *
> **2* Department of Radiology, University of Montreal, Montreal,
> Québec, Canada, *
> **3* Toronto Western Hospital/Research Institute & CAMH-PET Imaging
> Centre, University of Toronto, Toronto, Ontario, Canada, *
> **4* Movement Disorders Unit, McGill University Health Centre,
> Toronto, Ontario, Canada
>
>
> Abstract
>
>
> Background
>
> The goal of this study was to evaluate the effects of L-Dopa
> medication in Parkinson's disease (PD) on brain activation during the
> performance of a set-shifting task. Using fMRI, we have previously
> studied the patterns of activity observed in patients with PD after
> overnight removal of dopaminergic medication compared with control
> participants during the performance of different stages of the
> Wisconsin Card Sorting Task (WCST). The results revealed decreased
> cortical activity in the PD group compared to controls in the
> conditions that significantly required striatum, while increased
> cortical activity was observed when striatum was not involved.
> However, the effect of dopaminergic medication in PD patients on those
> patterns of activity has not yet been studied.
>
>
> Methodology/Principal Findings
>
> Here, eleven PD patients at early stage of the disease taking L-Dopa
> medication were recruited and underwent two fMRI sessions while
> performing the WCST: one session while taking their normal dose of
> medication and the other following overnight dopaminergic medication
> withdrawal. We found that L-dopa medication helped restoring a normal
> pattern of activity when matching and not planning was required, by
> increasing cortical activity in the premotor cortex. This effect was
> even stronger in the motor loop, i.e. when the putamen was required
> for controls, when matching following negative feedback. However, the
> medication did not change the pattern of activity in conditions
> relying primarily on a cognitive loop, i.e. when the caudate nucleus
> was required.
>
>
> Conclusions/Significance
>
> These studies provide explanation at the neural level regarding the
> relatively poor effects of L-Dopa on the cognitive deficits observed
> in PD.
>
> Source: PLoS One [Open Access]
> http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006154
> <http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006154>
>
> Posted by
> Robert Karl Stonjek
>
>