Neurokinin B, neurotensin, and cannabinoid receptor antagonists and Parkinson disease.

The neuropeptides neurokinin B, neurotensin, and anandamide, the endogenous ligands of NK3, NT1, and CB1 receptors respectively, are known to interact with brain dopaminergic transmission. This study evaluated the effects of these three antagonists of the NK3 (SR 142801), neurotensin (SR 48692), and cannabinoid (SR 141716) receptors on the severity of motor symptoms and levodopa-induced dyskinesias after administration of a single dose of levodopa in 24 patients with Parkinson disease. In this exploratory randomized, double-blind, placebo-controlled study, at the dose used, the drugs tested were well tolerated and could not improve parkinsonian motor disability.

Long-term prognosis of symptomatic lacunar infarcts. A hospital-based study.

BACKGROUND AND PURPOSE: This study concerns the long-term prognosis of lacunar infarcts. METHODS: We report the analysis of our hospital-based series of 178 patients consecutively admitted for a lacunar syndrome due to a lacunar infarct diagnosed with computed tomography and magnetic resonance imaging. Demographic data, medical history, vascular risk factors, and imaging data were recorded for each patient. The follow-up was 35 +/- 22 months. RESULTS: The lacunar syndrome was pure motor hemiparesis in 69 patients (39%), ataxic hemiparesis in 45 patients (25.4%), pure sensory stroke in 15 patients (8.5%), sensorimotor stroke in 14 patients (7.9%), and miscellaneous syndrome in 34 patients (19.2%). The 4-year survival rate was 80 +/- 4% and the 4-year survival rate without recurrent stroke was 85 +/- 3.5%. Using Cox proportional-hazards analysis, the predictors of death were age (P < .02), diabetes mellitus (P < .05), and cigarette smoking (P < .05). We did not find any predictors of recurrence. After 1 year, 74% of the patients had mild or no disability. Using logistic regression analysis, the predictive factors of disability were age more than 70 years (P < .01), diabetes (P < .01), history of stroke or transient ischemic attack (P < .05), and type of lacunar syndrome (P < .01). Imaging data, number of lacunes, and presence of leukoaraiosis were not predictors of outcome. CONCLUSIONS: Our study suggests that with a high survival rate, a low recurrence rate, and a relatively good functional recovery, lacunar infarcts have a relatively favorable prognosis.

[Association of lacunar infarction and intracerebral hematoma]. / Association infarctus lacunaire et hématome intra-cérébral.

Five out of 160 cases of lacunar infarcts were preceded or followed by intracerebral hemorrhage. Four patients were hypertensive. This association raises the question of a common risk factor in lacunar infarct and intracranial hemorrhage. The possibility that these different stroke types may be due to the same arteriolar pathology is discussed.

[Hearing in the elderly and hearing aids]. / L'audition des personnes âgées et l'appareillage auditif.

Statistically progressive deteriorations in the population, due more to pathological impairments than to aging properly speaking, must be distinguished from presbycusis. The onset of auditive impairment varies with genetic factors. In a statistical audiometric study, it is found that the better the hearing of a subject before the impact of presbycusis, the better the chances are of maintaining hearing; the opposite applies in the case of major auditive deterioration. Loss of hearing due to presbycusis affects all frequencies. The elderly patient has a better social value of hearing in the phonetic test than that expected from tonal audiometry, except in the case of disorders of central auditive integration.