Alzheimer Disease: Korczyn AD

Korczyn AD. · Sieratzki Chair of Neurology, Tel Aviv University, Ramat Avia, Israel. · Alzheimers Dement. · Pubmed #19328450 No free full text.

This publication has no abstract.

Korczyn AD. · No affiliation provided · J Neurol Sci. · Pubmed #15792813 No free full text.

This publication has no abstract.

Korczyn AD. · No affiliation provided · Stroke. · Pubmed #12364715 links to  free full text

This publication has no abstract.

Ariel A, Osimani A, Korczyn AD. · No affiliation provided · Harefuah. · Pubmed #12362484 No free full text.

Abstract: The progressive nature of the dementia of Alzheimer's disease has significant clinical, functional, legal and nursing implications. Traditionally, the grading of severity of the disease is based on evaluation of the patients' independence and competence. However, the term competence has been used in different respects, leading to obscuration and confusion. Moreover, the evaluation of competence is based on different tests and there is no single accepted method for this purpose. In the absence of such a criterion, there is a need for an objective test to evaluate the functional competence of the patient. This will be based on complex behavioral activities and instrumental activities of daily living in real situations, in the natural environment of the patient. The limits of available methods are discussed with practical suggestions for the development of such a test.

Halperin I, Morelli M, Korczyn AD, Youdim MB, Mandel SA. · Tel-Aviv Sourasky Medical Center, Department of Neurology, Memory Clinic, Tel-Aviv 64239, Israel. · Neurotherapeutics. · Pubmed #19110204 No free full text.

Abstract: During the last century, the world population has shown a staggering increase in its proportion of elderly members and thus neurodegenerative diseases like Alzheimer's disease (AD) and Parkinson's disease (PD), respectively, are becoming an increasing burden on society. Among the diverse, significant challenges facing clinicians, is the improvement of diagnostic measures to detect early and subtle symptoms, a phase in which prevention efforts might be expected to have their greatest impact and provide a measure of disease progression that can be evaluated during the course of drug treatment. At present, clinical diagnosis of AD and PD is based on a constellation of symptoms and manifestations, although the disease originated several years earlier. Given the multiple etiological nature of AD and PD, it is reasonable to assume that the initial causative pathobiological processes may differ between the affected individuals. Therefore, the availability of biological markers or biomarkers will help not only early disease diagnosis, but also delineate the pathological mechanisms more definitively and reliably than the traditional cognitive and neurological phenotypes. In the current article, we review the literature on biochemical, genetic, and neuroimaging biomarkers and discuss their predictive value as indicative for disease vulnerability to detect individuals at risk for PD and AD, and to determine the clinical efficacy of novel, disease-modifying (neuroprotective) strategies.

Halperin I, Korczyn AD. · Tel-Aviv Sourasky Medical Center, Neurology Department, Memory Clinic. · Harefuah. · Pubmed #18686817 No free full text.

Abstract: Dementia and depression are common disorders in old age. Dementia typically manifests itself as a neurodegenerative disease that affects cognitive functions such as memory, orientation and speech. Dementia is common in old age and its frequency increases from 1% in 65 year olds up to 50% beyond 90 years. Depression usually appears as an episodic disease which extends in length from a few weeks up to many years. The core symptoms of depression include depressed mood, loss of interests and pleasure and loss of will to live. Cognitive disorders may accompany depression and are considered separate from dementia, and were thus named "pseudo-dementia", presuming that these cognitive disorders will disappear as the depressed mood will remit. Lately it has been documented that depression may precede dementia, particularly in Alzheimer's disease. Although correlation never proves causation we discuss three possibilities, not mutually exclusive: 1) Certain brain changes may manifest first as depression and later as dementia. 2) Depression and dementia have partially overlapping biological causes. 3) Certain biological changes associated with depression may lead to dementia. Dementia and depression show many common biologic features such as white matter changes in the brain, reduction of hippocampus volume, changes in the serotonergic and noradrenalinergic systems and abnormalities in the hypothalamic-pituitary-adrenal axis.

Korczyn AD, Vakhapova V. · The Sieratzki Chair of Neurology, Tel-Aviv University Medical School, Ramat Aviv 69978, Israel. · J Neurol Sci. · Pubmed #17490685 No free full text.

Abstract: Alzheimer's disease (AD) is considered to be the most common dementing disorder. The understanding of this disorder has greatly advanced over the past few years, and new therapeutic options have been developed. Another disorder, vascular dementia (VaD), is a syndrome with multiple etiologies operating through a variety of different mechanisms. The combination of AD and VaD is extremely common, making mixed dementia the most common type of dementia. Risk factors for VaD, which are the common vascular risk factors, are presently known to apply also to AD. Cholinergic deficits occur in both conditions. The identification of several genetic factors that can contribute to vascular damage, as well as possible auto-immune damage to vascular components, are important. It is remarkable that amyloid precursor protein (APP) mutations can cause the typical pathological changes of AD as well as amyloid deposition around blood vessels. These may lead to deficient blood perfusion to the brain, changes of the blood-brain barrier, as well as cerebral hemorrhages. Interestingly, attention to risk factors, such as hypertension, coronary artery disease, hyperlipidemia and smoking could reduce or delay the incidence of dementia, both vascular and AD.

Korczyn AD, Reichmann H. · Sieratzki Chair of Neurology, Tel-Aviv University Medical School, Ramat-Aviv 69978, Tel-Aviv, Israel. · J Neurol Sci. · Pubmed #17034818 No free full text.

Abstract: Advanced Parkinson's disease (PD) is frequently associated with dementia. The pathogenesis of this dementia is complex, related to deficiency of several biogenic amines and cortical Lewy body deposition, as well as co-existent age-related brain changes, both of the Alzheimer type and vascular. However, degeneration of the cholinergic neurons in the nucleus basalis of Meynert may have an important contribution to the cognitive decline. The dementia of PD has a grave effect on the quality of life of the patients and their caregivers, as well as a negative effect on their survival. The treatment of dementia associated with PD with cholinesterase inhibitors produced gratifying (although limited) results. Future studies should define the exact role of these agents in the treatment of the dementia of PD. Another major problem presented by demented PD patients is the occurrence of delusions and hallucinations, which make the life of patients and caregivers miserable. Classical neuroleptics are of course contra-indicated in these patients but recent data increase concern about the safety of novel derivatives, leaving a void in the pharmacological armamentarium available when these manifestations appear.

Halperin I, Korczyn AD. · Sourasky Medical Center, Department of Neurololgy, Memory Clinic, Tel Aviv University. · Harefuah. · Pubmed #16599323 No free full text.

Abstract: Mild cognitive impairment (MCI) is a term describing the individual's cognitive state, ranging from normal aging to dementia. Since the term MCI was only recently introduced, there are still controversies regarding its definition, frequency and characteristics. Despite ambiguity in the clinical definitions, MCI is strongly considered as representing enhanced risk for the development of dementia. Therefore, MCI seems to be an important target phase for clinical intervention aimed at inhibiting deterioration to dementia. Despite the controversies regarding the diagnosis of MCI and its exact definition, great progress has been achieved in identifying brain changes, genetic risk factors and prevention factors associated with MCI.

Korczyn AD. · Sieratzki Chair of Neurology, Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv 69978, Israel. · Expert Opin Investig Drugs. · Pubmed #11060805 No free full text.

Abstract: The treatment of Alzheimer's disease attempts to correct cholinergic deficiency in the brain. In addition to the established, but restricted, efficacy of acetylcholinesterase inhibitors, attempts are being made to develop agents which will stimulate muscarinic receptors directly. This approach is logical and was found efficacious in several animal models of the disease; however none of these agents succeeded in clinical studies. Several reasons might account for this failure, which are discussed, as well as the prospects for the future.

Treves TA, Korczyn AD. · Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. · Dement Geriatr Cogn Disord. · Pubmed #10559567 No free full text.

Abstract: The xanthine derivative denbufylline has been evaluated in the treatment of cognitive dysfunction in 110 patients with vascular or mixed dementia (VD) and 226 patients with dementia of the Alzheimer type (DAT). After a run-in period of 4 weeks, during which all patients received placebo, the patients were randomly allocated to denbufylline 25, 50 or 100 mg or to placebo given twice daily for 16 weeks. By the end of the study (completed by 68% of the patients), but also at enrollment, the scores obtained on the Mini-Mental State Examination (MMSE) were higher among those who had received denbufylline than among those who had received placebo, but the differences were not statistically significant; a dose effect of denbufylline was not observed and there was no significant difference in the mean scores of the digit substitution subtest (DSST) of the Wechsler memory test. The responses of patients with VD were similar to those of patients with DAT. When patients were compared in terms of those who received denbufylline versus those who received placebo, improvement in the MMSE scores was observed in 46% of the patients who received placebo and 67% among those who received denbufylline (p < 0.05). An inverse relationship was found between the improvement that occurred during the run-in period and that observed by the end of the study, had the patients received denbufylline or placebo. No major adverse event was ascribed to denbufylline. In conclusion, denbufylline was not deemed efficacious in the treatment of DAT or VD, although patients who received denbufylline tended to improve in terms of cognitive scores, but the effects were not statistically significant. MMSE scores were found to be higher among patients who received denbufylline when these latter were combined as a single group, regardless of their diagnosis or dosage regimen. A placebo effect was observed in about half the patients who completed the study. Copyrightz1999S.KargerAG, Basel

Khachaturian ZS, Snyder PJ, Doody R, Aisen P, Comer M, Dwyer J, Frank RA, Holzapfel A, Khachaturian AS, Korczyn AD, Roses A, Simpkins JW, Schneider LS, Albert MS, Egge R, Deves A, Ferris S, Greenberg BD, Johnson C, Kukull WA, Poirier J, Schenk D, Thies W, Gauthier S, Gilman S, Bernick C, Cummings JL, Fillit H, Grundman M, Kaye J, Mucke L, Reisberg B, Sano M, Pickeral O, Petersen RC, Mohs RC, Carrillo M, Corey-Bloom JP, Foster NL, Jacobsen S, Lee V, Potter WZ, Sabbagh MN, Salmon D, Trojanowski JQ, Wexler N, Bain LJ. · Lou Ruvo Brain Institute, Las Vegas, NV 89106, USA. · Alzheimers Dement. · Pubmed #19328434 No free full text.

Abstract: This document proposes an array of recommendations for a National Plan of Action to accelerate the discovery and development of therapies to delay or prevent the onset of disabling symptoms of Alzheimer's disease. A number of key scientific and public-policy needs identified in this document will be incorporated by the Alzheimer Study Group into a broader National Alzheimer's Strategic Plan, which will be presented to the 111th Congress and the Obama administration in March 2009. The Alzheimer's Strategic Plan is expected to include additional recommendations for governance, family support, healthcare, and delivery of social services.

Korczyn AD. · Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. · Alzheimers Dement. · Pubmed #18790465 No free full text.

This publication has no abstract.

Korczyn AD. · Sieratzki Chair of Neurology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. · Alzheimers Dement. · Pubmed #18631966 No free full text.

Abstract: The amyloid deposits in the brains of patients with Alzheimer's disease have attracted attention and are now considered not only an essential requirement for pathological diagnosis but also an important clue to the pathogenesis of the disease. This article looks critically at the basis of the "amyloid cascade hypothesis" to conclude that there are many issues that need to be resolved since they are inconsistent with the hypothesis.

Kogan EA, Verchovsky RG, Neufeld MY, Klimovitsky SSh, Treves TA, Korczyn AD. · EEG and Epilepsy Unit, Tel-Aviv University, Tel-Aviv, Israel. · J Neural Transm Suppl. · Pubmed #17982896 No free full text.

Abstract: The development of therapies for Alzheimer's disease (AD) has focused on drugs designed to correct the loss of cholinergic function within the central nervous system. Quantitative EEG (qEEG) changes associated with AD consist of background slowing. One way to study the effects of cholinergic drugs may be through assessment of their qEEG effects. The aim of the current work was to evaluate the effect of long-term treatment with tetrahydroaminoacridine (THA) on qEEG in AD patients.

Suhanov AV, Pilipenko PI, Korczyn AD, Hofman A, Voevoda MI, Shishkin SV, Simonova GI, Nikitin YP, Feigin VL. · Institute of Internal Medicine Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia. · Eur J Neurol. · Pubmed #16930366 No free full text.

Abstract: No reliable data on risk factors of Alzheimer's disease (AD) are available in Russia. We aimed to evaluate the relative importance of various putative environmental and medical risk factors of AD in a Russian population. We conducted a hospital-based case-control study. Two hundred and sixty consecutive AD patients and an equal number of cognitive impairment-free control subjects matched for sex, age, level of education and place of birth selected from nursing homes and other long-term healthcare facilities in the Novosibirsk region for the period from 1998 to 2002 were examined. A conditional logistic regression analysis was employed to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for various putative risk factors. Of the 260 patients with AD, 187 (72%) were females. Patients' age varied from 40 to 89 years (mean +/- SD: 69.2 +/- 7.7 years). The majority of the patients (77%) had secondary education and 12% had university education. Risk factors independently associated with AD were family history of parkinsonism among first-degree relatives (OR = 4.2; 95% CI 1.2-15.1), hypothyroidism (OR = 2.7; 95% CI 1.1-6.7), and history of head trauma with loss of consciousness (OR = 1.7; 95% CI 1.0-2.8). The most important risk factors for AD in the Russian community are family history of parkinsonism, hypothyroidism and a history of head trauma with loss of consciousness. These findings have implications for developing preventive strategies of AD.

Korczyn AD. · The Sieratzki Chair of Neurology, Tel-Aviv University Medical School, Ramat-Aviv 69978, Israel. · J Neurol Sci. · Pubmed #15760612 No free full text.

Abstract: The existence of vascular dementia (VaD) was first identified by Marie, who described the etat lacunaire, and by Binswanger, who identified white matter lesions in the brain subcortical areas. Alois Alzheimer, when defining the disease now bearing his name, did so in a patient with a presenile onset. The majority of demented elderly people were then believed to have cerebral arteriosclerosis underlying their cognitive decline. The role of cortical vascular lesions, while clear to clinicians, was highlighted only later, by the pathological studies of Tomlinson et al. and the clinical demonstrations of Hachinski et al. who have defined multi-infarct dementia. Lately, the emphasis shifted to pathogenic mechanisms for vascular brain disease with the identification of a multitude of processes, such as lipohyalinosis, cardiac dysfunction and genetic causes, to name only a few. Epidemiologic studies have demonstrated the high frequency of vascular lesions in brains of demented individuals, as well as the fact that vascular factors can contribute to Alzheimer's disease (AD). Moreover, many factors, which were identified as contributing to cerebrovascular disease in general and VaD in particular, are frequently suspected as predisposing to AD as well. All these considerations converge to the realization that vascular components are extremely important in the pathogenesis of old-age dementia and that prevention and perhaps treatment of dementia are within reach. These surprising findings highlight the importance of mixed vascular-degenerative dementia as a disorder that has to be properly defined.

Mizrahi EH, Bowirrat A, Jacobsen DW, Korczyn AD, Traore F, Petot GJ, Lerner AJ, Debanne SM, Adunsky A, Dibello PM, Friedland RP. · Department of Geriatric Medicine, Chaim Sheba Medical Center, Affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel Hashomer, Israel. · J Neurol Sci. · Pubmed #15546600 No free full text.

Abstract: High plasma homocysteine (tHcy) is a risk factor for cardiovascular disease and stroke and Alzheimer's disease (AD). An inverse relationship has been reported between tHcy and plasma B12 and folate levels. Seventy-nine AD patients and 156 controls from three Arab villages in northern Israel participated. Plasma tHcy, B12 and folate levels were determined. Data were analyzed using univariate statistical tests and logistical regression with confounders. tHcy was significantly higher in AD patients (20.6+/-8.7 micromol/l) than in controls (16.4+/-6.5 micromol/l) (p=0.03) after correction for year of birth, gender and smoking status. Plasma B12 (322.9+/-136.0/350.5+/-175.3 pmol/l) and plasma folate (4.5+/-3.8/4.9+/-2.6 nmol/l) levels did not differ significantly between AD patients and controls. Subjects in the highest tHcy tertile or in the lowest B12 and folate tertiles did not have greater risk to develop AD. In this population residing in Arab villages in northern Israel, tHcy levels were significantly higher among AD patients than in controls. Plasma B12 and folate levels were lower among cases but were not significant. There was not a significant association between plasma tHcy, B12 and folate levels in controls or AD patients. High levels of tHcy may suggest the need for folate and vitamin B12 supplementation in this population.

Farrer LA, Bowirrat A, Friedland RP, Waraska K, Korczyn AD, Baldwin CT. · Department of Medicine, Genetics Program, Boston University School of Medicine, Boston, MA 02118, USA. · Hum Mol Genet. · Pubmed #12566388 links to  free full text

Abstract: We have observed an unusually high prevalence of dementia of the Alzheimer type (DAT) in Wadi Ara, an inbred Arab community in northern Israel comprising approximately 850 persons over the age of 60 years. Family studies revealed that more than one-third of the DAT cases are members of one hamula (tribal group) within Wadi Ara. To map chromosomal loci contributing to DAT susceptibility, we conducted a 10 cM scan in a series of five cases and five controls selected from this hamula. Markers from 18 chromosomal regions showed significant allelic association with DAT (P<0.05). Locations on chromosomes 2, 9 and 10 remained significant after testing additional affected and non-demented individuals. Significant associations were also observed for markers on chromosome 12 which overlap with a locus implicated in previous genome scans. Analysis of allele frequency distributions for 12 markers spanning 20 cM on chromosome 9 narrowed the possible location of an DAT susceptibility gene to a 13 cM interval between D9S157 and D9S259 (most significant result: P = 2.3 x 10(-7)). Analysis of 14 markers spanning 24 cM on chromosome 12 narrowed the possible location to a 14 cM interval distal to the LRP1 locus (most significant result: P = 1.3 x 10(-6)). Evidence for linkage on chromosome 9 stemmed primarily from excess homozygosity of marker alleles in cases compared with controls, suggesting that the gene at this location behaves in either a recessive or additive fashion. The unique characteristics of this community together with the emergent human genome data should allow for the rapid identification of DAT genes in these candidate regions.

Korczyn AD. · Tel Aviv University Medical School, Ramat Aviv 69978, Israel. · Ann N Y Acad Sci. · Pubmed #12480742 No free full text.

Abstract: The existence of vascular dementia (VaD) was first identified by Marie, who described the etat lacunaire, and by Binswanger, who identified white matter lesions. The role of cortical lesions, while clear to clinicians, was highlighted only later by the pathological studies of Tomlinson and the clinical demonstrations of Hachinski et al., who have defined multi-infarct dementia. Lately, the emphasis shifted to pathogenic mechanisms with the identification of a multitude of processes, including lipohyalinosis, cardiac dysfunction, and genetic causes, to name only a few. Epidemiologic studies have demonstrated the high frequency of VaD, as well as the fact that vascular factors can contribute to Alzheimer's disease (AD). All these considerations converge to the realization that VaD is an extremely important clinical entity and that its prevention and treatment are within reach. In fact, there are more data on how to prevent strokes (and presumably VaD) than AD. Moreover, many factors that were identified as contributing to cerebrovascular disease in general and VaD in particular are frequently suspected as predisposing to AD as well. This surprising finding highlights the importance of mixed vascular-degenerative dementia as a disorder that has to be properly defined and has important implications on prevention and treatment.

Assaf Y, Mayzel-Oreg O, Gigi A, Ben-Bashat D, Mordohovitch M, Verchovsky R, Reider-Groswasser II, Hendler T, Graif M, Cohen Y, Korczyn AD. · Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel. · J Neurol Sci. · Pubmed #12417390 No free full text.

Abstract: High b value diffusion weighted magnetic resonance imaging (high-b DWI) was used to characterize white matter changes in the brain of patients with vascular dementia (VaD). Hyperintense white matter areas detected by T2-weighted magnetic resonance imaging (MRI) represent lesions, also termed leukoaraiosis that are very common in VaD as well as in other types of dementia. Therefore, the role of white matter changes in the cognitive and memory decline that occurs in VaD patients is still under debate. High-b DWI, analyzed using the q-space approach, is a more sensitive MRI method for detection of white matter changes. High-b DWI revealed massive white matter loss in VaD patients that surpassed the boundaries of T2 hyperintensities. This technique, therefore, might serve as a better indication for the extensive nerve fiber loss in the white matter that is caused by vascular disease.

Kogan EA, Korczyn AD, Virchovsky RG, Klimovizky SSh, Treves TA, Neufeld MY. · EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel. · J Neural Transm. · Pubmed #11725819 No free full text.

Abstract: In this pilot study, we examined the long-term treatment effect of donepezil on the quantitative EEG (qEEG) in 12 Alzheimer's disease patients. The qEEGs of the mean absolute and relative amplitudes of betal, alpha, theta and delta activities were obtained at baseline and during donepezil treatment. Comparisons of awake qEEG prior to and during treatment were performed using a 2-way analysis of variance (ANOVA) with repeated measures. In patients with mild dementia (n = 5), the qEEG analysis showed a significant reduction of the mean absolute theta activity (p = 0.05) by donepezil, particularly in frontal and temporo-parietal areas. In patients with moderate/severe dementia (n = 7), a significant decrease in the mean absolute beta 1 activity (p = 0.02), particularly in the frontal and occipital areas may be attributed to disease progression which was not counteracted by the long-term treatment. The differences in qEEG in patients with different stages of dementia under donepezil treatment may be related to different compensatory capacities due to structural and functional brain disturbances.

Bowirrat A, Treves TA, Friedland RP, Korczyn AD. · Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Israel. · Eur J Neurol. · Pubmed #11284991 No free full text.

Abstract: The aim of this study was to estimate the prevalence of dementia of the Alzheimer type (DAT) in an Arab Israeli community. Epidemiological studies of dementia have rarely been reported in Arab populations. The target population, aged 60 years or older, comprised 821 persons (362 males) who, on 1 October 1995, were residents of the rural area of Wadi Ara. These persons were examined for symptoms of dementia (DSM-IV criteria), using a semistructured questionnaire for collection of demographic and medical data. Age, gender, and education-specific prevalence rates were calculated for this population and compared to those obtained in other studies. DAT was diagnosed in 20.5% of this population. Its prevalence increased steeply with age, from 8% among those younger than 70 years to 33% among those aged 70-79 and 51% among those 80 years or older. Illiteracy was very common in this population, and strongly associated with higher prevalence of DAT (27% vs. 4%, P < 0.001). DAT was more prevalent among females than males (25% vs. 15%, P < 0.001). However, illiteracy was also significantly more frequent among women (96% vs. 42%, P < 0.001). After correction for illiteracy, the gender difference lost statistical significance. Few women smoked, but among men, the prevalence of DAT in those who smoked was lower as compared to non-smokers (14% vs. 23%, a non-significant difference). These results were confirmed by logistic regression wherein DAT was included as the dependent variable and age, illiteracy, gender and smoking as independent variables (OR=2.8, 2.8, 1.2 and 0.7, respectively; P < 0.005 for each, except for smoking). Our findings suggest that this population is unique because of extremely high rates of dementia. While the results support a protective effect of schooling against the development of dementia, other factors (e.g. genetic) must be sought to explain this high frequency.

Treves TA, Verchovsky R, Klimovitsky S, Korczyn AD. · Department of Neurology, Sourasky Medical Center, Tel Aviv, Israel. · Alzheimer Dis Assoc Disord. · Pubmed #11186598 No free full text.

Abstract: Sample size calculations are important for planning drug trials and require anticipation of the proportion of potential patients finally recruited. Because most recent drug studies for dementia have similar requirements, it could be helpful to analyze the recruitment rate of recent studies. Records of demented patients candidates for drug trials for treatment of dementia of the Alzheimer type in 1994-1995 were analyzed for recruitment rate and reasons for nonrecruitment. From 279 patients with dementia of the Alzheimer type, only 13% were finally included in drug studies. The main reasons for non-enrollment included (1) cognitive test scores out of range for study inclusion criteria (Mini-Mental State Examination [MMSE] <12 [30%], MMSE >24 [5%]), (2) behavioral disturbances (25%), and (3) concomitant diseases (12%). Consent was refused in 8% of those to whom the experimental drug was offered. This low rate of enrollment, 13% of potential candidates, does not include postrecruitment drop-out cases, nor the availability of nonexperimental therapy for DAT. Further, the high selection may limit the generalizability of the results of such studies.

Bowirrat A, Friedland RP, Chapman J, Korczyn AD. · Department of Neurology, Tel-Aviv University, Ramat-Aviv, Israel. · Neurology. · Pubmed #10980749 No free full text.

This publication has no abstract.