Parkinson Disease: Harat M

Zabek M, Sławek J, Harat M, Koszewski W, Opala G, Friedman A. · Oddział Neurochirurgii Czynnościowej i Chorób Układu Pozapiramidowego, Klinika Neurochirurgii, Akademia Medyczna, ul Debinki 7, 80-211 Gdańsk. · Neurol Neurochir Pol. · Pubmed #16463215 links to  free full text

Abstract: The authors present the current views on the use of electrical stimulation in selected movement disorders (Parkinson's disease, dystonia) and pain syndromes (central and neuropathic pain) refractory to pharmacological therapy. Stimulation should be applied in cases with an established diagnosis (especially Parkinson's disease and dystonia) and with a lack of efficacy despite the best available medical therapy. Therefore it should be the last treatment option, except of generalized dystonia, where it seems to be nowadays the treatment of choice. Suggested selection criteria are based on experience of different centers and on current medical literature. They are published to make the procedure more rational and more available in Poland.

Olzak M, Laskowska I, Jelonek J, Michalak M, Szolna A, Gryz J, Harat M, Gorzelanczyk EJ. · Department of Neurosurgery, Military Hospital, Powstancow Warszawy 5, 85-681 Bydgoszcz, Poland. · J Neurol Sci. · Pubmed #16824546 No free full text.

Abstract: The goal of the study was to explore the immediate effects of unilateral posteroventral stereotactic pallidotomy (PVP) on psychomotor and executive functioning in patients with Parkinson's disease (PD). The original drawing task, conducted on a digitizing tablet, and neuropsychological tests were administered to 25 patients with PD, 2 or 3 days before and after the surgery. To assess executive functions, the following tests were used: Trail Making Test (TMT), Stroop Colour Interference Test and Wisconsin Card Sorting Test (WCST). To evaluate global mental functioning, Mini Mental State Examination (MMSE) was applied. Benton Visual Retention Test (BVRT) was introduced as a control non-executive task. The patients undergoing a surgery were compared with age and education matched healthy and PD controls. PVP resulted in an increased movability of the upper contralateral limbs reflected in larger average pressure put during the drawing task after the surgery. Assessment of the emotional state showed a significant postoperative improvement. An isolated significant decline of WCST performance, not related to the side of the lesion, was observed immediately after the surgery. The performance of the other executive and non-executive tasks remained unchanged. The results showed that unilateral PVP may lead to immediate selective executive impairment and is needed to be explored in further studies.

Kaźmierczak H, Gospodarek T, Harat M, Pawlak-Osińska K, Gospodarek G. · Katedra i Klinika Otolaryngologii Collegium Medicum im L Rydygiera w Bydgoszczy Uniwersytetu Mikołaja Kopernika w Toruniu. · Otolaryngol Pol. · Pubmed #16821536 No free full text.

Abstract: In the study oculomotor abnormalities were investigated in 35 patients with idiopathic Parkinson's disease. Vestibular-oculomotor reflexes, pursuit eye movement, saccades and optokinetic nystagmus were evaluated using videonystagmographic registration. Saccadis, smooth pursuit and optokinetic reflexes were significantly disturbed in the majority of cases. Pathological results of caloric and rotatory tests were observed rarely. In the patients after stereotactic thalamotomy--14 cases, there were no changes in visual-oculomotor reflexes pathology. The results show that visual reflexes are often disturbed in Parkinson's disease and suggest the possibility that subcortical neurons, not thalamus are engaged in reflex eye movements.

Friedman A, Harat M, Opala G, Sławek J, Zabek M. · Klinika Neurochirurgii-Oddział Neurochirurgii Czynnościowej i Chorób Układu Pozapiramidowego Akademia Medyczna w Gdańsku ul. Debinki 7, 80-211 Gdańsk. · Neurol Neurochir Pol. · Pubmed #15098326 No free full text.

Abstract: Renewed interest (also in Poland) in the neurosurgical treatment of Parkinson's Disease is the main cause of referring patients to stereotactic surgery. It is the result of our improved understanding of functional anatomy of basal ganglia and development of neurophysiological, neuroimaging and neurosurgical techniques. Various surgical options and possible targets offer different functional benefits, but due to almost 10 years experience we are aware of limited results and possible complications as well. There is a need of minimal standard of patient's evaluation before selection to surgery. The selection criteria include: good diagnosis of Parkinson's Disease, at least 5 years from the onset of symptoms, good responsiveness to L-dopa or apomorphine, exclusion of severe depression and dementia, neuroimaging (MRI) before surgery and optimal (but ineffective) pharmacological therapy before surgery.