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Background: The question of whether Parkinson's disease (PD) patients have nocturnal polyuria (NP) has not yet been fully answered. Objectives: To determine whether NP was present in PD patients and if so, what its relevant factors were. Methods: This was a retrospective analysis. We had 36 consecutive referred PD patients: age, 71.5 years (range, 54–83 years); 24 men, 12 women; mean disease duration, 2.5 years (1.0–4.5 years); Hoehn and Yahr motor scale, 3.0 (2.0–3.5); all ambulatory; all on treatment. All the PD patients completed a lower urinary tract symptom (LUTS questionnaire) and a bladder diary, and underwent urodynamics testing. Results: NP was identified in 56% of patients. NP was more common in patients with nocturia (p < 0.05), and in patients with urodynamic detrusor overactivity (p < 0.01). There was no relation between NP and gender, age, PD medications, blood pressure, or comorbid diabetes. Conclusions: A total of 56% of PD patients had NP, which had a close relation with detrusor overactivity (p < 0.01). These findings suggest that in PD, the loss of dopaminergic neurons leads to NP (hypothalamic circuit) and detrusor overactivity (nigrostriatal circuit). [ABSTRACT FROM AUTHOR]

• We demonstrated a significant indirect protective effect of COVID-19 vaccination. • The indirect protective effect of COVID-19 vaccination were attributed to an additive effect together with the direct effect. • These findings emphasize the importance of herd immunity by COVID-19 vaccination for not only unvaccinated but vaccinated individuals. There is little information on relationships between indirect and direct protection by COVID-19 vaccination on close contacts of the vaccinees. Here, we assessed effect modification of direct–indirect action influencing the protective effects of vaccination. Secondary attack rates (SARs) in household contacts (n = 2422) depending on vaccination status of the index cases (n = 1112) with known vaccination history during the delta variant-dominant period (August 2–November 2, 2021) in two public health jurisdictions were calculated using multivariable logistic regression analysis to assess indirect protection by COVID-19 vaccination as adjusted odds ratios (aORs) for SARs. The impact of the time of index case vaccination on indirect-direct protective effects was also assessed. Contacts of index cases receiving 2× COVID-19 vaccinations showed significantly lower SARs than contacts of unvaccinated index cases (aOR:0.48, 95 %CI = 0.32–0.74). Relative to contacts where neither index cases nor contacts themselves were vaccinated (0,0), those with (2,0), (0,2) and (2,2) had lower SARs (0.45, 95 %CI = 0.24–0.82, 0.24, 95 %CI = 0.17-0.032, 0.11, 95 %CI = 0.06–0.20, respectively. No significant interactions on the SARs regarding times of vaccination between index cases and household contacts were observed, indicating additive but not synergistic protection. The indirect protective effects of COVID-19 vaccination were attributed to an additive effect together with the direct effect on onward transmission in the household setting. These findings emphasize the importance of herd immunity by COVID-19 vaccination not only for unvaccinated but also vaccinated individuals. [ABSTRACT FROM AUTHOR]

Autonomic dysfunction has been occasionally described in varicella-zoster virus (VZV) infection, while few systematic reviews are available. We systematically review autonomic dysfunction due to VZV infection. This study followed the PRISMA guideline, and three databases were researched and included cross-sectional studies in full-length publications in the English language using appropriate search keywords. A total of 102 articles were identified initially; finally 45 studies were used for review, comprising pupillomotor dysfunction in 4, sudomotor dysfunction in 2, cardiovascular dysfunction in 2, gastrointestinal dysfunction in 14, and urogenital dysfunction in 23. They can be summarized as (1) VZV infection rarely produces orthostatic hypotension, which involves diffuse sympathetic dysfunction by polyneuropathy. (2) In contrast, VZV infection produces dysfunction of the bladder and the bowel, which involves segmental parasympathetic or sympathetic dysfunction by dorsal root ganglionopathy. Awareness of VZV-related autonomic dysfunction is important, because such patients may first visit a gastroenterology or urology clinic. Close collaboration among neurologists, dermatologists, gastroenterologists, and urologists is important to start early antiviral agents and maximize bowel and bladder care in such patients. [ABSTRACT FROM AUTHOR]

Objectives Dementia with Lewy bodies (DLB) is the second most common degenerative cause of dementia, whereas lower urinary tract (LUT) function in DLB patients has not been fully delineated. We investigated LUT function in DLB by clinical-urodynamic observations. Methods We examined 32 patients with DLB (23 men, 9 women; aged 59-86 [mean, 75.9] years; disease duration, 0.2-17 [3.3] years). All patients underwent an electromyography-cystometry, and 21 patients underwent the sphincter motor unit potential analysis. Results Ninety-one percent of patients had LUT symptoms: nighttime frequency (>8 times), 84%, and urinary incontinence (>1 per week), 50%. Detrusor overactivity was revealed in 87.1%, whereas postvoid residual was minimal. Neurogenic changes were shown in 50%. Conclusion LUT dysfunction is a common feature in DLB, attributable not only to dementia and immobility, but also to central and peripheral types of somato-autonomic dysfunction. © 2014 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

Background: It is known that age‐related brain symptoms (namely gait difficulty and/or dementia/delirium) occur in older individuals under hemodialysis (HD). However, it is not known which types of brain disease underlie such symptoms most. Objective: The aim of this study was to correlate brain symptoms with brain diseases in patients undergoing HD. Methods: This was a retrospective study at a multi‐faculty university hospital in Japan over a 12‐month period. All subjects were hospital inpatients undergoing HD (either started during hospitalization or maintenance therapy), with a diagnosis of brain symptoms resulting in referral to the neurogeriatric team (dementia/delirium support team, DST). Results: (1) More than half our HD patients (n = 133) were ≥ 65 years (mean age, 67 years) and male. (2) 37.6% of them showed brain symptoms and were DST‐referred, among whom 62.4% were > 65 years) (P < 0.05). (3) Of the referred patients, 16% had episodes of fall‐related surgery and 30% had aspiration pneumonia (all older). (4) 23.3% of referred patients needed restraint for the safety of HD (mostly older). (5) Most of the neurological disorders were age‐related brain diseases, for example, most commonly a combination of white matter disease (WMD) and Alzheimer's disease (AD) (85%, overlap counted), followed by alcoholism and dementia with Lewy bodies (DLB). Conclusion: In HD patients, age‐related brain symptoms (needed restraint for HD, or with recent fall and/or aspiration) increased with age. The most common underlying brain disease seemed to be a combination of WMD and AD. [ABSTRACT FROM AUTHOR]

Objective: 'Vascular incontinence' is a part of elderly incontinence due to cerebral white matter change (WMC). We studied the relationship between performance on several cognitive tasks and urodynamic detrusor overactivity (DO) in patients with vascular incontinence. Methods: We recruited 40 patients with lower urinary tract symptoms due to WMC [20 male, 20 female; mean age 77 years (60-89 years)]. Other neurologic, urologic, and systemic causes of LUT dysfunction were excluded. All patients underwent urodynamics tests and two sets of cognitive tasks, i.e., the Mini-Mental State Examination (MMSE) (general cognitive tasks), and the Frontal Assessment Battery (FAB) (frontal lobe tasks). Results: The most common urinary symptom was urinary urgency (27 patients), followed by urinary incontinence (26) and nocturnal urinary frequency (25). The urodynamic testing revealed DO in 22 patients. The cognitive testing revealed that the patients' mean MMSE score was 25.8 (range 15-30), and their mean FAB score was 13.6 (4-18). There was no relationship between DO and the total MMSE or FAB score, but our analysis of the relationship between DO and the six subdomains of the FAB (conceptualization, mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy) revealed a significant relationship between DO and the inhibitory control task ( p < 0.005). Conclusions: The results of the present study showed that performance on an inhibitory control task is decreased in vascular incontinence patients with DO. [ABSTRACT FROM AUTHOR]

Aim of study: While Lewy body diseases (LBDs, comprising Parkinson's disease, dementia with Lewy bodies) and white matter diseases (WMD) coexist pathologically, it is uncertain to what extent each disease and the combination of the two manifests clinically, particularly regarding gait disorders. To answer this question, we performed neuroimaging‐assisted analysis. Methods: This was a retrospective cohort study (215 patients with gait, cognitive, or sleep‐autonomic disorders who were referred to our department within a 2‐year period). The inclusion criteria were apparent gait disorder; age >65 years; WMD observed on MRI; and LBD observed on both DAT and MIBG for clarity. Results: We had 39 patients with LBD; 31 with WMD; and 52 with dual diseases. The types of motor disorder in LBD varied (purely akinetic, akineto‐rigid, and tremor forms), whereas in WMD it was purely akinetic with a wide‐based gait. Those with dual diseases showed a clinical combination of the two. Cognitive disorders of LBD‐only and of dual diseases were more severe than WMD only. Sleep disorder and postural hypotension occurred only in LBD‐only and in dual diseases; constipation was common in LBD and dual groups. However, none of the differences reached statistical significance. Conclusion: Among the patients, 23%‐50% of LBD and those of dual diseases had the purely akinetic form, which might be indistinguishable from WMD. In such cases, additional motor (subtle upper‐half akinesia, abnormal posture) and nonmotor (cognitive‐sleep‐autonomic) signatures may help in diagnosing (comorbid) LBD cases that require treatment. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is the most common degenerative cause of movement disorder, and autonomic dysfunction has been recognized in this disorder. PD patients' lower urinary tract (LUT) function is not established. We investigated LUT function in PD by single-photon emission computerized tomography (SPECT) imaging of the dopamine transporter with 123I-ioflupane and clinical-urodynamic observations. We retrospectively analyzed the cases of 30 patients diagnosed with PD based on published criteria who completed a systematized lower urinary tract symptoms (LUTS) questionnaire and a urodynamics examination irrespective of the presence of LUTS. None of the patients were taking anti-parkinsonian medication during the study. The questionnaire revealed that all 30 patients had LUTS: night-time urinary frequency (in 70%), urinary incontinence (40%), and daytime urinary frequency (80%). A urodynamic study revealed a mean volume at the first sensation at 92.3 ml, bladder capacity at 200.9 ml, and detrusor overactivity in 50%. Sphincter electromyography revealed neurogenic change in 13.6% of those for whom the test was performed. The average SBR showed a significant correlation with bladder capacity (Spearman's correlation coefficient p = 0.0076) and Hoehn Yahr motor stage (Spearman's correlation coefficient p = 0.012). Our findings demonstrate that the striatum is relevant to the higher control of storage in micturition function in PD. [ABSTRACT FROM AUTHOR]

Oxidative stress may accompany the pathological process in transient global amnesia (TGA). We measured the biological antioxidant potential (BAP) in the cerebrospinal fluid (CSF) of TGA patients. We enrolled 13 TGA patients (7 men, 6 women; mean age 65.0 years [48–70 years]) and 24 control subjects (12 men, 12 women; mean age 38.2 years [17–65 years]; age did not correlate with csfBAP in this group). We performed brain MRI in all TGA patients, and CA1 lesions were noted by MRI in 5 subjects. We measured csfBAP, total antioxidant properties, in all TGA patients and controls. csfBAP levels were higher in TGA patients than in controls (p = 0.024, 0.028). csfBAP levels in TGA patients did not differ between MRI-positive and -negative subgroups. Elevated csfBAP levels were observed in TGA patients, suggesting that oxidative stress may have a role in the pathogenesis of TGA. [ABSTRACT FROM AUTHOR]

Objective: Delirium/dementia (collectively called cognitive spectrum disorder [CSD]) is a major issue in hospital wards. However, few reports are available on the incidence of CSD on multi‐faculty wards or on the factors contributing to it. The aim of this study was to address these issues by a neurogeriatric team (neurologists, psychiatrists, specialist nurses, and link nurses from all wards). Patients and Methods: This was a retrospective study with a 12‐month recruiting period, a prospective follow‐up period of 3.0 ± 2.5 weeks, and ≥1×/week visits. We diagnosed acute‐onset delirium by the Confusion Assessment Method and analyzed underlying conditions. We also diagnosed premorbid dementia by neurocognitive examination and neuroimaging following published criteria. Results: Our subjects were 723 CSD from 15 faculties, accounting for 6.5% of admissions, 393 men and 330 women, mean age 81 years. CSD was prevalent in cardiology/cardiac surgery (CAR), orthopedic surgery (OP), and neurology/neurosurgery (N), with dementia alone in ophthalmology and a combination of delirium/dementia in the other faculties. Premorbid dementia were diagnosed with Alzheimer's disease (AD), white matter disease, dementia with Lewy bodies (DLB), or some combination of these. Delirium was accompanied by worsening of gait difficulty. The ratio of brain (N) versus extra‐brain was 105 (14.5%):618 (85.5%). Severe CSD was common in DLB than AD but without statistical significance. Conclusion: Total 6.5% of hospital admissions showed CSD, with CAR, OP, and N being prevalent. The ratio of brain versus extra‐brain was 14.5%:85.5%. Severe CSD was more prevalent in DLB patients than in AD patients, but without statistical significance. [ABSTRACT FROM AUTHOR]

Keywords: Autonomic failure; Alcoholism; Orthostatic hypotension; Urinary retention; Small fiber neuropathy EN Autonomic failure Alcoholism Orthostatic hypotension Urinary retention Small fiber neuropathy 581 584 4 12/02/20 20201201 NES 201201 Dear Editors, Autonomic failure occurs in the context of alcoholism, with manifestations in the cardiovascular system [1], [2], [3], bladder [4], and bowel. The urodynamic test of our patient showed a low-compliance detrusor, detrusor underactivity, and an abnormal sphincter EMG, all suggesting bladder/sphincter neuropathy. Autonomic failure, Alcoholism, Orthostatic hypotension, Urinary retention, Small fiber neuropathy. [Extracted from the article]

Objective: Alzheimer's disease (AD), Lewy body disease (LBD), and white matter disease (WMD) are common in the elderly. Although these diseases are observed together pathologically, the extent to which these diseases occur together clinically is uncertain. To address this question, we analyzed the clinical neuroimaging data of Japanese patients. Patients and Methods: This was a prospective study with a 3.0‐year recruiting period, a prospective follow‐up period of 2.0 ± 1.5 years, and ≥1×/year visits. We recruited 770 referred subjects who had undergone three neuroimaging markers: brain magnetic resonance imaging (MRI), dopamine transporter (DAT) scanning, and metaiodobenzylguanidine (MIBG) myocardial scintigraphy. Results: Among the 770 patients, 731 fulfilled the criteria of some of or all of the three diseases as follows: WMD (n = 46), WMD + AD (n = 110), WMD + LBD (n = 89), WMD + AD +LBD (n = 86), AD (n = 118), LBD (n = 239), and AD + LBD (n = 43). In total, there were patients with WMD (n = 331), AD (n = 357), and LBD (n = 414) (with overlap); dual diseases (n = 242; 33%) and triple diseases (n = 86; 12%). Clinically, pure WMD showed overactive bladder but mild gait/cognitive disorder. Pure AD showed cognitive disorder alone. Pure LBD showed cognitive, gait, and sleep/autonomic disorders. Triple/dual diseases showed combined clinical features, depending on the underlying diseases. However, these differences did not reach statistical significance. Conclusion: Forty‐five percent of the patients who visited dementia/movement disorder/sleep‐autonomic disorder clinics showed either triple or dual diseases. It is important to follow such patients from the viewpoint of disease progression and necessary care. [ABSTRACT FROM AUTHOR]

We report the case of a 52-year-old Japanese man who, while he had no cerebellar ataxia or parkinsonism, was revealed to have silent cerebellar hypoperfusion/mild cerebellar atrophy and sacral autonomic disorder. His sacral autonomic disorder was urinary retention without marked prostate hyperplasia. Urodynamics-sphincter electromyography revealed detrusor hyperactivity with impaired contraction and neurogenic changes of the sphincter motor unit potentials. Although he did not have a motor disorder, these features suggested possible multiple system atrophy-cerebellar (MSA-C) form. The present case report suggests that neuroimaging helps in diagnosing "premotor" MSA-C form in situ. [ABSTRACT FROM AUTHOR]

Background: Hypertrophic pachymeningitis has been recognized in neuromyelitis optica spectrum disorder (NMOSD). However, cranial nerve involvement as a result of pachymeningitis in NMOSD is not well known. Case presentation: A 49‐year‐old woman, during an 8‐year period, suffered from recurrent, multiple cranial nerve palsies; that is, palsy of the right third (4 times) and right sixth (twice) cranial nerves, due most probably to a right cavernous sinus lesion from NMOSD. Sarcoidosis, Sjögren's syndrome or other collagen diseases were negative. Magnetic resonance imaging was negative for the first to fifth episode. Aquaporin‐4 immunoglobulin G was negative at the first episode; and not measured for the subsequent second to fifth episodes. Therefore, first to fifth episodes could be irrelevant to pachymeningitis or NMOSD. In contrast, at the sixth episode, gadolinium‐enhanced T1‐weighted coronal magnetic resonance imaging showed a pachymeningeal lesion adjacent to the right cavernous sinus. Parallel with this, aquaporin‐4 immunoglobulin G became positive. The patient was finally diagnosed with probable NMOSD and started on steroid pulse therapy, and her symptoms soon disappeared completely. After this, 5 mg/day oral prednisolone was started. In the subsequent 2 years, she has had no recurrence of diplopia. Conclusions: This case report will help physicians suspect probable NMOSD in patients having recurrent, multiple cranial neuropathies, and provide them appropriate management and care. [ABSTRACT FROM AUTHOR]

Objectives: Neuroimaging markers for Lewy body diseases (LBDs) include dopamine transporter (DAT) scanning and metaiodobenzylguanidine (MIBG) myocardial scintigraphy. It is unknown which marker is more useful for identifying the three major LBD subtypes: Parkinson's disease (PD), dementia with Lewy bodies (DLB), and the autonomic‐sleep variant. To answer this question, we analyzed clinical‐neuroimaging data of 450 LBD patients. Methods: This study was a prospective cohort study with a recruiting period of 3.0 years, prospective follow‐up period of 2.0 ± 1.8 years, and visits at least once a year. We recruited 745 referred subjects who had undergone both DAT and MIBG tests, and the inclusion criteria accorded with published criteria of PD, DLB, and the autonomic/sleep variant (at least one of PD/DLB's known early features: orthostatic hypotension, constipation, overactive bladder, and REM sleep behavior disorder [RBD]). Results: A total of 450 patients fulfilled the criteria. Among the LBD subtypes, the most common was PD (49.3%), followed by DLB (46.4%) and the autonomic/sleep variant (4.2%). DAT and MIBG tests were almost equally abnormal in PD (98.2%, 79.3%, respectively); however, between the two measures, DAT was more frequently abnormal in DLB (82.3%, 56.9%, respectively) and MIBG in the autonomic/sleep variant (57.9%, 94.7%, respectively). Still, these differences did not reach statistical significance. Conclusion: Between the two neuroimaging tests, the DAT scan tended to parallel brain disease (PD/DLB), while the MIBG test tended to parallel peripheral disease (autonomic/sleep variant). [ABSTRACT FROM AUTHOR]

We report the case of a 46‐year‐old Japanese woman with leukocytoclastic vasculitis (LCV) neuropathy who presented with skin symptoms (skin ulcers and livedo reticularis) and multiple mononeuropathies of the axonal degeneration type. Intravenous methylprednisolone pulse therapy and subsequent oral prednisolone and warfarin gradually ameliorated all her clinical symptoms. Although rare, neuropathy is an important clinical manifestation of LCV. [ABSTRACT FROM AUTHOR]

Objective: The clinical features of white matter lesion (WML) may mimic those of Parkinson's disease (PD) and dementia with Lewy bodies (DLB). However, no data have been available regarding neuromelanin‐sensitive MRI (NM‐MRI) in WML. We present our data of NM‐MRI in WML and PD/DLB. Methods: We performed NM‐MRI in 24 patients with WML (12 male, 12 female; mean age 75.2 years), together with 60 PD patients, 39 DLB patients and 69 age‐matched controls. Results: The difference in the fast spin‐echo T1 values between the substantia nigra pars compacta and tegmentum (SNc − tegmentum) was higher in WML than in patients with PD/DLB (P < 0.05). There was no difference in this value between WML patients and controls. The overall sensitivity and specificity of this value (SNc − tegmentum) in differentiating WML and PD/DLB were 79.2% and 70.7%, respectively. Conclusion: The results of the present study showed that neuromelanin‐sensitive MRI had good sensitivity and specificity in differentiating WML from PD/DLB. [ABSTRACT FROM AUTHOR]

Background: While dual diseases of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are documented pathologically, few studies are available concerning the frequency of dual diseases. Aim: We present our data of the frequency of AD, DLB and dual diseases based on neuroimaging, together with the frequency of Parkinson's disease (PD) without dementia. Methods: This is a prospective cohort study (745 dementia and/or movement disorder referred patients; recruiting period, 3 years; prospectively follow‐up period, 2.0 ± 1.8 years; age 73.0 ± 6.3 years at the first visit; 360 men, 385 women; all underwent MRI scan). Patients met the published criteria at least once during a course of disease. We included both dopaminergic denervation in the striatum and noradrenergic denervation in the heart to the inclusion criteria of DLB and PD. Results: Among them, total 476 patients met the criteria as follows: 232 AD (48.7%), 91 DLB (19.1%), 29 dual diseases (6.1%), and 124 PD (26.1%). Patients with dual diseases were initially diagnosed as AD in 18, PD in 8, DLB in two, and Lewy body disease in one. Conclusion: In the cases presented, 6.1% of patients who visited dementia/movement disorder clinics showed duals diseases. It is therefore important to follow such patients, from the view point of disease progression and necessary care. [ABSTRACT FROM AUTHOR]

Objectives: Neuroimaging markers for Parkinson's disease (PD)/dementia with Lewy bodies (DLB) include dopamine transporter (DAT) scanning and metaiodobenzylguanidine (MIBG) myocardial scintigraphy. It is unknown which marker is useful to identify the premotor phase PD/DLB. We reported four patients who, during a negative DAT scan period, had a positive MIBG result that suggested premotor PD/DLB. Here we report 18 additional patients. Methods: This study was a prospective cohort study. The recruiting period was five years; prospective follow‐up period, 5.5 ± 3.0 years; and a once a year (minimum) follow‐up visit. We recruited 745 referred subjects. The inclusion criteria were having at least one of the following known PD nonmotor features: (1) autonomic: postural hypotension (pure autonomic failure [PAF]), constipation, bladder dysfunction; (2) sleep: REM sleep behavior disorder (RBD); and (3) cognitive: mild cognitive impairment or psychiatric symptoms. Also, the patient had to have undergone both DAT and MIBG tests. Results: Only 18 patients fulfilled these criteria. Their characteristics were: elderly (mean age 75.5 years), with long histories (onset 61.0 years; duration 14.5 years), and predominately male (14 men, four women). The patients' neurologic diagnoses were constipation/RBD in 10, constipation/RBD/PAF in six, and constipation/PAF in two. During the follow‐up period, seven patients developed PD or DLB. An abnormal MIBG result was noted in 94%, and an abnormal DAT result was noted in 56%. Conclusions: MIBG has the potential to be a useful marker during the DAT scan negative period to identify premotor PD/DLB, but further studies are needed. [ABSTRACT FROM AUTHOR]

Dear Editors, Volvulus is a life-threatening event that occurs in 1.0-1.9% of all bowel obstruction cases [[1]]. More recently, a neurogenic cause (i.e., loss of myenteric plexus and ganglion cells) has attracted attention [[2]], and Parkinson's disease (PD)/dementia with Lewy bodies (DLB) is considered to constitute up to 20% of volvulus cases in gastroenterology clinics [[2]]. Considering all of the reported and present patients with PD and volvulus, the recently reported cases were mostly elderly (age > 65 years); the cases were male-dominant (male to female ratio 14:5); the motor duration varies (2-28 years); and almost all of the patients had constipation. [Extracted from the article]

A letter to the editor is presented in response to research on deep brain stimulation and its possible benefits in treating those with Parkinson's Disease.

ABSTRACT Background The objective of this work was to perform an open trial of the effects of nizatidine (NZT), a selective histamine H2-receptor antagonist and a cholinomimetic, on gastroparesis in Parkinson's disease (PD) patients, using objective parameters given by a gastric emptying study using a 13C-sodium acetate expiration breath test. Methods Twenty patients with PD were enrolled in the study. There were 13 men and 7 women; aged 68.0 ± 7.72 years; disease duration 5.50 ± 3.62 years. All patients underwent the breath test and a gastrointestinal questionnaire before and after 3 months of administration of NZT at 300 mg/day. Statistical analysis was performed by Student t test. Results NZT was well tolerated by all patients and none had abdominal pain or other adverse effects. NZT significantly shortened Tmax (13C) (the peak time of the 13C-dose-excess curve) ( P < 0.05). Conclusions Although this is a pilot study, we found a significant shortening of gastric emptying time after administration of NZT in PD patients. © 2013 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which examines the medical case of a 75-year-old female Parkinson's disease (PD) patient who was diagnosed with a stercoral ulcer and colonic perforation, and it mentions how constipation and delayed gastric emptying can impact PD patients.

The authors have developed an experimental fine pitch detector multislice CT scanner with an ultrasmall focal spot x-ray tube and a high-density matrix detector through current CT technology. The latitudinal size of the x-ray tube focal spot was 0.4 mm. The detector dimension was 1824 channels (azimuthal direction)×32 rows (longitudinal direction) at row width of 0.3125 mm, in which a thinner reflected separator surrounds each detector cell coupled with a large active area photodiode. They were mounted on a commercial 64-slice CT scanner gantry while the scan field of view (50 cm) and gantry rotation speed (0.35 s) can be maintained. The experimental CT scanner demonstrated the spatial resolution of 0.21–0.22 mm (23.8–22.7 lp/cm) with the acrylic slit phantom and in-plane 50%-MTF 9.0 lp/cm and 10%-MTF 22.0 lp/cm. In the longitudinal direction, it demonstrated the spatial resolution of 0.24 mm with the high-resolution insert of the CATPHAN phantom and 0.34 mm as the full width at half maximum of the slice sensitivity profile. In low-contrast detectability, 3 mm at 0.3% was visualized at the CTDIvol of 47.2 mGy. Two types of 2.75 mm diameter vessel phantoms with in-stent stenosis at 25%, 50%, and 75% stair steps were scanned, and the reconstructed images can clearly resolve the stenosis at each case. The experimental CT scanner provides high-resolution imaging while maintaining low-contrast detectability, demonstrating the potentiality for clinical applications demanding high spatial resolution, such as imaging of inner ear, lung, and bone, or low-contrast detectability, such as imaging of coronary artery. [ABSTRACT FROM AUTHOR]

To investigate the distribution of antibodies against H5N2 influenza virus in humans living in Ibaraki prefecture, Japan, 266 single serum samples were collected to perform serological tests. Results were compared to investigate the relationship between positive results and several factors. The number of positive serum neutralization antibody titers (≥40) against avian influenza virus A/H5N2 was significantly greater ( P < 0.05) among poultry workers, in comparison to a Japanese healthy population. The geometric mean titers of serum neutralization antibody against A/H5N2 were significantly higher ( P < 0.05) among Ibaraki inhabitants and poultry workers ( P < 0.0001) when compared to a Japanese healthy population. Seropositivity against A/H5N2 virus was significantly ( P < 0.05) associated with age (≥50 years old) in poultry workers. These results suggest that seropositivity against H5N2 virus in Ibaraki specimens is significantly higher than those of a Japanese healthy population and that the surveillance of avian influenza viruses is very important to evaluate the invasion or emergence of new pandemic influenza viruses from species other than humans. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to research on neuroimaging tests that are available to detect brain dopamine depletion in Parkinson's disease.

A letter to the editor is presented in response to research regarding transdermal dopamine agonist ameliorates gastric emptying in Parkinson's disease.