Motor disorders

In summary, the steadily increasing size of geriatric populations in developed countries and the resultant increases in age-related diseases of the brain have provided the impetus for intensive study of the processes underlying neurodegeneration. A better understanding of these processes will likely lead to better methods of treatment not only for progressive memory disorders such as Alzheimer disease, but also for motor disorders such as amyotrophic lateral sclerosis, and cerebrovascular disorders such as stroke. 

Spasticity A motor disorder characterized by an increase in muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. 

Rat (White) 15 d continuous 26 (mild motor disorders during the first 4 days of exposure, 4.4° decrease in sliding angle) Dalin and Kristoffersson 1974... 

Liiddens, H. and Korpi, E.R. (1996) GABAa receptors pharmacology, behavioral roles, and motor disorders. Neuroscientist 1 15-23. 

Extrapy rami dal motor disorders (particularly with antipsychotics having a pronounced antipsychotic action)... 

Parkinsonism is an extrapyramidal motor disorder, characterized by akinesia, rigidity and tremor with secondary manifestations such as excessive salivation, seborrhoea, mood changes (especially depression) and in certain patients, liver damage has been reported. It was first described by James Parkinson in 1817. 

Huntington s disease is named after a 19th century New York neurologist who studied several families who suffered from a severe, and lethal, motor disorder which appeared to be inherited as an autosomal dominant gene. It was calculated that 50% of the offspring of an affected person have a probability of contracting the disease. The frequency in the general population is 0.01%. 

Paulsen et al. (1994) reviewed the literature and found that TD was generally reported to be associated with cognitive impairment. Krab-bendam et al. (2000) found a particular correlation between orofacial TD and cognitive impairment, especially delayed memory that may be caused by a frontal subcortical disturbance related to orofacial TD. It is apparent that TD is not merely a motor disorder but afflicts a range of cognitive and emotional functions. 

First introduced over 30 years ago, botulinum chemode-nervation has been recommended by strabismofogists as the sole or supportive treatment for diverse ocular motor disorders in both children and adults (Box 33-3). However, there is disagreement among authorities regarding the effectiveness of botulinum, on both short term and long term, and about the specific indications for its use. 

Zidovudine monotherapy was the only available treatment for HIV disease before the 1990s, and was used until 1992. Zidovudine monotherapy has been proven to be efficacious for both the treatment of HAD as well as for HIV-associated minor cognitive/motor disorder (MCMD) (Arendt et al., 1992 Sidtis et al., 1993 Tozzi et al., 1993). Unfortunately, the beneficial effect of zidovudine was transient and an addition of a second NRTI such as dideoxyinosine (ddl), lamivudine (3TC), or dideoxycytidine (ddC), may not further improve psychomotor performance. Stavudine was shown to improve motor performance even after pretreatment with zidovndine (Arendt et al., 2001). A study in 1998, using abacavir versns placebo showed no nenrologic deterioration in the abacavir group as compared with the placebo group (Lanier et al., 2001). However, there was no benefit when abacavir was added to a stable ART, despite good proven CNS penetration. 

A less radical and much less expensive approach to the management of motor fluctuations has been described in 14 patients with advanced Parkinson s disease and levo-dopa-induced motor disorders (69). Amantadine (mean dose 350 mg/day) reduced the severity and duration of dyskinesias by 33-75%, depending on the parameter measured. The rationale was that amantadine blocked iV-methyl-D-aspartate receptors. 

Delta-9-Tetrahydrocannabinol (Delta-9-THC) and, to a small extent, also Delta-8-THC are the biologically active constituents in extracts of the plant Cannabis sativa (marihuana, hashish) and are responsible for the effects on the human central nervous system (CNS). Potential historical and contemporary therapeutic uses of cannahis preparations include, interalia, analgesia, emesis, anorexia, glaucoma and motor disorders. 

Extensive studies on the endocannabinoid system have revealed a number of cannabinergic proteins involved in the inactivation and biosynthesis of endocannabinoids. These include fatty acid amide hydrolase (FAAH) (Di Marzo et al. 1994 Gaetani et al. 2003 Piomelli et al. 1999), monoglyceride lipase (MAG) (Dinh et al. 2002), and the anandamide transporter (ANT) (Beltramo et al. 1997 Di Marzo et al. 1994 Fegley et al. 2004 Hillard et al. 1997). The above three proteins and the two cannabinoid receptors have received considerable attention and show great promise as potential targets for the development of novel medications for various conditions, including pain, immunosuppression, peripheral vascular disease, appetite enhancement or suppression, and motor disorders. 

Potential Therapeutic Applications of Cannabinoids in Motor Disorders. . . 490... 

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