Neurotransmitter - June 1995

Current Clinical Trials

Below you will find a list of several clinical trials now in progress. Please notify the contact person listed in each trial for patient referrals and additional information.

Anti-Oxidant Therapy in ALS: The Neuromuscular Unit is still actively recruiting patients with amyotrophic lateral sclerosis for a one year placebo controlled double-blind clinical trial evaluating the efficacy if anti-oxidant therapy. Contact Person (s): Dr. Didier Cros at 726-3642 or Dr. Merit Cudkowicz at 724-1873.

Trial of Citicoline in Stroke: The Stroke Service is still recruiting patients with acute onset of stroke to participate in a 12 week placebo controlled clinical trial evaluating the efficacy of CDP-choline. Contact Person (s): Dr. Ufuk Can at 726-2241 or 726-2066 (beeper #1214).

Psychosis in Parkinson's Disease: The Movement Disorder Unit is still recruiting patients with levo-dopa induced psychosis to participate in a 12 week placebo compared clinical trial evaluating the efficacy of Risperidone and Clozapine. Contact Person (s): Dr. Merit Cudkowicz at 724- 1873.

Cerestat in Parkinson's Disease: The Movement Disorder Unit is still recruiting patients with Parkinson's Disease to participate in the safety, tolerability, and preliminary efficacy of Cerestat. Contact Person (s): Dr. Leslie Shinobu at 724-1487

Delaviridine Mesylate in the Treatment of AIDS Dementia Complex (ADC) : The HIV Neurology Unit is actively recruiting patients with ADC to participate for a 12 week placebo controlled clinical trial evaluating the efficacy of Delaviridine Mesylate. Contact Person (s): Dr. Brad Navia at 726-2066, Dr. David Margolin at 726-2066( Beeper #1373).

Apolipoprotein E (Apo E) in Intracerebral Hemorrhage: The Stroke Service is actively recruiting patients with any type of intracerebral hemorrhage for determination of apolipoprotein E genotype. Contact Person (s): Dr. Steven Greenberg at 724-1874.

Clinical Experience and Use of Sabril in Patients with Partial Seizures: The Epilepsy Service is actively recruiting patients with seizures not fully controlled with antiepileptic drug therapy or have unacceptable side effects that affect quality of life. Patients must be 18 - 65 years old. Contact Person (s): Dr. Andrew Cole or Kim Oas, RN, NP at 726-3311.

Evaluatation of the Efficacy and Tolerability of ucb LO59: The Epilepsy Service is actively recruiting patients with complex partial seizures occuring a minimum of 12 times in a 12 week period to participate in a 38 week double - blind, placebo- controlled clinical study. Contact Person (s): Dr. Dan Hoch or Kim Oas at 726-3311.

Dose Response Study of the Efficacy and Safety of Vigabatrin (Sabril): The Epilepsy Service is actively recruiting patients with a diagnosis of complex partial seizures occuring at a minimum of 2 times per month. Contact Person (s): Dr. Andrew Cole or Kim Oas, RN, NP at 726-3311.

Paula Eggleston

NMR in the Pathophysiology of Epilepsy

When MRS and fMRI are used simultaneously with EEG, the correlation between brain hemodynamics, metabolism and function can be studied, allowing a non-invasive investigation of the acute and chronic pathophysiology of human epilepsy. This has been an ongoing study for the past 2 years involving Epilepsy/EEG Fellow Rosamund Hill (who returns to New Zealand this June), Bruce Jenkins from the Charlestown NMR Center and Keith Chiappa. Thus far, using gradient echo/echo planar fMRI in patients with photosensitive epilepsy, they have shown that the hemodynamic response in the primary visual cortex to photic stimulation may be greater than normal, and that the patients show a peri-rolandic zone of deactivation not present in the normal subjects. A small increase in lactate and decrease in glucose was seen with spectroscopy. These results were presented at the American Epilepsy Society meeting in New Orleans in December.

In March the team was awarded a 3 year, $60,000 grant from Nintendo, via the Japanese Epilepsy Society, to study video game-induced seizures in a project entitled "Acute and chronic metabolic and hemodynamic changes in photosensitive epilepsy using MR spectroscopy and functional MR".

Anyone who has a patient over 18 with either photosensitive epilepsy or frequent generalized epileptic discharges (at least one every 30 secs) who could participate in the study should contact Keith.

About 1% of all patients having an EEG have a photoparoxysmal response (PPR) and 75% of these have a definite history of epilepsy, but only 5% of all patients with a definite history of epilepsy have a PPR. Most patients with a PPR and focal spikes or sharp waves have partial seizures. In general, a PPR is indicative of abnormal cortical excitability. These patients are being studied because their epileptic discharge can be triggered as necessary in the MR scanner using goggles containing LEDs.

Keith Chiappa

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John Lester (lester@helix.mgh.harvard.edu).