The authors report two cases of catechol-O-methyltransferase (COMT) inhibitor-induced asymptomatic hepatic dysfunction in women with Parkinson disease. The patients were genotyped for the UDP-glucuronosyltransferase (UGT) 1A9 gene (which encodes the main COMT inhibitor- metabolizing enzyme), and found to carry mutations leading to defective glucuronidation activity. This suggests that UGT1A9 poor metabolizer genotype(s) may be a predisposing factor for COMT inhibitor- induced hepatotoxicity.

To assess internal consistency and validity of measures of balance (Berg balance scale, BBS), postural changes (postural changes scale, PCS) and fear of falling (fear of fall measure, FFM) in 70 ambulant Parkinson's disease (PD) persons, these instruments were matched with performance-based balance and mobility tests, and other clinical, functional and quality of life PD-specific measures. The BBS, PCS and FFM showed a good internal consistency, moderate to good inter-correlation, and a significant correlation with measures of both disability (UPDRS-ADL, Schwab and England scale) and--to a lesser extent--impairment/severity of symptoms (UPDRS-ME, Hoehn and Yahr Scale). Tandem Romberg, Single-Limb Stance, Functional Reach, and the Timed Up & Go test correlated slightly better with BBS than with PCS and FFM. This study shows that problems of balance and postural control in PD patients result from complex interactions between motor impairment, functional abilities and fear of falling.

The internal consistency (Cronbach’s alpha and item-totalcorrelation) and construct validity (factor analysis,intercorrelations, and relationship with Hoehn and Yahr stagingand Schwab and England’s ADL scale) of the sections “motorexamination” and “activities of daily living” of the UnifiedParkinson’s Disease Rating Scale (UPDRS) and of the ShortParkinson’s Evaluation Scale (SPES) were analyzed in 59 subjectswith Parkinson’s disease (PD) with various degrees ofdisability. Our results indicate that the SPES is easier andquicker than UPDRS and that it maintains many psychometricproperties similar to those of the UPDRS, but with the reductionof a number of items and ordinal levels of each item studiedhere (producing more homogenous sections than the originalversions). The tremor items would be better represented as aseparate section in both scales.