A single-blind, crossover study was carried out to compare the efficacy and safety of pergolide against that of bromocriptine in 57 patients with Parkinson's disease who showed a declining response to levodopa therapy. Patients were randomly assigned to receive either bromocriptine followed by pergolide, or pergolide followed by bromocriptine. Both drugs were administered for 12 weeks. Patients were assessed by a clinician blinded to treatment assignment using the New York University Parkinson's Disease Scale. The average daily dose of pergolide was 2.3 +/- 0.8 mg and of bromocriptine 24.2 +/- 8.4 mg. Addition of pergolide or bromocriptine resulted in a significant improvement in total scores when compared with the previous treatment of levodopa alone (pergolide, p = 0.0001; bromocriptine, p = 0.0005). Pergolide was more effective than bromocriptine in daily living scores (p = 0.02) and motor scores (p = 0.038). No differences in the incidence of dyskinesias, dystonias, or psychosis were observed between groups. Fewer adverse events were recorded in the pergolide group, and most patients and physicians preferred pergolide to bromocriptine. Pergolide as adjunctive therapy to levodopa was more effective than bromocriptine in this short-term trial.

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SUMMARY -In patients with cervical spondylotic myelopathy MRI sometimes shows increased signal intensity zones on the T -weighted images. I t has been suggested that these findings carry prognostic significance. W e studied 56 subjects with cervical spinal cord compression. Twelve patients showed an increased signal intensity (21.4%) and a prevalence of narrowing of the AP-diameter (62% vs 24%). Furthemore, in this group, there was evidence of a longer mean duration of the symptoms and, in most of t h e patients, of more serious clinical conditions. The importance of these predisposing factors remains, however, to be clarified since they are also present in some patients without the increased signal intensity.KEY WORDS: magnetic resonance imaging, cervical spondylotic myelopathy.Ressonância magnética na compressão da medula cervical.RESUMO -Em pacientes com mielopatia cervical espondilótica a ressonância magnética (RMN) à s vezes mostra algumas zonas com sinal de maior intensidade nas imagens em T > 2 , que teriam significado prognóstico. Examinamos 56 pacientes com compressão da medula cervical. Em 12 havia hiperintensidade (21,4%) e maior incidência de estreitamento do diâmetro ântero-posterior (62% contra 24%). Ainda, neste grupo se verificava duração média maior da sintomatologia e, na maior parte dos pacientes, sinais clínicos mais graves. Todavia, a importância desses fatores deve ainda ser esclarecida, pois estão presentes também em alguns pacientes que não apresentam a hiperintensidade. PALAVRAS-CHAVE: ressonância magnética, mielopatia cervical espondilótica. The value of magnetic resonance imaging (MRI) in the prognosis of outcome from surgery of subjects with cervical spondylotic myelopathy has been suggested by several authorsThe MRI shows increased signal intensity zones on the T 2 -weighted images in these patients. The aim of the present study is to verify the incidence and clinical correlations of these findings and also a possible pathogenesis. MATERIALS AND METHODSAll the patients examined were suffering from symptoms and signs of cervical myelopathy. In all of them there w a s neuroradiological evidence of cervical spinal cord compression. We studied fifty-six inpatients by MRI with a 0.5-Tesla superconducting magnet (Philips gyroscan). T spin echo images with TRY 460 and TEA 30 and ^-w e i g h t e d images with TR1200 and T E from 50 to 200 m s were obtained. The high signal intensity on ^-w e i g h t e d images in cervical spinal cord was observed in twelve subjects (21.4%). Patients without full clinical data were excluded. Among the eleven cases left with altered signal we selected eight patients (group 1). Two of the excluded underwent decompressive surgery and the third had a cervical trauma. The control group, without altered signal, was made u p of twenty-five Institute of Clinical Neurology, University of Catania. Aceite: 2-março-1993.