Movement Disorders Movement Disorders Edited by NANDKUMAR S. SHAH, Ph.D. t Director, Ensor Foundation Research Laboratory William S. Hall Psychiatric Institute Research Professor, Department of Neuropsychiatry and Behavioral Science University of South Carolina School of Medicine Columbia, South Carolina and ALEXANDER G. DONALD, M.D. Director, William S. Hall Psychiatric Institute Professor and Chairman, Department of Neuropsychiatry and Behavioral Science University of South Carolina School of Medicine Columbia, South Carolina PLENUM MEDICAL BOOK COMPANY New York and London Library of Congress Cataloging in Publication Data Movement disorders. Includes bibliographies and index. 1. Movement disorders. 2. Neuropharmacology. I. Shah, Nandkumar S. II. Donald, Alexander G., 1928- . [DNLM: I. Movement Disorders. WL 390 M9352] RC385.M69 1986 616.7'4 86-4884 ISBN-13: 978-1-4684-5040-8 e-ISBN-13: 978-1-4684-5038-5 DOl: 10.1007/978-1-4684-5038-5 © 1986 Plenum Publishing Corporation Softcover reprint of the hardcover 1s t edition 1986 233 Spring Street, New York, N.Y. 10013 Plenum Medical Book Company is an imprint of Plenum Publishing Corporation All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher In Memoriam Nandkumar S. Shah (1928-1983) Nandkumar S. Shah died on May 23, 1983, at the age of 55. Dr. Shah was Chief of Research Services and Director of the Ensor Research Laboratory at the William S. Hall Psychiatric Institute and Research Professor, Department of Neuropsychiatry and Behavioral Science, at the University of South Carolina School of Medicine. He had completed the majority of the work involved in the publication of this volume at the time of his death. Dr. Shah, a son of the late Shankarbhai and Parvati Shah, was born in Nandurbar, India. He received his B.S. and M.S. in biochemistry from Poona University, India. He completed his Ph.D. in pharmacology at the University of Florida, Gainesville, Florida, in 1965. Dr. Shah was the epitome of a scholar and an excellent teacher. In addition, he was a superb researcher. He made significant contributions to the medical community of Columbia, South Carolina, through his research and teaching. v vi IN MEMORIAM Through his many publications and presentations at national and international symposia, his work became known worldwide. Dr. Shah's professional career began in 1955 at Poona University and at the Gandhi Memorial Hospital, where he conducted studies on lathyrism. He was later selected by the Atomic Energy Commission to continue his research in clinical biochemistry. He came to the United States in 1961 and studied at the College of Medicine at the University of Florida. On completion of his studies, he joined the staff at the Thudichum Psychiatric Research Laboratory in Galesburg, Illinois, working with the late Dr. Harold Himwich. He subse quently became Chief of the Psychopharmacology Radioisotope Laboratory, conducting studies on biogenic amines and hallucinogens: uptake, distribution, metabolism, and excretions under various conditions. From 1970 to the time of his death, Dr. Shah directed research programs including projects in psychopharmacology, biochemical mechanisms, neuro chemical aspects of developing brain, fetal growth, and drug metabolism at the Hall Institute. At the University of South Carolina School of Medicine he became a Research Professor in Neuropsychiatry in 1975 and an Adjunct Pro fessor in Pharmacology in 1978. He was Adjunct Distinguished Professor in the College of Pharmacy of the University. Through formal lectures, he taught residents and medical students in psychiatry and pharmacology. He directed graduate programs in the Department of Psychology and in the School of Phar macy. Dr. Shah served as a consultant to the Neuroscience Laboratory at the Veterans Administration Hospital in Columbia, South Carolina, and to the Biomedical Research Program at Voorhees College in Denmark, South Carolina. Dr. Shah published over 140 papers related to psychopharmacology and the biological basis of psychiatry in national and international journals. In ad dition, he co-edited two major books entitled Endorphins and Opiate Antag onists in Psychiatric Research: Clinical Implications and GABA Neurotrans mission: Current Developments in Physiology and Neurochemistry. For the last 13 years, Dr. Shah conducted an annual research symposium of international significance on topics of pharmacological interest, under the auspices of the William S. Hall Psychiatric Institute. These symposia, over the years, have brought scientists of international stature to Columbia, providing the local scientific, medical, and psychiatric communities with a unique op portunity to personally exchange ideas with these outstanding men and women. Dr. Shah earned several awards from national and international scientific and pharmaceutical associations: (1) from the American Society for Pharma cology and Experimental Therapeutics (1975-1976); (2) from the National In stitute for General Medical Sciences (1980); (3) from the Deutscher Akadem ischer Austauschdienst (German Academic Exchange Service) to work at Max Planck Institute for Psychiatry, Munich, West Germany, in psychoneuroen docrinology (1983); and (4) the Director's Award, from the William S. Hall Psychiatric Institute. He was listed in The Marquis Who's Who, Who's Who in the Biomedical Sciences, and the International Directory of Investigators in IN MEMORIAM vii Psychopharmacology published by the World Health Organization and the Na tional Institute of Mental Health. He was also a member of the Ad Hoc Com mittee of the NASA Biochemical Research Program in space and an editor/ advisor for several professional journals. Dr. Shah was strongly attached to his family. He had affection for his brothers, nephews, and nieces, helping to guide and shape their careers and financing their education when needed. Neeta, his wife of 22 years, is a re markable person who shared his experiences, successes, and disappointments. His daughter shares her father's love of science and is pursuing a career in medicine. Dr. Shah was an excellent teacher, an internationally known researcher, a humane colleague, and a gentleman who is missed by all. In June, 1983, when he was selected as the first recipient (posthumously) of the Director's Award of the William S. Hall Psychiatric Institute for the most significant contribution to its mission and purpose during the preceding year, Dr. Shah was described as "always interested in and willing to help students ... the epitome of the scholar and the teacher-an extremely diligent and hard-working faculty mem ber who set a high standard of excellence for students in all disciplines." This volume is respectfully dedicated to the memory of Dr. Nandkumar S. Shah in appreciation of his accomplishments and his compassion for his fellow man. Alexander G. Donald Contributors LARRY D. ALPHS • Maryland Psychiatric Research Center, Department of Psy chiatry, University of Maryland, Baltimore, Maryland GEORGE M. ANDERSON • Child Study Center and Department of Laboratory Medicine, Yale University, New Haven, Connecticut ROSS J. BALDESSARINI • Department of Psychiatry and Neuroscience Program, Harvard Medical School and Massachusetts General Hospital, and Mailman Re search Center, McLean Hospital, Belmont, Massachusetts THOMAS R. E. BARNES • Department of Psychiatry, Charing Cross and West minster Medical School, London, England HEMENDRA N. BHARGAVA • Department of Pharmacodynamics, College ofPhar macy, The University of Illinois at Chicago, Health Sciences Center, Chicago, Illinois J. R. BIANCHINE • Department of Pharmacology, College of Medicine, The Ohio State University, Columbus, Ohio. Present address: Medical Affairs, American Critical Care, McGaw Park, Illinois RICHARD L. BORISON • Department of Psychiatry, Downtown Veterans Admin istration Medical Center, and Medical College of Georgia, Augusta, Georgia DONALD B. CALNE • Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. Present address: Health Sciences Center Hospital, Department of Medicine, University of British Columbia, Vancouver, British Co lumbia, Canada DANIEL E. CASEY • Departments of Psychiatry, Research, and Neurology, Vet erans Administration Medical Center and Oregon Health Sciences University, Portland, Oregon C. C. CLOUGH • Department of Neurology, Queen Elizabeth Hospital, Birming ham, England ix x CONTRIBUTORS DONALD J. COHEN • Child Study Center, Children's Clinical Research Center, and Departments of Psychiatry, Pediatrics, and Psychology, Yale University, New Haven, Connecticut JONATHAN O. COLE • Psychopharmacology Services, McLean Hospital, Belmont, Massachusetts JOHN M. DAVIS • Illinois State Psychiatric Institute, Chicago, Illinois BRUCE I. DIAMOND • Department of Psychiatry, Downtown Veterans Adminis tration Medical Center, and Medical College of Georgia, Augusta, Georgia RICHARD DORSEY • Department of Psychiatry, Doctors Hospital West, Colum bus, Ohio GEORGE GARDOS. West-Ros-Park Mental Health Center, Boston, Massachusetts JES GERLACH • Department H, Saint Hans Hospital, Roskilde, Denmark CHRISTOPHER G. GOETZ • Department of Neurological Sciences, Rush-Pres byterian-St. Lukes Medical Center, Chicago, Illinois THOMAS J. GOLDSCHMIDT • Department of Neuropsychiatry and Behavioral Sci ence, University of South Carolina School of Medicine, Columbia, South Carolina. Present address: Department of Neurology and Psychiatry, Tulane University School of Medicine, New Orleans, Louisiana MENEK GOLDSTEIN • Department of Neurochemistry, New York University School of Medicine, New York, New York ANA HITRI • Department of Psychiatry, Downtown Veterans Administration Med ical Center, and Medical College of Georgia, Augusta, Georgia DILIP V. JESTE • Neuropsychiatry Branch, National Institute of Mental Health, Saint Elizabeths Hospital, Washington, D.C. CHARLES A. KAUFMANN • Neuropsychiatry Branch, National Institute of Mental Health, Saint Elizabeths Hospital, Washington, D.C. HAROLD L. KLAWANS • Department of Neurological Sciences, Rush-Presbyter ian-St. Lukes Medical Center, Chicago, Illinois JOSEPH KNOLL • Department of Pharmacology, Semmelweis University of Med icine, Budapest, Hungary S0REN KORSGAARD • Department H, Saint Hans Hospital, Roskilde, Denmark JAMES F. LECKMAN • Child Study Center, Children's Clinical Research Center, and Departments of Psychiatry and Pediatrics, Yale University, New Haven, Connecticut ABRAHAM N. LIEBERMAN • Department of Neurology, New York University School of Medicine, New York, New York RUUD B. MINDERAA • Eramus Universiteit Rotterdam, Rotterdam, The Netherlands CONTRIBUTORS xi RICHARD P. NEWMAN • Experimental Therapeutics Branch, National Insitute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. Present address: 1004 Beverly Drive, Rockledge, Florida DAVID L. PAULS • Child Study Center and Department of Human Genetics, Yale University, New Haven, Connecticut J. M. S. PEARCE • Department of Neurology, Hull Royal Infirmary, Hull, England EDMOND H. PI • Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, California R. ARLEN PRICE • Department of Psychiatry, University of Pennsylvania, Phila delphia, Pennsylvania C. W. RICHARD III • Department of Pharmacology, College of Medicine, The Ohio State University, Columbus, Ohio MARK A. RIDDLE • Child Study Center, Children's Clinical Research Center, and Departments of Psychiatry and Pediatrics, Yale University, New Haven, Connecticut ROBERT C. SCHNACKENBERG • Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina R. D. SCHWARTZ • Department of Pharmacology, College of Medicine, The Ohio State University, Columbus, Ohio ARTHUR K. SHAPIRO • Tourette and Tic Laboratory and Clinic, Mount Sinai School of Medicine, New York, New York ELAINE SHAPIRO • Tourette and Tic Laboratory and Clinic, Mount Sinai School of Medicine, New York, New York GEORGE M. SIMPSON • Department of Psychiatry, The Medical College of Penn sylvania, Philadelphia, Pennsylvania STEPHEN M. STAHL • VA-Stanford Mental Health Clinical Research Center, De partment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, and Laboratory of Neuropsychopharmacology, Schizophrenia Biologic Research Center, Veterans Administration Medical Center, Palo Alto, California. Present address: Neuroscience Research Centre, Merck Sharp and Dohme Research Laboratories, Terlings Park-Eastwick Road, Harlow, Essex, England CHARLES N. STILL • Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina CAROLINE M. TANNER • Department of Neurological Sciences, Rush-Presbyter ian-St. Lukes Medical Center, Chicago, Illinois DANIEL TARSY • Department of Neurology, Boston University and Harvard Med-