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Published on: November 21, 2013
Susceptibility to neuroleptic-induced parkinsonism--age and increased substantia nigra echogenicity as putative risk
Burkhard Emanuel Jabs1, Andreas Joachim Bartsch, Bruno Pfuhlmann
1Department of Psychiatry, Julius-Maximilians-University, Füchsleinstrasse 15, 97080 Würzburg, Germany. burkhard.jabs@mail.uni-wuerzburg.de
Objective:
Patients treated by neuroleptics often develop neuroleptic-induced parkinsonism (NIP) to a varying extent. The reasons for this are discussed controversially in the literature. Previous transcranial sonography (TCS) findings of the substantia nigra (SN) in patients with idiopathic Parkinson's disease suggest a correlation of echogenicity with nigrostriatal dysfunction.
Method:
One hundred psychiatric patients receiving neuroleptics were included. They underwent clinical examination for NIP (Simpson and Angus-scale) and, independently, TCS of the SN. History of smoking habits and medication were taken from the patient's chart.
Results:
We found a significant positive association of the prevalence of NIP with age (P < 0.01) and the echogenic area of the SN (P < 0.05). Neither type nor dosage of the neuroleptics was found to have any significant impact on the occurrence of NIP. Smokers displayed lower prevalence of NIP (P < 0.05) and lower EPS scores (P < 0.01).
Conclusions:
These findings suggest that age and increased size of SN echogenicity are possible risk factors for NIP. In contrast, smoking seems to have a certain protecting effect.
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