Tardive dyskinesia: clinical correlation with computed tomography in patients aged less than 60 years

In a prevalence study of 335 psychiatric in-patients 49 patients (14.6%) with tardive dyskinesia were found. In view of the high prevalence of spontaneous dyskinetic syndromes in elderly patients only patients under 60 years were included (n = 21; mean age: 44.9). Clinical rating was performed with the AIMS-scale. CT measurements of ventricular enlargement and cortical atrophy were obtained. Tardive dyskinesia cases did not differ significantly from healthy controls, though some patients with severe dyskinesia showed signs of brain atrophy. These findings did not provide evidence to support neuropathological reports describing neuronal cell loss and midbrain gliosis in such patients. It is concluded that such structural brain changes in tardive dyskinesia patients are not detectable with present CT technology: they may either be due to concurrent aging processes or, in the case of younger patients, can be confirmed only by more functional methods of testing.