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Drug-induced parkinsonism as a risk factor for Parkinson's disease: a historical cohort study in Olmsted County,
D R Chabolla1, D M Maraganore, J E Ahlskog
1Department of Neurology, Mayo Clinic Jacksonville, Florida 32224, USA.
Objective:
To investigate whether subjects who experienced a reversible episode of drug-induced parkinsonism have an increased risk of subsequent Parkinson's disease.
Design:
We undertook a historical cohort study based on the medical records-linkage system of the Rochester Epidemiology Project in Olmsted County, Minnesota.
Material And Methods:
All subjects in whom drug-induced parkinsonism developed between 1955 and 1990 and was indexed in the medical records-linkage system were identified. In the 24 eligible subjects, follow-up for the subsequent development of Parkinson's disease consisted of a total of 192.7 person-years. The observed number of cases of Parkinson's disease was compared with the expected number of cases in an age- and sex-matched cohort from the general population.
Results:
In 2 of 24 subjects with drug-induced parkinsonism, Parkinson's disease later developed. A comparison with the expected number of cases in the general population (0.08) yielded a relative risk of 24.3 (95% confidence interval, 2.9 to 87.5; P = 0.006).
Conclusion:
Our findings suggest that drug-induced parkinsonism is associated with an increased risk of Parkinson's disease. Clarification of the mechanisms of this association may have preventive implications.