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Susceptibility to neuroleptic-induced parkinsonism—age and increased substantia nigra echogenicity as putative risk factors

Published online by Cambridge University Press:  16 April 2020

Burkhard Emanuel Jabs ,
Andreas Joachim Bartsch  and
Bruno Pfuhlmann
Burkhard Emanuel Jabs*
Affiliation:
Department of Psychiatry, Julius-Maximilians-University, Füchsleinstraße 15, 97080Würzburg, Germany
Andreas Joachim Bartsch
Affiliation:
Division of Neuroradiology, Julius-Maximilians-University, Josef-Schneider-Str. 11, 97080Würzburg, Germany
Bruno Pfuhlmann
Affiliation:
Department of Psychiatry, Julius-Maximilians-University, Füchsleinstraße 15, 97080Würzburg, Germany
*
*E-mail address: [email protected]
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Abstract

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.

Methods

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.

Keywords

Antipsychotic agentsAdverse effectsSecondary Parkinson’s diseaseTranscranial ultrasonographySubstantia nigra
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 4 , June 2003 , pp. 177 - 181
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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