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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Feb;60(2):213–216. doi: 10.1136/jnnp.60.2.213

Neuroleptic induced parkinsonism: MRI findings in relation to clinical course after withdrawal of neuroleptic drugs.

V Bocola 1, G Fabbrini 1, A Sollecito 1, C Paladini 1, N Martucci 1
PMCID: PMC1073810  PMID: 8708659

Abstract

Parkinsonism is a common complication of neuroleptic drug use; however, the pathophysiology of the persistence of parkinsonian symptoms after withdrawal of neuroleptic drugs is poorly understood. Twenty patients with neuroleptic induced parkinsonism were studied by high field MRI. Persistence of symptoms was associated with different findings depending on the age of the patients--namely, putaminal hypointensity in young patients and striatal hyperintensities in old patients. High field MRI may be useful in identifying patients at higher risk for neuroleptic induced parkinsonism.

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Selected References

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  1. AYD F. J., Jr A survey of drug-induced extrapyramidal reactions. JAMA. 1961 Mar 25;175:1054–1060. doi: 10.1001/jama.1961.03040120016004. [DOI] [PubMed] [Google Scholar]
  2. Aronson T. A. Persistent drug-induced parkinsonism. Biol Psychiatry. 1985 Jul;20(7):795–798. doi: 10.1016/0006-3223(85)90160-x. [DOI] [PubMed] [Google Scholar]
  3. Burn D. J., Brooks D. J. Nigral dysfunction in drug-induced parkinsonism: an 18F-dopa PET study. Neurology. 1993 Mar;43(3 Pt 1):552–556. doi: 10.1212/wnl.43.3_part_1.552. [DOI] [PubMed] [Google Scholar]
  4. Campbell W. G., Raskind M. A., Gordon T., Shaw C. M. Iron pigment in the brain of a man with tardive dyskinesia. Am J Psychiatry. 1985 Mar;142(3):364–365. doi: 10.1176/ajp.142.3.364. [DOI] [PubMed] [Google Scholar]
  5. Casanova M. F., Comparini S. O., Kim R. W., Kleinman J. E. Staining intensity of brain iron in patients with schizophrenia: a postmortem study. J Neuropsychiatry Clin Neurosci. 1992 Winter;4(1):36–41. doi: 10.1176/jnp.4.1.36. [DOI] [PubMed] [Google Scholar]
  6. Casanova M. F., Waldman I. N., Kleinman J. E. A postmortem quantitative study of iron in the globus pallidus of schizophrenic patients. Biol Psychiatry. 1990 Jan 15;27(2):143–149. doi: 10.1016/0006-3223(90)90644-h. [DOI] [PubMed] [Google Scholar]
  7. Christensen E., Moller J. E., Faurbye A. Neuropathological investigation of 28 brains from patients with dyskinesia. Acta Psychiatr Scand. 1970;46(1):14–23. doi: 10.1111/j.1600-0447.1970.tb02097.x. [DOI] [PubMed] [Google Scholar]
  8. DATATOP: a multicenter controlled clinical trial in early Parkinson's disease. Parkinson Study Group. Arch Neurol. 1989 Oct;46(10):1052–1060. doi: 10.1001/archneur.1989.00520460028009. [DOI] [PubMed] [Google Scholar]
  9. Dexter D. T., Carayon A., Javoy-Agid F., Agid Y., Wells F. R., Daniel S. E., Lees A. J., Jenner P., Marsden C. D. Alterations in the levels of iron, ferritin and other trace metals in Parkinson's disease and other neurodegenerative diseases affecting the basal ganglia. Brain. 1991 Aug;114(Pt 4):1953–1975. doi: 10.1093/brain/114.4.1953. [DOI] [PubMed] [Google Scholar]
  10. Floyd R. A., Carney J. M. Free radical damage to protein and DNA: mechanisms involved and relevant observations on brain undergoing oxidative stress. Ann Neurol. 1992;32 (Suppl):S22–S27. doi: 10.1002/ana.410320706. [DOI] [PubMed] [Google Scholar]
  11. Goetz C. G. Drug-induced Parkinsonism and idiopathic Parkinson's disease. Arch Neurol. 1983 May;40(5):325–326. doi: 10.1001/archneur.1983.04050050093019. [DOI] [PubMed] [Google Scholar]
  12. Grafton S. T., Sumi S. M., Stimac G. K., Alvord E. C., Jr, Shaw C. M., Nochlin D. Comparison of postmortem magnetic resonance imaging and neuropathologic findings in the cerebral white matter. Arch Neurol. 1991 Mar;48(3):293–298. doi: 10.1001/archneur.1991.00530150061019. [DOI] [PubMed] [Google Scholar]
  13. Hausner R. S. Neuroleptic-induced parkinsonism and Parkinson's disease: differential diagnosis and treatment. J Clin Psychiatry. 1983 Jan;44(1):13–16. [PubMed] [Google Scholar]
  14. Heinz R., Rayasam K., Krishnan K. R., Wingfield M., Irigaray P., Ellinwood E. H. MRI scans in patients with tardive dyskinesia. Biol Psychiatry. 1988 Nov;24(7):852–857. doi: 10.1016/0006-3223(88)90266-1. [DOI] [PubMed] [Google Scholar]
  15. Jungreis C. A., Kanal E., Hirsch W. L., Martinez A. J., Moossy J. Normal perivascular spaces mimicking lacunar infarction: MR imaging. Radiology. 1988 Oct;169(1):101–104. doi: 10.1148/radiology.169.1.3420242. [DOI] [PubMed] [Google Scholar]
  16. Klawans H. L., Jr, Bergen D., Bruyn G. W. Prolonged drug-induced Parkinsonism. Confin Neurol. 1973;35(6):368–377. doi: 10.1159/000102857. [DOI] [PubMed] [Google Scholar]
  17. Melamed E., Achiron A., Shapira A., Davidovicz S. Persistent and progressive parkinsonism after discontinuation of chronic neuroleptic therapy: an additional tardive syndrome? Clin Neuropharmacol. 1991 Jun;14(3):273–278. doi: 10.1097/00002826-199106000-00013. [DOI] [PubMed] [Google Scholar]
  18. Nielsen E. B., Lyon M. Evidence for cell loss in corpus striatum after long-term treatment with a neuroleptic drug (flupenithixol) in rats. Psychopharmacology (Berl) 1978 Sep 15;59(1):85–89. doi: 10.1007/BF00428036. [DOI] [PubMed] [Google Scholar]
  19. Rajput A. H., Rozdilsky B., Hornykiewicz O., Shannak K., Lee T., Seeman P. Reversible drug-induced parkinsonism. Clinicopathologic study of two cases. Arch Neurol. 1982 Oct;39(10):644–646. doi: 10.1001/archneur.1982.00510220042009. [DOI] [PubMed] [Google Scholar]
  20. Sethi K. D., Zamrini E. Y. Asymmetry in clinical features of drug-induced parkinsonism. J Neuropsychiatry Clin Neurosci. 1990 Winter;2(1):64–66. doi: 10.1176/jnp.2.1.64. [DOI] [PubMed] [Google Scholar]
  21. Stephen P. J., Williamson J. Drug-induced parkinsonism in the elderly. Lancet. 1984 Nov 10;2(8411):1082–1083. doi: 10.1016/s0140-6736(84)91516-2. [DOI] [PubMed] [Google Scholar]
  22. Thajeb P. Gait disorders of multi-infarct dementia. CT and clinical correlation. Acta Neurol Scand. 1993 Mar;87(3):239–242. doi: 10.1111/j.1600-0404.1993.tb04109.x. [DOI] [PubMed] [Google Scholar]
  23. Thompson P. D., Marsden C. D. Gait disorder of subcortical arteriosclerotic encephalopathy: Binswanger's disease. Mov Disord. 1987;2(1):1–8. doi: 10.1002/mds.870020101. [DOI] [PubMed] [Google Scholar]

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