Early-onset drug-induced parkinsonism after exposure to offenders implies nigrostriatal dopaminergic dysfunction

Seok Jong Chung, Han Soo Yoo, Hyojeong Moon, Jungsu S. Oh, Jae Seung Kim, Yong Hee Park, Jin Yong Hong, Byoung Seok Ye, Young H. Sohn, Phil Hyu Lee

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives The onset of parkinsonism in patients with drug-induced parkinsonism (DIP) exhibits extensive individual variability following exposure to offending drugs. We investigated whether the individual variations in the onset time of parkinsonism reflected the underlying subtle dopaminergic dysfunction in DIP. Methods We enrolled 71 patients with DIP who had visually normal striatal dopamine transporter (DAT) availability in 18 F-FP-CIT positron emission tomography scans. According to their exposure durations to the offending drugs prior to onset of the parkinsonism, the patients were divided into the early-onset group (duration ≤6 months; n=35) and delayed-onset group (duration >6 months; n=36). We performed the quantitative analysis of the DAT availability in each striatal subregion between the groups. Results No patients with DIP had DAT availability that was more than 2 SD below the normal mean of DAT availability. Compared with the delayed-onset group, the early-onset DIP group had decreased DAT availability in the striatal subregions including the posterior putamen (p=0.018), anterior putamen (p=0.011), caudate (p=0.035) and ventral striatum (p=0.027). After adjusting for age, sex and cross-cultural smell identification test scores, a multivariate analysis revealed that the DAT availability in the striatal subregions of the patients with DIP was significantly and positively associated with the natural logarithm of the duration of drug exposure. Conclusions These results suggest that a short exposure to the offending drugs before the development of parkinsonism would be associated with subtle nigrostriatal dopaminergic dysfunction in patients with DIP.

Original languageEnglish
Pages (from-to)169-174
Number of pages6
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume89
Issue number2
DOIs
Publication statusPublished - 2018 Feb 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

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