Original ArticleDrug-Induced Parkinsonism as a Risk Factor for Parkinson's Disease: A Historical Cohort Study in Olmsted County, Minnesota
Section snippets
Patients And Methods
Subjects affected by drug-induced parkinsonism were identified from two sources. The medical records-linkage system of the Rochester Epidemiology Project was used to identify patients with drug-induced parkinsonism who resided in Olmsted County, Minnesota, at the time of onset of the disorder.4 Using the computerized indexes of the system, we identified subjects who received a diagnosis of drug-induced parkinsonism between Jan. 1, 1970, and Dec. 31, 1990. Because drug-induced parkinsonism was
Results
Of the 120 potential cases of drug-induced parkinsonism initially identified through the medical records-linkage system, 70 cases (58%) were excluded (another cause of parkinsonism in 29, indeterminate temporal relationship between use of dopamine antagonist and onset of parkinsonism in 15, nonresident in 11, insufficient data to confirm the diagnosis of parkinsonism in 9, and more than one reason in 6).
Of the remaining 50 patients with drug-induced parkin sonism, use of dopamine antagonists
Discussion
Our findings suggest that subjects who experience an episode of drug-induced parkinsonism are at increased risk for the subsequent development of Parkinson's disease. These findings are consistent with the limited prior results of investigations in this area. The one previous study thai addressed the frequency of Parkinson's disease in patients with drug-induced parkinsonism was based on patients referred to a geriatrics unit. Stephen and Williamson6 prospectively identified 5 cases of
Conclusion
We suggest that drug-induced parkinsonism is associated with an increased risk of Parkinson's disease; however, the mechanism of this increased risk remains to be determined. Because of the relatively high frequency of drug-induced parkinsonism in the population,1 this association deserves further investigation. Better understanding of the relationship between drug-induced parkinsonism and Parkinson's disease may have preventive implications.
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2007, Handbook of Clinical NeurologyCitation Excerpt :A number of studies have shown that in a variable number of cases DIP is only the expression of subclinical PD unmasked by the action of neuroleptics, calcium channel blockers or other drugs known to cause DIP. Several authors have shown that findings suggest that DIP is associated with an increased risk for PD (Chabolla et al., 1998). Several studies have shown that cigarette smoking may have a protective effect as regards the risk for PD (Allam et al., 2004).
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This study was supported in part by Grant NS 33978 from the National Institute of Neurological Disorders and Stroke, Grant AR 30582 from the National Institutes of Health, Public Health Service, and the Mayo Foundation.