Manganese-induced parkinsonism in methcathinone abusers: bio-markers of exposure and follow-up
| Autor: | Sten-Magnus Aquilonius, Jonas Bergquist, Katrin Sikk, Andres Asser, Sulev Haldre, Ä. Roose, S.-L. Eriksson, J. Petterson, Pille Taba, M. Paris |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Estonia Male medicine.medical_specialty Adolescent Substance-Related Disorders Methcathinone Cohort Studies Young Adult Internal medicine medicine Manganism Humans Young adult Parkinson Disease Secondary Psychiatry Manganese Propiophenones business.industry Parkinsonism Follow up studies Middle Aged medicine.disease nervous system diseases Neurology Female Neurology (clinical) business Biomarkers Cohort study medicine.drug Follow-Up Studies Hair |
| Zdroj: | European journal of neurology. 20(6) |
| ISSN: | 1468-1331 |
| Popis: | Methcathinone abuse is a new cause of manganism. The psychostimulant is prepared from pseudoephedrine using potassium permanganate as an oxidant. We describe the clinical, biological, neuroimaging characteristics and follow-up results in a large Estonian cohort of intravenous methcathinone users.During 2006-2012 we studied 38 methcathinone abusers with a mean age of 33 years. Subjects were rated by the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr (HY), and Schwab and England (SE) rating scales. Twenty-four cases were reassessed 9-70 (20 ± 15) months after the initial evaluation. Manganese (Mn) in plasma and hair was analysed by inductively coupled plasma-atom emission spectrometry. Magnetic resonance imaging (MRI) was performed in 11, and single-photon emission computed tomography (SPECT) with iodobenzamide (IBZM) in eight subjects.The average total UPDRS score was 43 ± 21. The most severely affected domains in UPDRS Part III were speech and postural stability, the least affected domain was resting tremor. At follow-up there was worsening of HY and SE rating scales. Subjects had a higher mean level of Mn in hair (2.9 ± 3.8 ppm) than controls (0.82 ± 1.02 ppm), P = 0.02. Plasma Mn concentrations were higher (11.5 ± 6.2 ppb) in active than in former users (5.6 ± 1.8 ppb), P = 0.006. Active methcathinone users had increased MRI T1-signal intensity in the globus pallidus, substantia nigra and periaquaductal gray matter. IBZM-SPECT showed normal symmetric tracer uptake in striatum.Methcathinone abusers develop a distinctive hypokinetic syndrome. Though the biomarkers of Mn exposure are characteristic only of recent abuse, the syndrome is not reversible. |
| Databáze: | OpenAIRE |
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