Manganese toxicity, dopaminergic dysfunction and hepatic encephalopathy
| Autor: | L. Spahr, Roger F. Butterworth, Suzanne Fontaine, Gilles Pomier Layrargues |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Pathology
medicine.medical_specialty Manganese Dopamine Manganese Poisoning Encephalopathy Biology medicine.disease Chronic liver disease Biochemistry Magnetic Resonance Imaging Hyperintensity Cellular and Molecular Neuroscience Liver disease Globus pallidus Extrapyramidal symptoms Hepatic Encephalopathy medicine Humans Neurology (clinical) medicine.symptom Hepatic encephalopathy |
| Zdroj: | Metabolic brain disease. 10(4) |
| ISSN: | 0885-7490 |
| Popis: | Patients with chronic liver disease manifest a high incidence (> 75%) of pallidal signal hyperintensity on T1-weighted Magnetic Resonance Imaging (MRI), the intensity of which correlates with blood manganese levels and the presence of extrapyramidal symptoms. A major cause of pallidal hyperintensity on T1-weighted MRI is manganese deposition; chronic manganese intoxication in the absence of liver disease results in pallidal MR signal hyperintensity, in extrapyramidal symptoms and in selective effects on the dopaminergic neurotransmitter system in basal ganglia. Direct measurements in globus pallidus obtained at autopsy from patients with chronic liver disease who died in hepatic coma reveal 2 to 7-fold increases of pallidal manganese and a concomitant loss of dopamine D2 binding sites. Liver transplantation results in normalization of pallidal MR signals and of blood manganese levels. These findings suggest that (1) pallidal MR signal hyperintensity in patients with chronic liver disease is the result of manganese deposition and (2) alterations of dopaminergic function due to the toxic effects of manganese may contribute to the extrapyramidal symptoms in these patients. |
| Databáze: | OpenAIRE |
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