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MPTP-induced parkinsonism: an historical case series

[...]the videos suggest that these patients presented with two different subtypes: a milder subtype, with a prominent tremor (patients 4 and 5), and a more severe subtype, with no or a less prominent tremor, but with much more pronounced bradykinesia, akinesia, and rigidity (patients 1-3). According...

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Published in:Lancet neurology 2018-04, Vol.17 (4), p.300-301
Main Authors: Nonnekes, Jorik, Post, Bart, Tetrud, James W, Langston, J William, Bloem, Bastiaan R
Format: Article
Language:English
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Summary:[...]the videos suggest that these patients presented with two different subtypes: a milder subtype, with a prominent tremor (patients 4 and 5), and a more severe subtype, with no or a less prominent tremor, but with much more pronounced bradykinesia, akinesia, and rigidity (patients 1-3). According to this hypothesis, tremor at rest could be the side-effect of cerebral or cerebellar mechanisms that compensate for akinesia.7 Such compensatory activity in the cortex or cerebellum could make these regions more sensitised to perturbing influences from the basal ganglia, resulting in tremor at rest. Supplementary Materials 1 PA Ballard, JW Tetrud, JW Langston, Permanent human parkinsonism due to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP): seven cases, Neurology, Vol. 35, 1985, 949-956 2 JW Langston, P Ballard, JW Tetrud, I Irwin, Chronic parkinsonism in humans due to a product of meperidine-analog synthesis, Science, Vol. 219, 1983, 979-980 3 RR Ramsay, J Dadgar, A Trevor, TP Singer, Energy-driven uptake of N-methyl-4-phenylpyridine by brain mitochondria mediates the neurotoxicity of MPTP, Life Sci, Vol. 39, 1986, 581-588 4 J Nonnekes, AH Snijders, JG Nutt, G Deuschl, N Giladi, BR Bloem, Freezing of gait: a practical approach to management, Lancet Neurol, Vol. 14, 2015, 768-778 5 MA Thenganatt, J Jankovic, Parkinson disease subtypes, JAMA Neurol, Vol. 71, 2014, 499-504 6 RC Helmich, M Hallett, G Deuschl, I Toni, BR Bloem, Brain, Vol. 135, 2012, 3206-3226 7 M Rivlin-Etzion, O Marmor, G Heimer, A Raz, A Nini, H Bergman, Basal ganglia oscillations and pathophysiology of movement disorders, Curr Opin Neurobiol, Vol. 16, 2006, 629-637 8 A Zaidel, D Arkadir, Z Israel, H Bergman, Akineto-rigid vs. tremor syndromes in parkinsonism, Curr Opin Neurol, Vol. 22, 2009, 387-393
ISSN:1474-4422
1474-4465
DOI:10.1016/S1474-4422(18)30072-3