Parkinsonism in patients with a history of amphetamine exposure.
Parkinsonism in patients with a history of amphetamine exposure.
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DOI：
10.1002/mds.22915
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发表时间：
2010-01-30
影响因子：
8.6
通讯作者：
McCulloch, Charles E.
中科院分区：
文献类型：
--
作者：
Christine, Chadwick W.;Garwood, Elisabeth R.;Schrock, Lauren E.;Austin, Daniel E.;McCulloch, Charles E.
我们最近发现，在被诊断为帕金森氏病(PD)的患者中，安非他明长期暴露的比率高于配偶/照顾者对照组。由于一些因环境暴露(如锰)而导致的帕金森症患者具有不同的特征，我们试图比较长期暴露于苯丙胺的帕金森病患者和未暴露于苯丙胺的帕金森病患者的临床特征。长期暴露的定义是，在≥3个月内每周至少两次，或每周使用≥1年。我们回顾了参与药物和环境暴露电话调查的帕金森病患者的临床记录，并比较了有长期苯丙胺暴露史的患者和没有这种暴露史的患者的临床特征。有安非他明暴露史的17名患者中有16名(94%)有记录，137名未暴露的患者中有127名(92%)有记录。安非他明暴露组的初诊年龄较小(49.8±8.2岁vs.53.1±7.4岁；p<；0.05)，但其他特征，包括临床症状、最初和后来的治疗、运动波动的发展和MRI表现在两组之间是相似的。由于我们没有发现在长期接触苯丙胺的患者中区分帕金森综合症的临床特征，因此要确定安非他明接触是否是帕金森综合症的风险因素，研究将需要详细的药物和娱乐药物使用史。
We recently found a higher rate of prolonged amphetamine exposure in patients diagnosed with Parkinson's disease (PD) than in spouse/caregiver controls. Since distinguishing features have been described in some patients with parkinsonism due to environment exposures (e.g. manganese), we sought to compare the clinical features of PD patients with prolonged amphetamine exposure with unexposed PD patients. Prolonged exposure was defined as a minimum of twice a week for ≥ 3 months, or weekly use ≥ 1 year. We reviewed the clinical records of patients with PD who had participated in a telephone survey of drug and environmental exposures and compared the clinical features of patients with a history of prolonged amphetamine exposure to patients who had no such exposure. Records were available for 16 of 17 (94%) patients with prior amphetamine exposure and 127 of 137 (92%) of those unexposed. Age at diagnosis was younger in the amphetamine-exposed group (49.8 ± 8.2 years vs. 53.1 ±7.4 years; p < 0.05), but other features, including presenting symptoms, initial and later treatments, development of motor fluctuations, and MRI findings were similar between these groups. Because we did not detect clinical features that differentiate parkinsonism in patients with prolonged amphetamine exposure, research to determine whether amphetamine exposure is a risk factor for parkinsonism will require detailed histories of medication and recreational drug use.
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