Parkinsonism in cirrhosis: pathogenesis and current therapeutic options.
Identifieur interne : 000D03 ( Main/Exploration ); précédent : 000D02; suivant : 000D04Parkinsonism in cirrhosis: pathogenesis and current therapeutic options.
Auteurs : Roger F. Butterworth [Canada]Source :
- Metabolic brain disease [ 1573-7365 ] ; 2013.
English descriptors
- KwdEn :
- Antiparkinson Agents (therapeutic use), Brain Chemistry (physiology), Chelating Agents (therapeutic use), Dopamine (physiology), Dopamine Agents (therapeutic use), Humans, Hyperammonemia (drug therapy), Levodopa (therapeutic use), Liver Cirrhosis (complications), Liver Cirrhosis (pathology), Liver Transplantation, Manganese Poisoning (etiology), Manganese Poisoning (pathology), Parkinson Disease (etiology), Parkinson Disease (pathology), Parkinson Disease (therapy).
- MESH :
- chemical , physiology : Dopamine.
- chemical , therapeutic use : Antiparkinson Agents, Chelating Agents, Dopamine Agents, Levodopa.
- complications : Liver Cirrhosis.
- drug therapy : Hyperammonemia.
- etiology : Manganese Poisoning, Parkinson Disease.
- pathology : Liver Cirrhosis, Manganese Poisoning, Parkinson Disease.
- physiology : Brain Chemistry.
- therapy : Parkinson Disease.
- Humans, Liver Transplantation.
Abstract
Acquired hepatolenticular degeneration, also known as "Parkinsonism in cirrhosis" is characterized by extrapyramidal symptoms including hypokinesia, dystonia and rigidity that are rapidly progressive and may be independent of the severity of cognitive dysfunction. Magnetic resonance imaging reveals T1-weighted hyperintense signals in both globus pallidus and substantia nigra. Estimates of the prevalence of Parkinsonism in cirrhosis have been reported as high as 21 %. The cause of Parkinsonism in cirrhosis has been attributed to manganese deposition in basal ganglia structures, leading to the dysfunction of the dopaminergic neurotransmitter system. In particular, there is evidence from both spectroscopic and biochemical investigations for damage to (or dysfunction of) presynaptic dopamine transporters together with a loss of post-synaptic dopamine receptors in basal ganglia of affected patients. Therapeutic options are limited; ammonia-lowering strategies are without substantial benefit, and an effective manganese chelator is not available. In many patients, L-Dopa replacement therapy and the dopamine receptor agonist bromocriptine are beneficial, and liver transplantation is generally effective. However, reports of post-transplant residual extrapyramidal symptoms suggest an element of irreversibility in some cases.
DOI: 10.1007/s11011-012-9341-7
PubMed: 23086199
Affiliations:
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Le document en format XML
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Butterworth</name><affiliation wicri:level="3"><nlm:affiliation>Unité de recherche en neurosciences, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal, Canada. roger.butterworth@umontreal.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Unité de recherche en neurosciences, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal</wicri:regionArea><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23086199</idno><idno type="pmid">23086199</idno><idno type="doi">10.1007/s11011-012-9341-7</idno><idno type="wicri:Area/PubMed/Corpus">000911</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000911</idno><idno type="wicri:Area/PubMed/Curation">000911</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000911</idno><idno type="wicri:Area/PubMed/Checkpoint">000911</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000911</idno><idno type="wicri:Area/Ncbi/Merge">001289</idno><idno type="wicri:Area/Ncbi/Curation">001289</idno><idno type="wicri:Area/Ncbi/Checkpoint">001289</idno><idno type="wicri:Area/Main/Merge">000D12</idno><idno type="wicri:Area/Main/Curation">000D03</idno><idno type="wicri:Area/Main/Exploration">000D03</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Parkinsonism in cirrhosis: pathogenesis and current therapeutic options.</title><author><name sortKey="Butterworth, Roger F" sort="Butterworth, Roger F" uniqKey="Butterworth R" first="Roger F" last="Butterworth">Roger F. Butterworth</name><affiliation wicri:level="3"><nlm:affiliation>Unité de recherche en neurosciences, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal, Canada. roger.butterworth@umontreal.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Unité de recherche en neurosciences, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal</wicri:regionArea><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author></analytic><series><title level="j">Metabolic brain disease</title><idno type="eISSN">1573-7365</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents (therapeutic use)</term><term>Brain Chemistry (physiology)</term><term>Chelating Agents (therapeutic use)</term><term>Dopamine (physiology)</term><term>Dopamine Agents (therapeutic use)</term><term>Humans</term><term>Hyperammonemia (drug therapy)</term><term>Levodopa (therapeutic use)</term><term>Liver Cirrhosis (complications)</term><term>Liver Cirrhosis (pathology)</term><term>Liver Transplantation</term><term>Manganese Poisoning (etiology)</term><term>Manganese Poisoning (pathology)</term><term>Parkinson Disease (etiology)</term><term>Parkinson Disease (pathology)</term><term>Parkinson Disease (therapy)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="physiology" xml:lang="en"><term>Dopamine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Chelating Agents</term><term>Dopamine Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Liver Cirrhosis</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Hyperammonemia</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Manganese Poisoning</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Liver Cirrhosis</term><term>Manganese Poisoning</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Brain Chemistry</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Liver Transplantation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Acquired hepatolenticular degeneration, also known as "Parkinsonism in cirrhosis" is characterized by extrapyramidal symptoms including hypokinesia, dystonia and rigidity that are rapidly progressive and may be independent of the severity of cognitive dysfunction. Magnetic resonance imaging reveals T1-weighted hyperintense signals in both globus pallidus and substantia nigra. Estimates of the prevalence of Parkinsonism in cirrhosis have been reported as high as 21 %. The cause of Parkinsonism in cirrhosis has been attributed to manganese deposition in basal ganglia structures, leading to the dysfunction of the dopaminergic neurotransmitter system. In particular, there is evidence from both spectroscopic and biochemical investigations for damage to (or dysfunction of) presynaptic dopamine transporters together with a loss of post-synaptic dopamine receptors in basal ganglia of affected patients. Therapeutic options are limited; ammonia-lowering strategies are without substantial benefit, and an effective manganese chelator is not available. In many patients, L-Dopa replacement therapy and the dopamine receptor agonist bromocriptine are beneficial, and liver transplantation is generally effective. However, reports of post-transplant residual extrapyramidal symptoms suggest an element of irreversibility in some cases.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Québec</li></region><settlement><li>Montréal</li></settlement></list><tree><country name="Canada"><region name="Québec"><name sortKey="Butterworth, Roger F" sort="Butterworth, Roger F" uniqKey="Butterworth R" first="Roger F" last="Butterworth">Roger F. Butterworth</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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