Neuroleptic-induced Parkinsonism: Clinicopathological study.
Identifieur interne : 000284 ( PubMed/Curation ); précédent : 000283; suivant : 000285Neuroleptic-induced Parkinsonism: Clinicopathological study.
Auteurs : Umar A. Shuaib [Canada] ; Ali H. Rajput [Canada] ; Christopher A. Robinson [Canada] ; Alex Rajput [Canada]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2016.
English descriptors
- KwdEn :
- Aged, Antipsychotic Agents (adverse effects), Antipsychotic Agents (therapeutic use), Dopamine Agents (adverse effects), Dopamine Agents (therapeutic use), Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Lewy Bodies (pathology), Male, Middle Aged, Parkinson Disease, Secondary (chemically induced), Parkinson Disease, Secondary (pathology), Substantia Nigra (pathology).
- MESH :
- chemical , adverse effects : Antipsychotic Agents, Dopamine Agents, Levodopa.
- chemical , therapeutic use : Antipsychotic Agents, Dopamine Agents, Levodopa.
- chemically induced : Parkinson Disease, Secondary.
- pathology : Lewy Bodies, Parkinson Disease, Secondary, Substantia Nigra.
- Aged, Humans, Male, Middle Aged.
Abstract
Drug-induced parkinsonism is a well-known complication of several different drugs--the most common being neuroleptic-induced parkinsonism. However, very few autopsies have been reported in such cases.
DOI: 10.1002/mds.26467
PubMed: 26660063
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000284
Links to Exploration step
pubmed:26660063Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Neuroleptic-induced Parkinsonism: Clinicopathological study.</title><author><name sortKey="Shuaib, Umar A" sort="Shuaib, Umar A" uniqKey="Shuaib U" first="Umar A" last="Shuaib">Umar A. Shuaib</name><affiliation wicri:level="1"><nlm:affiliation>Saskatchewan Movement Disorders Program, Royal University Hospital, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Saskatchewan Movement Disorders Program, Royal University Hospital, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author><author><name sortKey="Rajput, Ali H" sort="Rajput, Ali H" uniqKey="Rajput A" first="Ali H" last="Rajput">Ali H. Rajput</name><affiliation wicri:level="1"><nlm:affiliation>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author><author><name sortKey="Robinson, Christopher A" sort="Robinson, Christopher A" uniqKey="Robinson C" first="Christopher A" last="Robinson">Christopher A. Robinson</name><affiliation wicri:level="1"><nlm:affiliation>Neuropathology, Department of Pathology, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Neuropathology, Department of Pathology, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author><author><name sortKey="Rajput, Alex" sort="Rajput, Alex" uniqKey="Rajput A" first="Alex" last="Rajput">Alex Rajput</name><affiliation wicri:level="1"><nlm:affiliation>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26660063</idno><idno type="pmid">26660063</idno><idno type="doi">10.1002/mds.26467</idno><idno type="wicri:Area/PubMed/Corpus">000284</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000284</idno><idno type="wicri:Area/PubMed/Curation">000284</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000284</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Neuroleptic-induced Parkinsonism: Clinicopathological study.</title><author><name sortKey="Shuaib, Umar A" sort="Shuaib, Umar A" uniqKey="Shuaib U" first="Umar A" last="Shuaib">Umar A. Shuaib</name><affiliation wicri:level="1"><nlm:affiliation>Saskatchewan Movement Disorders Program, Royal University Hospital, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Saskatchewan Movement Disorders Program, Royal University Hospital, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author><author><name sortKey="Rajput, Ali H" sort="Rajput, Ali H" uniqKey="Rajput A" first="Ali H" last="Rajput">Ali H. Rajput</name><affiliation wicri:level="1"><nlm:affiliation>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author><author><name sortKey="Robinson, Christopher A" sort="Robinson, Christopher A" uniqKey="Robinson C" first="Christopher A" last="Robinson">Christopher A. Robinson</name><affiliation wicri:level="1"><nlm:affiliation>Neuropathology, Department of Pathology, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Neuropathology, Department of Pathology, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author><author><name sortKey="Rajput, Alex" sort="Rajput, Alex" uniqKey="Rajput A" first="Alex" last="Rajput">Alex Rajput</name><affiliation wicri:level="1"><nlm:affiliation>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan</wicri:regionArea></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antipsychotic Agents (adverse effects)</term><term>Antipsychotic Agents (therapeutic use)</term><term>Dopamine Agents (adverse effects)</term><term>Dopamine Agents (therapeutic use)</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Levodopa (therapeutic use)</term><term>Lewy Bodies (pathology)</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease, Secondary (chemically induced)</term><term>Parkinson Disease, Secondary (pathology)</term><term>Substantia Nigra (pathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antipsychotic Agents</term><term>Dopamine Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term><term>Dopamine Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Parkinson Disease, Secondary</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lewy Bodies</term><term>Parkinson Disease, Secondary</term><term>Substantia Nigra</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Drug-induced parkinsonism is a well-known complication of several different drugs--the most common being neuroleptic-induced parkinsonism. However, very few autopsies have been reported in such cases.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26660063</PMID><DateCreated><Year>2016</Year><Month>03</Month><Day>08</Day></DateCreated><DateCompleted><Year>2016</Year><Month>12</Month><Day>15</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>31</Volume><Issue>3</Issue><PubDate><Year>2016</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Neuroleptic-induced Parkinsonism: Clinicopathological study.</ArticleTitle><Pagination><MedlinePgn>360-5</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.26467</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Drug-induced parkinsonism is a well-known complication of several different drugs--the most common being neuroleptic-induced parkinsonism. However, very few autopsies have been reported in such cases.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Patients assessed at Movement Disorders Clinic Saskatchewan are offered brain autopsy. Detailed clinical records are kept.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Brains were obtained from 7 drug-induced parkinsonism patients with parkinsonian symptom onset coinciding with use of drugs known to produce parkinsonism. Six were on antipsychotics and 1 was on metoclopramide. Three cases were treated with levodopa for parkinsonism. In two cases, parkinsonian features reversed after stopping the offending agent. Both had autopsy evidence of preclinical PD. In 4 of the remaining 5, dopamine-blocking drugs were continued until death. In 4 of those 5, brain histology revealed no cause for the parkinsonism, but 1 had mild SN neuronal loss without Lewy bodies.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">This study shows that reversal of parkinsonism after discontinuing offending drugs does not indicate absence of underlying pathology. Neuroleptics can unmask preclinical PD in patients with insufficient SN damage for the disease to manifest clinically. Though the mechanism of sustained parkinsonian features after discontinuing neuroleptics remains to be established, it is unlikely that dopamine receptor block leads to retrograde SN neuronal degeneration. Furthermore, L-dopa does not appear to be toxic to SN.</AbstractText><CopyrightInformation>© 2015 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Shuaib</LastName><ForeName>Umar A</ForeName><Initials>UA</Initials><AffiliationInfo><Affiliation>Saskatchewan Movement Disorders Program, Royal University Hospital, Saskatoon, Saskatchewan, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajput</LastName><ForeName>Ali H</ForeName><Initials>AH</Initials><AffiliationInfo><Affiliation>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Robinson</LastName><ForeName>Christopher A</ForeName><Initials>CA</Initials><AffiliationInfo><Affiliation>Neuropathology, Department of Pathology, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajput</LastName><ForeName>Alex</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>12</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014150">Antipsychotic Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015259">Dopamine Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance UI="D007980">Levodopa</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Schizophr Res. 2014 Feb;152(2-3):344-9</RefSource><PMID Version="1">24369987</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Neurology. 2009 Jul 21;73(3):206-12</RefSource><PMID Version="1">19620608</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Neurology. 1967 May;17(5):427-42</RefSource><PMID Version="1">6067254</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Parkinsonism Relat Disord. 2014 Aug;20(8):808-14</RefSource><PMID Version="1">24935237</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Neurol. 1982 Oct;39(10):644-6</RefSource><PMID Version="1">6127066</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2015 May;30(6):780-5</RefSource><PMID Version="1">25801826</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Gen Psychiatry. 1992 Jul;49(7):538-44</RefSource><PMID Version="1">1352677</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):124-8</RefSource><PMID Version="1">22633343</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Int Med Res. 1980;8(5):343-6</RefSource><PMID Version="1">7418951</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Rev Neurol (Paris). 1994 Nov;150(11):757-62</RefSource><PMID Version="1">7597368</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ann Neurol. 1984 Sep;16(3):278-82</RefSource><PMID Version="1">6333204</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Klin Wochenschr. 1960 Dec 15;38:1236-9</RefSource><PMID Version="1">13726012</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2006 Jun;21(6):800-8</RefSource><PMID Version="1">16482566</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Acta Neuropathol. 2012 Jan;123(1):1-11</RefSource><PMID Version="1">22101365</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Expert Opin Drug Saf. 2013 Jul;12(4):487-96</RefSource><PMID Version="1">23540800</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Neurol. 1999 Jan;56(1):33-9</RefSource><PMID Version="1">9923759</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Adv Neurol. 1974;5:175-93</RefSource><PMID Version="1">4374061</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2002 Sep;17(5):910-6</RefSource><PMID Version="1">12360539</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2006 Apr;21(4):510-4</RefSource><PMID Version="1">16250023</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):850-4</RefSource><PMID Version="1">2900293</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Mod Treat. 1968 Mar;5(2):257-82</RefSource><PMID Version="1">5655944</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Brain. 1991 Oct;114 ( Pt 5):2283-301</RefSource><PMID Version="1">1933245</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neuropsychiatry Clin Neurosci. 1990 Winter;2(1):64-6</RefSource><PMID Version="1">1983774</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Am J Psychiatry. 1976 Aug;133(8):940-3</RefSource><PMID Version="1">782262</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 1991 Jan;54(1):30-3</RefSource><PMID Version="1">2010756</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Neurologia. 1996 Jan;11(1):10-5</RefSource><PMID Version="1">8714170</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014150" MajorTopicYN="N">Antipsychotic Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015259" MajorTopicYN="N">Dopamine Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007980" MajorTopicYN="N">Levodopa</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016631" MajorTopicYN="N">Lewy Bodies</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010302" MajorTopicYN="N">Parkinson Disease, Secondary</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013378" MajorTopicYN="N">Substantia Nigra</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">drug induced</Keyword><Keyword MajorTopicYN="N">neuroleptic-induced</Keyword><Keyword MajorTopicYN="N">parkinsonism</Keyword><Keyword MajorTopicYN="N">pathology</Keyword><Keyword MajorTopicYN="N">substantia nigra</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>06</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2015</Year><Month>09</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>10</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>12</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26660063</ArticleId><ArticleId IdType="doi">10.1002/mds.26467</ArticleId><ArticleId IdType="pmc">PMC5064745</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Canada/explor/ParkinsonCanadaV1/Data/PubMed/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000284 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/PubMed/Curation/biblio.hfd -nk 000284 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Canada
|area= ParkinsonCanadaV1
|flux= PubMed
|étape= Curation
|type= RBID
|clé= pubmed:26660063
|texte= Neuroleptic-induced Parkinsonism: Clinicopathological study.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Curation/RBID.i -Sk "pubmed:26660063" \
| HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Curation/biblio.hfd \
| NlmPubMed2Wicri -a ParkinsonCanadaV1
| This area was generated with Dilib version V0.6.29. |  |