BACKGROUND: Manganese is known to cause a parkinsonian syndrome similar clinically to Parkinson disease (PD). L-Dopa responsiveness is a hallmark of PD; however, L-dopa's effect on manganese-induced parkinsonism is not well defined. OBJECTIVE: To access the efficacy and safety of L-dopa therapy in a double-blind, randomized, placebo-controlled trial. METHODS:Thirteen patients with manganese-induced parkinsonism were evaluated in a cross-over study with a modified Unified PD Rating Scale (UPDRS), timed walk test, tapping, and global clinical impression scores. Adverse reactions were assessed. RESULTS: There was no significant difference between placebo and L-dopa for any measure: motor UPDRS, 27.4 vs 28.8; walk time, 16.6 seconds vs 17.7 seconds; tapping right hand, 69.5 vs 64.7; and tapping left hand, 66.8 vs 64.4. There were no differences in the global impression scores. Adverse reactions occurred similarly in the two groups, including headaches, drowsiness, and diarrhea. CONCLUSIONS:L-Dopa therapy is not effective for the management of parkinsonism in welders. L-dopa unresponsiveness may be useful to distinguish manganese-induced parkinsonism from Parkinson disease.
RCT Entities:
BACKGROUND:Manganese is known to cause a parkinsonian syndrome similar clinically to Parkinson disease (PD). L-Dopa responsiveness is a hallmark of PD; however, L-dopa's effect on manganese-induced parkinsonism is not well defined. OBJECTIVE: To access the efficacy and safety of L-dopa therapy in a double-blind, randomized, placebo-controlled trial. METHODS: Thirteen patients with manganese-induced parkinsonism were evaluated in a cross-over study with a modified Unified PD Rating Scale (UPDRS), timed walk test, tapping, and global clinical impression scores. Adverse reactions were assessed. RESULTS: There was no significant difference between placebo and L-dopa for any measure: motor UPDRS, 27.4 vs 28.8; walk time, 16.6 seconds vs 17.7 seconds; tapping right hand, 69.5 vs 64.7; and tapping left hand, 66.8 vs 64.4. There were no differences in the global impression scores. Adverse reactions occurred similarly in the two groups, including headaches, drowsiness, and diarrhea. CONCLUSIONS:L-Dopa therapy is not effective for the management of parkinsonism in welders. L-dopa unresponsiveness may be useful to distinguish manganese-induced parkinsonism from Parkinson disease.
Authors: Michael Aschner; Keith M Erikson; Elena Herrero Hernández; Elena Herrero Hernández; Ronald Tjalkens Journal: Neuromolecular Med Date: 2009 Impact factor: 3.843
Authors: Rosemarie M Bowler; Harry A Roels; Sanae Nakagawa; Marija Drezgic; Emily Diamond; Robert Park; William Koller; Russell P Bowler; Donna Mergler; Maryse Bouchard; Donald Smith; Roberto Gwiazda; Richard L Doty Journal: Occup Environ Med Date: 2006-10-03 Impact factor: 4.402
Authors: Michael Nelson; Turkesha Huggins; Roshney Licorish; Margaret A Carroll; Edward J Catapane Journal: Comp Biochem Physiol C Toxicol Pharmacol Date: 2010-03 Impact factor: 3.228
Authors: Dinamene Santos; M Camila Batoreu; Michael Aschner; Ana P Marreilha dos Santos Journal: Biol Trace Elem Res Date: 2013-01-15 Impact factor: 3.738