Parkinsonism in neuroleptic-naive schizophrenic patients

Am J Psychiatry. 1993 Sep;150(9):1343-8. doi: 10.1176/ajp.150.9.1343.

Abstract

Objective: Previous studies in schizophrenia have identified abnormalities involving the basal ganglia, but the contribution of neuroleptics to the motor system abnormalities in schizophrenia is usually a confounding factor. This study addressed the issue of whether parkinsonism, a reflection of dopaminergic hypofunction, occurs in schizophrenia per se.

Method: Clinical ratings and quantitative instrumental measures of parkinsonian rigidity, tremor, and bradykinesia were obtained in 24 neuroleptic-naive schizophrenic patients and 24 age- and gender-matched comparison subjects.

Results: According to the clinical ratings, 21% of the schizophrenic patients had rigidity and 12% had bradykinesia, in contrast to none of the normal comparison subjects. With the use of instrumental measures, rigidity and tremor were observed in 29% and 37%, respectively, of the schizophrenic patients, compared to 4% and none in the normal comparison group. The schizophrenic patients also exhibited greater right-side than left-side parkinsonism.

Conclusions: The findings suggest that extrapyramidal motor signs may be part of schizophrenia proper and that some patients with schizophrenia have left striatal hypodopaminergia unrelated to neuroleptic treatment.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Basal Ganglia Diseases / diagnosis
  • Basal Ganglia Diseases / physiopathology
  • Brain / physiopathology
  • Dopamine / physiology
  • Female
  • Functional Laterality / physiology
  • Humans
  • Male
  • Middle Aged
  • Neurologic Examination
  • Parkinson Disease / complications
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology
  • Psychiatric Status Rating Scales
  • Schizophrenia / complications*
  • Schizophrenia / diagnosis
  • Schizophrenia / physiopathology
  • Schizophrenic Psychology
  • Severity of Illness Index

Substances

  • Dopamine