Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Psychopharmacology (Berl). 2011 Apr;214(3):729-36. doi: 10.1007/s00213-010-2079-1. Epub 2010 Nov 12.
This study aims to further evaluate the impact of family history of primary movement disorders (FHpMD) and a candidate genetic variant on risk of antipsychotic-induced extrapyramidal symptoms (EPS).
We examined 156 (76 men) inpatients receiving antipsychotics for EPS and FHpMD stratified by patient characteristics. The genetic analysis included genotyping of a multiallelic dinucleotide polymorphism in the ATP1A3 gene.
EPS lifetime prevalence was 69% and more frequent in the presence of FHpMD (p = 0.052), particularly in patients younger than 60 years (p = 0.012) and with acute dystonic reactions. The ATP1A3 polymorphism showed an allele length-dependent association with parkinsonism (p=0.019 uncorrected, p=0.057 corrected) exclusively. Carriers of the shortest allele had a 7.7-fold increased risk for parkinsonism.
The association of FHpMD and EPS may be linked to the EPS subtype and age of the patient. A common ATP1A3 genomic variation may represent a susceptibility factor for the risk for antipsychotic-induced parkinsonism in an allele-dependent manner.
本研究旨在进一步评估原发性运动障碍家族史（FHpMD）和候选遗传变异对抗精神病药引起的锥体外系症状（EPS）风险的影响。
我们根据患者特征对 156 名（76 名男性）接受抗精神病药治疗 EPS 的住院患者进行了 FHpMD 分层。基因分析包括对 ATP1A3 基因中的多等位二核苷酸多态性进行基因分型。
EPS 的终生患病率为 69%，且在存在 FHpMD 的情况下更为常见（p=0.052），尤其是在 60 岁以下的患者（p=0.012）和伴有急性张力障碍反应的患者中更为常见。ATP1A3 多态性与帕金森病呈等位基因依赖性关联（未经校正 p=0.019，校正后 p=0.057）。最短等位基因携带者患帕金森病的风险增加了 7.7 倍。
FHpMD 和 EPS 的关联可能与 EPS 亚型和患者年龄有关。常见的 ATP1A3 基因组变异可能以等位基因依赖的方式代表抗精神病药引起的帕金森病风险的易感因素。
