Savica Rodolfo, Grossardt Brandon R, Bower James H, Ahlskog J Eric, Mielke Michelle M, Rocca Walter A
Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
Mov Disord. 2017 Feb;32(2):227-234. doi: 10.1002/mds.26839. Epub 2016 Oct 25.
Epidemiological studies of drug-induced parkinsonism remain limited.
To investigate the incidence and time trends of drug-induced parkinsonism over 30 years in a geographically defined American population.
We used the medical records-linkage system of the Rochester Epidemiology Project to identify all persons in Olmsted County, Minnesota, who received a screening diagnostic code for parkinsonism from 1976 through 2005. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of drug-induced parkinsonism associated with dopamine-blocking or dopamine-depleting medications.
Among 906 incident cases of parkinsonism from 1976 to 2005, 108 persons had drug-induced parkinsonism (11.9%). The average annual incidence rate of drug-induced parkinsonism was 3.3 per 100,000 person-years, was higher in women, and increased with older age. Drug-induced parkinsonism was the fifth-most common type of parkinsonism overall; however, it was the most common type among persons younger than age 40 years. Typical antipsychotic drugs were the most common class of drugs associated with parkinsonism, whereas atypical antipsychotic drugs were rarely involved. The incidence rate of drug-induced parkinsonism decreased 32.0% per decade (relative risk = 0.68; 95% confidence interval: 0.49-0.94) and 68.6% over the 30 years of the study. The decrease was similar in men (65.2%) and women (69.4%); however, the trend was significant only in women.
The incidence of drug-induced parkinsonism increased with older age and was higher in women at all ages. Typical antipsychotic drugs were the most common cause. The incidence of drug-induced parkinsonism decreased over the 30 years of the study because of changes in drug use. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
药物性帕金森综合征的流行病学研究仍然有限。
调查在一个地理区域界定明确的美国人群中，30年间药物性帕金森综合征的发病率及时间趋势。
我们利用罗切斯特流行病学项目的医疗记录链接系统，确定明尼苏达州奥尔姆斯特德县1976年至2005年期间所有接受帕金森综合征筛查诊断编码的人。一名运动障碍专家查阅了每个人的完整医疗记录，以确认是否存在与多巴胺阻断或多巴胺耗竭药物相关的药物性帕金森综合征。
在1976年至2005年的906例帕金森综合征新发病例中，108人患有药物性帕金森综合征（11.9%）。药物性帕金森综合征的平均年发病率为每10万人年3.3例，女性发病率更高，且随年龄增长而增加。药物性帕金森综合征是总体上第五大最常见的帕金森综合征类型；然而，它是40岁以下人群中最常见的类型。典型抗精神病药物是与帕金森综合征相关的最常见药物类别，而非典型抗精神病药物很少涉及。药物性帕金森综合征的发病率每十年下降32.0%（相对风险=0.68；95%置信区间：0.49 - 0.94），在30年的研究期间下降了68.6%。男性（65.2%）和女性（69.4%）的下降情况相似；然而，该趋势仅在女性中具有统计学意义。
药物性帕金森综合征的发病率随年龄增长而增加，且在各年龄段女性中均更高。典型抗精神病药物是最常见的病因。由于药物使用的变化，在30年的研究期间药物性帕金森综合征的发病率有所下降。© 2016作者。《运动障碍》由威利期刊公司代表国际帕金森和运动障碍协会出版。
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