Parkinson’s Disease and Metal Storage Disorders: A Systematic Review

Abstract

Metal storage disorders (MSDs) are a set of rare inherited conditions with variable clinical pictures including neurological dysfunction. The objective of this study was, through a systematic review, to identify the prevalence of Parkinsonism in patients with MSDs in order to uncover novel pathways implemented in Parkinson’s disease. Human studies describing patients of any age with an MSD diagnosis were analysed. Foreign language publications as well as animal and cellular studies were excluded. Searches were conducted through PubMed and Ovid between April and September 2018. A total of 53 publications were identified including 43 case reports, nine cross-sectional studies, and one cohort study. The publication year ranged from 1981 to 2018. The most frequently identified MSDs were Pantothenate kinase-associated neurodegeneration (PKAN) with 11 papers describing Parkinsonism, Hereditary hemochromatosis (HH) (7 papers), and Wilson’s disease (6 papers). The mean ages of onset of Parkinsonism for these MSDs were 33, 53, and 48 years old, respectively. The Parkinsonian features described in the PKAN and HH patients were invariably atypical while the majority (4/6) of the Wilson’s disease papers had a typical picture. This paper has highlighted a relationship between MSDs and Parkinsonism. However, due to the low-level evidence identified, further research is required to better define what the relationship is.

Idiopathic brain calcification in a patient with hereditary hemochromatosis

“…While not pathologically proven, the CT hyperattenuation in this case is most consistent with calcification, as previously reported in common clinical practice and in the literature [3,10]. It is difficult to find CT-pathologic correlation in the literature for HH and brain iron accumulation, which may in part be because some or most brain iron accumulation do not demonstrate calcification [12,16].…”

Behavioral, Biochemical and Histopathological effects of Standardised Pomegranate extract with Vinpocetine, Propolis or Cocoa in a rat model of Parkinson’s disease

“…But yet the complex multifactorial mechanisms of parkinsonism are not fully understood so far. It has been proposed previously that Manganese can cause severe neurological damage [1]. Parkinsonism is defined as the presence of bradykinesia, rest tremor and rigidity.…”

Drug-Resistant Parkinson’s Disease in a Patient With Hereditary Hemochromatosis: A Case Report

“…Atypical syndromes can involve psychiatric disturbances, as well as difficulties with gaze, autonomic function, and sensation. A 2018 systematic review of 50 papers found seven papers describing both typical and atypical Parkinsonian symptoms associated with HH [ 12 ]. These studies were also all associated with Parkinsonian symptoms that were unresponsive to treatment with traditional pharmacologic therapy such as levodopa [ 12 ].…”

“…A 2018 systematic review of 50 papers found seven papers describing both typical and atypical Parkinsonian symptoms associated with HH [ 12 ]. These studies were also all associated with Parkinsonian symptoms that were unresponsive to treatment with traditional pharmacologic therapy such as levodopa [ 12 ]. This pattern was corroborated in our patient, where dopamine agonists and levodopa-carbidopa did not alleviate his neurological symptoms.…”