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Neurobehavioral performance of patients diagnosed with manganism and idiopathic Parkinson disease

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Abstract

Purpose

There is a lack of knowledge about neurobehavioral performance among patients with manganism and how their performance differs from that of idiopathic Parkinson disease patients (PD). This study was initiated with the aim to describe and compare neurobehavioral performance among patients diagnosed with manganism, PD and a group of referents.

Materials and methods

Neurobehavioral performance was assessed in 34 patients diagnosed with manganism, 13 with PD, and 43 healthy workers (turners/fitters) who served as the reference group. Seventeen of the manganism patients had also been tested approximately 65 months previously.

Results

Manganism patients scored substantially more poorly than referents on tests for motor speed, manual dexterity and balance. They also performed more poorly than the PD patients on the postural sway test. In contrast, the PD patients had higher postural tremor intensity with narrower frequency dispersion than manganism patients. The pattern of neurobehavioral performance was more asymmetrical in PD compared to manganism patients, in particular when testing for tremor intestity, grooved pegboard and static steadiness, indicating lateralized impairment in the PD patients. The amount of bradykinesia was comparable between the patient groups. Neurobehavioral performance deteriorated slightly among 17 manganism patients followed for 65 months compared with the age-related decline among referents.

Conclusions

Patients with manganism had severe bradykinesia and balance disturbances, but only slight postural tremor. In contrast, PD patients had significant postural tremor and bradykinesia, but only slight balance disturbances. Their neurobehavioral performance indicated lateralized impairment, more unilateral. Neurobehavioral performance deteriorated slightly in manganism patients during a 65-month follow-up.

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Acknowledgements

The study was supported by Grant Number W81XWH-05-1-0239 from the National Institutes of Health, the United States Department of Defense, and the United States Army Medical Research and Materiel Command through Vanderbilt University. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health, the United States Department of Defense, the United States Army Medical Research and Materiel Command or Vanderbilt University.

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Correspondence to Dag G. Ellingsen.

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The study was approved by the Norwegian Regional Ethical Committee for Medical Research (REK2), the Ethics Committee of the NWPHRC (St. Petersburg, Russia), and the Office of Research Protection, US Army Medical Research and Materiel Command (Fort Detrick, MD, USA). Participation was voluntary. Informed written consent was obtained from each participant.

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Ellingsen, D.G., Shvartsman, G., Bast-Pettersen, R. et al. Neurobehavioral performance of patients diagnosed with manganism and idiopathic Parkinson disease. Int Arch Occup Environ Health 92, 383–394 (2019). https://doi.org/10.1007/s00420-019-01415-6

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