Caudate Hyperintensities in Elderly Depressed Patients With Neuroleptic-Induced Parkinsonism

Abstract

Elderly patients are particularly sensitive to the neurologic side effects of psychotropic medications. This increased sensi tivity may be related to brain structural changes associated with aging. In this pilot study, the authors report on the oc currence of caudate hyperintensities, using brain magnetic resonance imaging, in seven elderly depressed subjects who developed neuroleptic-induced parkinsonism. Caudate hyperintensities were not observed in any of the seven healthy elderly controls examined. These results suggest that caudate hyperintensities may render some elderly depressed pa tients susceptible to neuroleptic-induced parkinsonism. (J Geriatr Psychiatry Neurol 1991;4:86-89).

Get full access to this article

View all access options for this article.

References

Salzman C. : Clinical Geriatric Psychopharmacology. New York, McGraw-Hill, 1984, pp 4-5.

Figiel GS , Coffey CE , Djang WT , et al: Brain magnetic resonance imaging findings in ECT-induced delirium . J Neuropsychiatry Clin Neurosci 1990;2:53-58.

Figiel GS , Krishnan Krr , Breitner JC , et al: Radiologic correlates of antidepressant-induced delirium: The possible significance of basal-ganglia lesions. J Neuropsychiatry Clin Neurosci 1989;1:188-190.

Figiel GS , Krishnan Krr , Doraiswamy PM : Subcortical structural changes in ECT induced delirium. J Geriatr Psychiatry Neurol 1990;3:172-176.

Botteron K. , Figiel GS , Zorumski CF : Electroconvulsive therapy in patients with late age onset psychoses and structural brain changes. J Geriatr Psychiatry Neurol, in press.

Cummings JL : Clinical Neuropsychiatry. Orlando, FL, Grune & Stratton, 1985, p 144.

Yahr MD , Bergmann KJ : Parkinsonism and its treatment, in Jeste DV , Wyatt RJ (eds): Neuropsychiatric movement disorders. Washington, DC, American Psychiatric Press, 1984, pp 1-17.

Coffey CE , Figiel GS , Djang WT , et al: Leukoencephalopathy in elderly depressed patients referred for ECT. Biol Psychiatry 1988;24:143-161.

Coffey CE , Figiel GS , Djang WT , et al: White matter hyperintensity on magnetic resonance imaging: Clinical and neuroanatomic correlates in the depressed elderly. J Neuropsychiatry Clin Neurosci 1989;1:135-144.

10.

Figiel GS , Coffey CE , Weiner RD : Brain magnetic resonance imaging in elderly depressed patients receiving electroconvulsive therapy. Convulsive Ther 1989;5:26-34.

11.

Coffey CE , Figiel GS , Djang WT , et al: Subcortical hyperintensity on magnetic resonance imaging: A comparison of normal and depressed elderly subjects. Am J Psychiatry 1990;147: 187-189.

12.

Figiel GS , Krishnan Krr , Doraiswamy PM , et al: Subcortical hyperintensities on brain magnetic resonance imaging: A comparison between late age onset and early onset elderly depressed subjects . Neurobiol Aging, 1991;12:245-247.

13.

Jungreis CA , Kanal E. , Hirsch WL , et al: Normal perivascular spaces mimicking lacunar infarction. Radiology 1988;169:101-104.

14.

Cote L. , Crutcher MD : Motor functions of the basal ganglia and diseases of transmitter metabolism , in Kandel ER , Schwartz JH (eds): Principles of Neural Science, 2nd ed. New York, Elsevier , 1985, pp 523-535.

15.

Sethi KD , Zamrini EY : Asymmetry in clinical features of drug induced parkinsonism. J Neuropsychiatry Clin Neurosci 1990;2:64-66.

16.

Roman GC : Senile dementia of the Binswanger type: A vascular form of dementia in the elderly. JAMA 1987;258:1782-1788.

17.

Figiel GS , Krishnan R. , Doraiswamy PM , et al: Brain MRI subcortical structural changes in late age onset depression . Biol Psychiatry 1990;27:61A.

18.

Starkstein SE , Robinson RG , Price TR : Comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain 1987;110:1045-1059.