Atypical parkinsonian syndromes in a North African tertiary referral center
Abstract Introduction Data on epidemiology of atypical parkinsonian syndromes (APS) in North African countries are limited. Our objective was to study the epidemiological features of APS in a Tunisian population. Methods We conducted a 17‐year retrospective cross‐sectional descriptive study in the D...
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doaj-bcc78200ee4e48c5bda4a18e41fa3bc72021-10-07T11:31:04ZengWileyBrain and Behavior2162-32792021-01-01111n/an/a10.1002/brb3.1924Atypical parkinsonian syndromes in a North African tertiary referral centerAmina Nasri0Mouna Ben Djebara1Ikram Sghaier2Saloua Mrabet3Sabrina Zidi4Amina Gargouri5Imen Kacem6Riadh Gouider7Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaNeurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health" Razi University Hospital Tunis TunisiaAbstract Introduction Data on epidemiology of atypical parkinsonian syndromes (APS) in North African countries are limited. Our objective was to study the epidemiological features of APS in a Tunisian population. Methods We conducted a 17‐year retrospective cross‐sectional descriptive study in the Department of Neurology at Razi University Hospital. We included all patients responding to consensus diagnosis criteria of APS. We recorded demographic and clinical data. Group differences were assessed with a post hoc ANOVA with a Bonferroni error correction. Results We included 464 APS patients. Hospital prevalence of APS among all parkinsonism cases was 20.6%. Mean annual increase of incidence defined as newly diagnosed APS cases per year reached 38.8%/year. APS were divided into 4 etiological subgroups: dementia with Lewy bodies (DLB; 56.7%); progressive supranuclear palsy(PSP; 16.2%); multiple system atrophy (MSA; 14.6%); and finally corticobasal syndrome (CBS; 12.5%). Sex‐ratio was 1.2. This male predominance was found in all subgroups except MSA (p = .013). Mean age at onset was 68.5 years, most belated in DLB (69.7 years; p < .001). Young‐onset parkinsonism (<40 years) was found only in MSA subgroup (p = .031). Parkinsonism was of late onset (>70 years) in 50.7% of patients and was significantly associated with DLB subgroup (p = .013). Inaugural parkinsonism was associated with CBS and MSA (p = .0497), and gait disorders at disease onset were associated with PSP and MSA (p = .0062). Cognitive and mood disorders were more marked in DLB and most preserved in MSA. Consanguinity was more marked in CBS (p = .037), and family history of dementia and psychiatric diseases was more common in DLB. Thirty‐seven families with similar cases of APS were identified. Conclusions This is the largest African epidemiological study on APS. In our population, APS were frequent and dominated by DLB. The age of onset of parkinsonism was the most decisive feature for differential diagnosis.https://doi.org/10.1002/brb3.1924atypical parkinsonismepidemiologyParkinson's disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amina Nasri Mouna Ben Djebara Ikram Sghaier Saloua Mrabet Sabrina Zidi Amina Gargouri Imen Kacem Riadh Gouider |
spellingShingle |
Amina Nasri Mouna Ben Djebara Ikram Sghaier Saloua Mrabet Sabrina Zidi Amina Gargouri Imen Kacem Riadh Gouider Atypical parkinsonian syndromes in a North African tertiary referral center Brain and Behavior atypical parkinsonism epidemiology Parkinson's disease |
author_facet |
Amina Nasri Mouna Ben Djebara Ikram Sghaier Saloua Mrabet Sabrina Zidi Amina Gargouri Imen Kacem Riadh Gouider |
author_sort |
Amina Nasri |
title |
Atypical parkinsonian syndromes in a North African tertiary referral center |
title_short |
Atypical parkinsonian syndromes in a North African tertiary referral center |
title_full |
Atypical parkinsonian syndromes in a North African tertiary referral center |
title_fullStr |
Atypical parkinsonian syndromes in a North African tertiary referral center |
title_full_unstemmed |
Atypical parkinsonian syndromes in a North African tertiary referral center |
title_sort |
atypical parkinsonian syndromes in a north african tertiary referral center |
publisher |
Wiley |
series |
Brain and Behavior |
issn |
2162-3279 |
publishDate |
2021-01-01 |
description |
Abstract Introduction Data on epidemiology of atypical parkinsonian syndromes (APS) in North African countries are limited. Our objective was to study the epidemiological features of APS in a Tunisian population. Methods We conducted a 17‐year retrospective cross‐sectional descriptive study in the Department of Neurology at Razi University Hospital. We included all patients responding to consensus diagnosis criteria of APS. We recorded demographic and clinical data. Group differences were assessed with a post hoc ANOVA with a Bonferroni error correction. Results We included 464 APS patients. Hospital prevalence of APS among all parkinsonism cases was 20.6%. Mean annual increase of incidence defined as newly diagnosed APS cases per year reached 38.8%/year. APS were divided into 4 etiological subgroups: dementia with Lewy bodies (DLB; 56.7%); progressive supranuclear palsy(PSP; 16.2%); multiple system atrophy (MSA; 14.6%); and finally corticobasal syndrome (CBS; 12.5%). Sex‐ratio was 1.2. This male predominance was found in all subgroups except MSA (p = .013). Mean age at onset was 68.5 years, most belated in DLB (69.7 years; p < .001). Young‐onset parkinsonism (<40 years) was found only in MSA subgroup (p = .031). Parkinsonism was of late onset (>70 years) in 50.7% of patients and was significantly associated with DLB subgroup (p = .013). Inaugural parkinsonism was associated with CBS and MSA (p = .0497), and gait disorders at disease onset were associated with PSP and MSA (p = .0062). Cognitive and mood disorders were more marked in DLB and most preserved in MSA. Consanguinity was more marked in CBS (p = .037), and family history of dementia and psychiatric diseases was more common in DLB. Thirty‐seven families with similar cases of APS were identified. Conclusions This is the largest African epidemiological study on APS. In our population, APS were frequent and dominated by DLB. The age of onset of parkinsonism was the most decisive feature for differential diagnosis. |
topic |
atypical parkinsonism epidemiology Parkinson's disease |
url |
https://doi.org/10.1002/brb3.1924 |
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