Manganese toxicity, dopaminergic dysfunction and hepatic encephalopathy

被引:134
作者
Butterworth, RF
Spahr, L
Fontaine, S
Layrargues, GP
机构
[1] UNIV MONTREAL,LIVER UNIT,HOP ST LUC,MONTREAL,PQ H2X 3J4,CANADA
[2] UNIV MONTREAL,DEPT RADIOL,HOP ST LUC,MONTREAL,PQ H2X 3J4,CANADA
关键词
manganese; hepatic encephalopathy; MR signal hyperintensity; globus pallidus; dopamine D-2 receptors; MAO; extrapyramidal symptoms;
D O I
10.1007/BF02109357
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with chronic liver disease manifest a high incidence (>75%) of pallidal signal hyperintensity on T-1-weighted Magnetic Resonance Imaging (MRI), the intensity of which correlates with blood manganese levels and the presence of extrapyramidal symptoms. A major cause of pallidal hyperintensity on T-1-weighted MRI is manganese deposition; chronic manganese intoxication in the absence of liver disease results in pallidal MR signal hyperintensity, in extrapyramidal symptoms and in selective effects on the dopaminergic neurotransmitter system in basal ganglia. Direct measurements in globus pallidus obtained at autopsy from patients with chronic liver disease who died in hepatic coma reveal 2 to 7-fold increases of pallidal manganese and a concomitant loss of dopamine D-2 binding sites. Liver transplantation results in normalization of pallidal MR signals and of blood manganese levels. These findings suggest that (1) pallidal MR signal hyperintensity in patients with chronic liver disease is the result of manganese deposition and (2) alterations of dopaminergic function due to the toxic effects of manganese may contribute to the extrapyramidal symptoms in these patients.
引用
收藏
页码:259 / 267
页数:9
相关论文
共 37 条
  • [11] HOOGENRAAD TU, 1995, Z GASTROENTEROL, V486
  • [12] PORTAL-SYSTEMIC ENCEPHALOPATHY - PRESENCE OF BASAL GANGLIA LESIONS WITH HIGH SIGNAL INTENSITY ON MR IMAGES
    INOUE, E
    HORI, S
    NARUMI, Y
    FUJITA, M
    KURIYAMA, K
    KADOTA, T
    KURODA, C
    [J]. RADIOLOGY, 1991, 179 (02) : 551 - 555
  • [13] KULISEVSKY J, 1991, AM J NEURORADIOL, V12, P527
  • [14] PALLIDAL HYPERINTENSITY ON MAGNETIC-RESONANCE-IMAGING IN CIRRHOTIC-PATIENTS - CLINICAL CORRELATIONS
    KULISEVSKY, J
    PUJOL, J
    BALANZO, J
    JUNQUE, C
    DEUS, J
    CAPDEVILLA, A
    VILLANUEVA, C
    [J]. HEPATOLOGY, 1992, 16 (06) : 1382 - 1388
  • [15] LAYRARGUES GP, 1995, LANCET, V345, P735
  • [16] LAYRARGUES GP, 1995, METAB BRAIN DIS, V10, P351
  • [17] THE REGIONAL DISTRIBUTION OF MONOAMINE-OXIDASE ACTIVITIES TOWARDS DIFFERENT SUBSTRATES - EFFECTS IN RAT-BRAIN OF CHRONIC ADMINISTRATION OF MANGANESE CHLORIDE AND OF AGING
    LEUNG, TKC
    LAI, JCK
    LIM, L
    [J]. JOURNAL OF NEUROCHEMISTRY, 1981, 36 (06) : 2037 - 2043
  • [18] RAT STRIATAL DOPAMINE AND TETRAHYDROBIOPTERIN CONTENT FOLLOWING AN INTRASTRIATAL INJECTION OF MANGANESE CHLORIDE
    LISTA, A
    ABARCA, J
    RAMOS, C
    DANIELS, AJ
    [J]. LIFE SCIENCES, 1986, 38 (23) : 2121 - 2127
  • [19] ALTERED CEREBRAL BLOOD-FLOW AND GLUCOSE-METABOLISM IN PATIENTS WITH LIVER-DISEASE AND MINIMAL ENCEPHALOPATHY
    LOCKWOOD, AH
    YAP, EWH
    RHOADES, HM
    WONG, WH
    [J]. JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 1991, 11 (02) : 331 - 336
  • [20] CHRONIC MANGANESE POISONING - CLINICAL PICTURE AND MANGANESE TURNOVER
    MENA, I
    MARIN, O
    FUENZALIDA, S
    COTZIAS, GC
    [J]. NEUROLOGY, 1967, 17 (02) : 128 - +