Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-25T17:24:09.969Z Has data issue: false hasContentIssue false

The coincidence of schizophrenia and Parkinsonism: some neurochemical implications

Published online by Cambridge University Press:  09 July 2009

T. J. Crow*
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, and St Nicholas Hospital, Gosforth, Newcastle upon Tyne
Eve C. Johnstone
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, and St Nicholas Hospital, Gosforth, Newcastle upon Tyne
H. A. McClelland
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, and St Nicholas Hospital, Gosforth, Newcastle upon Tyne
*
1Address for correspondence: Dr T. J. Crow, Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ.

Synopsis

The hypothesis has recently been advanced that increased activity of central dopaminergic mechanisms underlies the symptomatology of the schizophrenias. The evidence that dopaminergic transmission in the corpus striatum is impaired in Parkinson's disease suggests that observations on the relationship between Parkinson's disease and schizophrenia may illuminate the pathophysiology of the latter disease. Four cases are reported in which an illness with schizophrenic features developed in the setting of longstanding Parkinson's disease; attention is drawn to earlier reports of schizophrenic illnesses occurring as.postencephalitic sequelae in the presence of a parkinsonian syndrome. These observations appear to conflict with the view that increased dopamine release in the striatum is necessary for the expression of schizophrenic psychopathology, but do not exclude the possibility that increased transmission may occur at other dopaminergic sites in the brain, for example the nucleus accumbens, tuberculum olfactorium or cerebral cortex. Similarly the dopamine receptor blockade hypothesis of the therapeutic effects of neuroleptic drugs cannot be maintained with respect to an action in the striatum in view of the differences between the actions of thioridazine and chlorpromazine in this structure, but may be tenable for actions at extra-striatal sites.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1976

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Andén, N. E., Dahlström, A., Fuxe, K. & Larsson, K. (1965). Further evidence for the presence of nigrostriatal dopamine neurones in the rat. American Journal of Anatomy 116, 329333.CrossRefGoogle Scholar
Bernheimer, H., Birkmayer, W., Hornykiewicz, O., Jellinger, K. & Seitelberger, F. (1965). Zur Differenzierung des Parkinson-Syndroms: biochemisch-neurohistologische Vergleichsuntersuchungen. Proceedings of the Eighth International Congress of Neurology, vol. 4, pp. 145148. Wiener Medizinische Akademie: Vienna.Google Scholar
Bertler, Å. & Rosengren, E. (1959). Occurrence and distribution of catecholamines in brain. Acta Physiologica Scandinavica 47, 350361.Google ScholarPubMed
Bishop, M. P., Gallant, D. M. & Sykes, T. F. (1965). Extrapyramidal side-effects and therapeutic response. Archives of General Psychiatry 13, 155162.CrossRefGoogle ScholarPubMed
Bunney, B. S. & Aghajanian, G. K. (1974). Differentiation between neuroleptic antipsychotic properties and side-effects by subgroups of dopaminergic neurones. Psycho-pharmacology Bulletin 10, 1718.Google Scholar
Carlsson, A. (1959). The occurrence, distribution and physiological role of catecholamines in the nervous system. Pharmacological Reviews 11, 490493.Google ScholarPubMed
Carlsson, A. & Lundqvist, M. (1963). Effect of chlorpromazine or haloperidol on formation of 3-methoxy-tyramine and normetanephrine in mouse brain. Acta Pharmacologica et Toxicologica 20, 140144.CrossRefGoogle ScholarPubMed
Chien, C. P. & Di Mascio, A. (1967). Drug-induced extrapyramidal symptoms and their relations to clinical efficacy. American Journal of Psychiatry 123, 14901498.CrossRefGoogle ScholarPubMed
Cole, J. O. et al. (1964). Phenothiazine treatment in acute schizophrenia. Archives of General Psychiatry 10, 246261.Google Scholar
Cole, J. O. & Clyde, D. J. (1961). Extrapyramidal side effects and clinical response to the phenothiazines. Revue Cana-dienne Biologie 20, 565574.Google Scholar
Crow, T. J. & Gillbe, C. (1973). Dopamine antagonism and antischizophrenic potency of neuroleptic drugs. Nature 245, 2728.Google ScholarPubMed
Crow, T. J. & Gillbe, C. (1974). Brain dopamine and behaviour: a critical analysis of the relationship between dopamine antagonism and therapeutic efficacy of neuroleptic drugs. Journal of Psychiatric Research 11, 163172.CrossRefGoogle ScholarPubMed
Deniker, P. (1960). Experimental neurological syndromes and the new drug therapies in psychiatry. Comprehensive Psychiatry 1, 92102.Google Scholar
Ehringer, H. & Hornykiewicz, O. (1960). Verteilung von Noradrenalin und Dopamin (3-Hydroxytyramin) im Gehirn des Menschen und ihr Verhalten bei Erkrankungen des Extrapyramidalen-Systems. Klinische Wochenschrift 38, 12361239.CrossRefGoogle Scholar
Fairweather, D. S. (1947). Psychiatric aspects of the postencephalitic syndrome. Journal of Mental Science 93, 201254.CrossRefGoogle Scholar
Flügel, F. (1953). Thérapeutique par médication neuro-léptique obtenue en réalisant systématiquement des états Parkinsoniformes. L'Encéphaie 45, 10901092.Google Scholar
Herman, E. & Pleasure, H. (1963). Clinical evaluation of thioridazine and chlorpromazine in chronic schizophrenia. Diseases of the Nervous System 24, 5459.Google Scholar
Hökfelt, T., Ljungdahl, Å., Fuxe, K. & Johansson, O. (1974). Dopamine nerve terminals in the rat limbic cortex: aspects of the dopamine hypothesis of schizophrenia. Science 184, 177179.CrossRefGoogle ScholarPubMed
Hollister, L. E. & Glazener, F. S. (1961). Concurrent paralysis agitans and schizophrenia. Diseases of the Nervous System 22, 187189.Google ScholarPubMed
Horn, A. S. & Snyder, S. H. (1971). Chlorpromazine and dopamine: conformational similarities that correlate with the antischizophrenic activity of phenothiazine drugs. Proceedings of the National Academy of Sciences 68, 23252328.CrossRefGoogle Scholar
Hornykiewicz, O. (1973). Dopamine in the basal ganglia: its role and therapeutic implications. British Medical Bulletin 29, 172178.CrossRefGoogle ScholarPubMed
Jackson, J. A., Free, G. B. M. & Pike, H. V. (1923). The psychic manifestations in paralysis agitans. Archives of Neurology and Psychiatry 10, 680684.CrossRefGoogle Scholar
Jelliffe, S. E. (1927). The mental pictures in schizophrenia and in epidemic encephalitis. American Journal of Psychiatry 6, 413465.CrossRefGoogle Scholar
Kelly, P., Miller, R. J. & Sahakian, B. (1974). Interaction of neuroleptic and anticholinergic drugs with central dopaminergic mechanisms. British Journal of Pharmacology 52, 430431.Google ScholarPubMed
Klawans, H. L., Goetz, C. & Westheimer, R. (1972). Pathophysiology of schizophrenia and the striatum. Diseases of the Nervous System 33, 711719.Google ScholarPubMed
McCowan, P. K. & Cook, L. C. (1928). The mental aspect of chronic epidemic encephalitis. Lancet i, 13161320.CrossRefGoogle Scholar
Matthysse, S. (1972). Discussion in ‘Prospects for Research in Schizophrenia’. Neurosciences Research Program Bulletin 10, 439445.Google Scholar
Miller, R. J. & Hiley, D. R. (1974). Relation of antimus-carinic properties of neuroleptics to drug-induced Parkinsonism. Nature 248, 596597.CrossRefGoogle Scholar
Randrup, A. & Munkvad, I. (1965). Special antagonism of amphetamine-induced abnormal behaviour. Psychopharma-cologia 7, 416422.CrossRefGoogle ScholarPubMed
Randrup, A. & Munkvad, I. (1972). Evidence indicating an association between schizophrenia and dopaminergic hyperactivity in the brain. Orthomolecular Psychiatry 1, 27.Google Scholar
Snyder, S. H. (1973). Amphetamine psychosis: a model of schizophrenia mediated by catecholamines. American Journal of Psychiatry 120, 6167.CrossRefGoogle Scholar
Snyder, S. H., Greenberg, D. & Yamamura, M. I. (1974). Antischizophrenic drugs and brain cholinergic receptors. Archives of General Psychiatry 31, 5861.CrossRefGoogle ScholarPubMed
Stevens, J. R. (1973). An anatomy of schizophrenia. Archives of General Psychiatry 29, 177189.Google Scholar
van Rossum, J. M. (1966). The significance of dopamine receptor blockade for the mechanism of action of neuroleptic drugs. Archives Internationales de Pharmacodynamic et de Thérapie 160, 492494.Google ScholarPubMed
Waldrop, R. N., Robertson, R. H. & Vourlekis, A. (1961). A comparison of the therapeutic and toxic effects of thioridazine and chlorpromazine in chronic schizophrenic patients. Comprehensive Psychiatry 2, 96105.Google Scholar