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 Volume 56, Number 1, January 09, 2001
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Neurology 2001;56:8-13
© 2001 American Academy of Neurology
Articles

Welding-related parkinsonism

Clinical features, treatment, and pathophysiology B. A. Racette, MD;, L. McGee-Minnich, BSN;, S. M. Moerlein, PhD;, J. W. Mink, MD, PhD;, T. O. Videen, PhD; and J. S. Perlmutter, MD

From the Departments of Neurology and Neurological Surgery (Neurology) (Drs. Racette, Mink, Videen, Perlmutter, and L. McGee–Minnich), Pediatrics (Dr. Mink), Anatomy & Neurobiology (Drs. Mink and Perlmutter), American Parkinson Disease Association Advanced Center for Parkinson Research (Drs. Racette, Mink, Perlmutter, and L. McGee–Minnich), and the Mallinckrodt Institute of Radiology (Drs. Moerlein, Videen, and Perlmutter), Washington University School of Medicine, St. Louis, MO.

Address correspondence and reprint requests to Dr. Brad A. Racette, Washington University School of Medicine, 660 South Euclid Avenue, Box 8111, St. Louis, MO 63110; e-mail: racetteb{at}neuro.wustl.edu

Objective: To determine whether welding-related parkinsonism differs from idiopathic PD. Background: Welding is considered a cause of parkinsonism, but little information is available about the clinical features exhibited by patients or whether this is a distinct disorder. Methods: The authors performed a case-control study that compared the clinical features of 15 career welders, who were ascertained through an academic movement disorders center and compared to two control groups with idiopathic PD. One control group was ascertained sequentially to compare the frequency of clinical features, and the second control group was sex- and age-matched to compare the frequency of motor fluctuations. Results: Welders were exposed to a mean of 47,144 welding hours. Welders had a younger age at onset (46 years) of PD compared with sequentially ascertained controls (63 years; p < 0.0001). There was no difference in frequency of tremor, bradykinesia, rigidity, asymmetric onset, postural instability, family history, clinical depression, dementia, or drug-induced psychosis between the welders and the two control groups. All treated welders responded to levodopa. Motor fluctuations and dyskinesias occurred at a similar frequency in welders and the two control groups. PET with 6-[18F]fluorodopa obtained in two of the welders showed findings typical of idiopathic PD, with greatest loss in posterior putamen. Conclusions: Parkinsonism in welders is distinguished clinically only by age at onset, suggesting welding may be a risk factor for PD. These preliminary data cannot exclude a genetic contribution to susceptibility in these exposed individuals.




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Correspondence:

Read all Correspondence

Environmental toxins accelerate PD Onset
G Pezzoli, et al.
Neurology Online, 5 May 2001 [Full text]
Welding related Parkinsonism
Bernard Ravina, et al.
Neurology Online, 5 May 2001 [Full text]
Reply to Pezzoli and Canesi
B A Racette, et al.
Neurology Online, 5 May 2001 [Full text]
Letter in reply to Ravina
B A Racette, et al.
Neurology Online, 5 May 2001 [Full text]
Welding-related parkinsonism
Ahmed H Sadek, et al.
Neurology Online, 3 Jul 2001 [Full text]
Reply to Sadek
Brad A Racette, et al.
Neurology Online, 3 Jul 2001 [Full text]