Characteristic of neuropsychological deficits in patients diagnosed with manganese encephalopathy due to ephedrone use - case series analysis.

Agnieszka Kałwa

doi:10.12740/pp/105420

Abstract

The study presents neuropsychological characteristic of 16 individuals with manganese-induced parkinsonism due to intravenous ephedrone use. Overall cognitive function screening as well as full examination of various cognitive domains (verbal learning, visual memory, working memory, executive functions, construction and visuospatial functions) with the use of elastic neuropsychological test battery were performed. Dyshartric speech disorders were also precisely evaluated. Additionally, all individuals filled in the Beck Depression Inventory (BDI), which is used to assess mood. All patients had evident dysarthric speech disorders accompanied with palilalia and writing disorders (micrographia) in the majority of investigated individuals. Neuropsychological screening diagnosis showed no overall cognitive deficits at the level of dementia. Mild decrease in verbal learning and visual memory processes was found; as well as ideomotor but no construction praxis disorders. Results of working memory and executive function assessment indicated decrease in cognitive flexibility and logical conceptualization abilities, as well as set-shifting disorders. Patients varied significantly in their severity of executive dysfunction. Duration of ephedrone use was found nonsignificant for patients' cognition. The mean BDI score indicated moderate depression. Higher level of depressive symptoms was associated with poorer overall cognitive screening, decrease of visual and verbal learning as well as phonemic verbal fluency.

Highlights

Manganese encephalopathy [1] manifests with neurological symptoms occurring due to exposure to neurotoxic influence of manganese on the central nervous system (CNS).The disease occurs in individuals exposed to higher manganese con
Manganese neurotoxicity manifests itself in serious manganese encephalopathy symptoms, e.g., body posture and speech disorders which usually appear after 5–9 months of exposure [5, 6]
The results suggested global cognitive function decrease in some patients and no such disorders in others

Summary

Introduction

Manganese encephalopathy [1] manifests with neurological symptoms occurring due to exposure to neurotoxic influence of manganese on the central nervous system (CNS).The disease occurs in individuals exposed to higher manganese con-Agnieszka Kałwa centrations in environmental circumstances (e.g., in residents of areas of industrial manganese use or industrial workers). Manganese encephalopathy symptoms has been found in intravenous ephedrone users, accessing it in a process of home-made drug production. The first mention of such individuals appeared over 20 years ago in Russian studies on patients from ex-USRR states and the neighboring countries [2, 3]. This problem seems rare it still might be relevant in a population of drug users all over the world. Manganese neurotoxicity manifests itself in serious manganese encephalopathy symptoms, e.g., body posture and speech disorders which usually appear after 5–9 months of exposure [5, 6]

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Discussion

Conclusion