ArticleAnnals of clinical and translational neurology2025
Clinical Characteristics of Parkinsonism in HTLV-1-Associated Myelopathy.
Article in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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9 authors.
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Abstract
objectiveHuman T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the classic neurological manifestation of HTLV-1 infection; however, this virus has also been associated with other neurological disorders. Concurrent parkinsonism is relatively rare and presents diagnostic challenges. The present study aimed to identify the clinical characteristics of HAM/TSP with parkinsonism.
methodsThis retrospective study included HAM/TSP patients hospitalized in Kagoshima University Hospital from January 2000 to March 2022. Clinical and laboratory findings of the HAM/TSP patients with parkinsonism (P-HAM) were collected from the medical records and compared with HAM/TSP patients without parkinsonism (typical HAM/TSP [T-HAM]). P-HAM cases were defined as patients presenting with any combination of rigidity, resting tremor, bradykinesia, and/or postural instability, with these symptoms not attributed to HAM/TSP.
resultsOf 246 HAM/TSP patients, 11 (4.5%) presented with parkinsonism. Compared with T-HAM, the age of onset was significantly older (65.0 vs. 48.8 years, p = 0.001) in patients with P-HAM. Moreover, despite a shorter illness duration (8.5 vs. 12.5 years, p = 0.151), the Osame Motor Disability Score was significantly higher in P-HAM cases than in T-HAM cases (6.3 vs. 4.6, p = 0.0132), and all P-HAM cases had scores ≥ 4. Laboratory findings showed no differences between the groups.
interpretationIn our cohort, 4.5% of HAM/TSP patients had concomitant parkinsonism, which was associated with a later age of onset and greater disease severity. The coexistence of parkinsonism in HAM/TSP may be underrecognized, and our findings expand the clinical spectrum of neurological disease with HTLV-1 infection.
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