Epidemiology and Pathophysiology of Parkinsonism in the Caribbeans

  • End date
    Aug 3, 2023
  • participants needed
  • sponsor
    Centre Hospitalier Universitaire de Pointe-a-Pitre
Updated on 21 January 2021


The primary aim of this study is to estimate the frequency and to characterize clinically atypical parkinsonism in the French West Indies and Guyana.


An atypical akineto-rigid parkinsonian syndrome, unresponsive to L-dopa has been evidenced in Guadeloupe. Abnormally frequent, this progressive supranuclear palsy (PSP)-like syndrome represents a new clinical entity. Unlike in classical PSP 70% of patients have myoclonus, 59% hallucinations, 78% REM sleep behavior disorders. Oculomotor pattern differs from classical PSP suggesting that cortical dysfunction predominates over brainstem impairments. Neuropathological examination in four patients has shown a widespread accumulation of the tau protein in the basal ganglia, the midbrain and cortical areas.

This syndrome has been associated to the regular consumption of food products derived from plants of the Annonaceae family, more specifically Annona Muricata (soursop), suggesting a toxic origin. We have already confirmed the neurotoxic potential of the lipophilic mitochondrial complex I inhibitor annonacin, the major acetogenin in Annona muricata. This class of compounds is specific to Annonaceae. Nanomolar concentrations of annonacin induce the death of dopaminergic neurons in culture, by impairment of energy production. Chronic systemic intoxication of rats with annonacin causes neuronal damage in the same brain regions that are damaged in patients with atypical parkinsonism. These results greatly suggest that the consumption of annonacea might contribute to the pathogenesis of the disease. The H1 subhaplotype in tau gene associated with PSP in Caucasians did not confer risk for PSP-like atypical parkinsonism in Guadeloupe.

Condition Atypical Parkinsonism
Treatment Clinical and biological exam
Clinical Study IdentifierNCT03368300
SponsorCentre Hospitalier Universitaire de Pointe-a-Pitre
Last Modified on21 January 2021


Yes No Not Sure

Inclusion Criteria

Pour les patients
Patient ou tiers responsable ayant reu une information sur l'tude et ayant sign le consentement clair
Patient g de plus de 18 ans
Patient consultant en neurologie ou en griatrie pour symptomatologie parkinsonienne ou pour troubles cognitifs vocateurs d'une dmence corps de Lewy
Patient domicili aux Antilles-Guyane
Pour les tmoins
\. Conjoint ou accompagnant ayant reu une information sur l'tude et ayant
sign le consentement clair
\. Personne ge de plus de 18 ans
\. Personne ne prsentant pas de pathologie d'allure neurodgnrative
(Parkinson, dmence notamment)
\. Personne domicilie aux Antilles-Guyane

Exclusion Criteria

Pour les patients
Syndrome parkinsonien secondaire (post-traumatique, vasculaire, iatrogne, post encphalitique)
Patient non affili au rgime de scurit sociale
En cas de difficult de suivi le patient sera exclu de l'tude longitudinale
Pour les tmoins
Personnes prsentant des troubles cognitifs ou un syndrome parkinsonien diagnostiqu
Patient non affili au rgime de scurit sociale -
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