Parkinsonian features in a case of pellagra: a historical report

Research output: Contribution to journalArticlepeer-review

External organisations

  • Michael Trimble Neuropsychiatry Research Group
  • Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK.
  • Sobell Department of Motor Neuroscience and Movement Disorders, National Hospital of Neurology and Neurosurgery, Institute of Neurology and University College London, London, UK
  • Stroke Research Group, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.
  • Barts & London Royal London Hosp
  • School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
  • Aston University


Pellagra is a complex systemic disease resulting from inadequate dietary intake of coenzyme precursors nicotinamide and tryptophan. Improved nutritional habits in most developed economies have led to a decrease in clinicians' and researchers' attention to this condition and its pathophysiological bases, although new cases of pellagra have recently been identified in association with alcohol abuse and HIV infection in Western countries. Pellagra is characterized by a complex clinical picture, which can include neuropsychiatric symptoms and Parkinsonian features. Interestingly, pellagra and Parkinson's disease could share some basic pathophysiological mechanisms at the level of nicotinamide metabolism, resulting in mitochondrial dysfunction and alterations in dopaminergic pathways. Both neuropsychiatric and motor symptoms were mentioned in historical reports of pellagra cohorts. Here we present the English translation of the first detailed description of an original case of pellagra with Parkinsonian features, documented in a clinical note by Dr Giuseppe Paravicini one century ago.


Original languageEnglish
Pages (from-to)539-45
Number of pages7
JournalJournal of Parkinson's Disease
Issue number4
Publication statusPublished - 2013


  • History, 20th Century, Humans, Male, Middle Aged, Parkinson Disease/complications, Pellagra/complications, Sciatica/complications