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A 49-year-old man without a family history of neuropsychiatric diseases was admitted to the Department of Psychiatry 1 year after first developing depressed mood, feelings of despair, insomnia, fatigue and poor concentration, without other neuropsychiatric signs or symptoms, which had led to a diagnosis of depression. Despite receiving antidepressants for 3 months, the symptoms had not improved. On admission, neurological examination revealed decreased cognition, mask-like face, positive glabellar reflex, tongue tremor, four-limb cogwheel rigidity, wide-base short steps …
Handling editor Anna Maria Geretti
KG and CJ contributed equally.
Contributors KG and CJ collected the data and drafted the manuscript. ZH revised the manuscript. ZD conceptualised and revised the manuscript.
Funding This work was supported by the Key R&D Projects of Science and Technology, Department of Sichuan Province (grant no. 2019YFS0217).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.