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Article ; Online: The clinical and neuroimaging differences between vascular parkinsonism and Parkinson's disease: a case-control study.

George, Peter / Roushdy, Tamer / Fathy, Mai / Hamid, Eman / Ibrahim, Yosra Abdelzaher / El-Belkimy, Mahmoud / Abdulghani, Mohamed Ossama / Shalash, Ali

BMC neurology

2024  Volume 24, Issue 1, Page(s) 56

Abstract: Background: Parkinson's disease (PD) and vascular parkinsonism (VaP) have highly overlapping phenotypes, and different prognosis. This study comprehensively investigated the clinical, brain MRI and transcranial sonography differences between VaP and PD.! ...

Abstract Background: Parkinson's disease (PD) and vascular parkinsonism (VaP) have highly overlapping phenotypes, and different prognosis. This study comprehensively investigated the clinical, brain MRI and transcranial sonography differences between VaP and PD.
Methods: Forty-eight patients with PD, 27 patients with VaP, and 29 healthy controls were compared. All patients were assessed using the MDS-UPDRS, Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT), Time Up and Go Test, and Non-Motor Symptoms Scale. Beck Depression Inventory, PD questionnaire- 39, international urine incontinence scale, cognitive assessment scales, MRI brain and transcranial colour-coded doppler. The study was registered on clinical-Trial.gov (NCT04308135) on 03/12/2020.
Results: VaP patients showed significantly older age of onset, shorter disease duration, lower drug doses and levodopa responsiveness, higher On and Off axial scores, On and Off BBS, higher On scores for PIGD, rigidity, bradykinesia and total motor MDS-UPDRS, lower On and Off tremor, lower-half predominance, lower asymmetrical presentation and symmetric index than PD patients. VaP patients had worse non-motor symptoms Scale (NMSS) than controls except for perceptual problems/hallucinations but better symptoms than PD patients except for urinary dysfunction. Quality of life (QoL) was impaired in VaP patients and was correlated with motor function and NMSs. The VaP group had significantly higher white matter lesions and brain atrophy, with lower hyperechogenicity of the substantia nigra and more impaired cerebral vascular resistance and vasoreactivity than the PD group.
Conclusions: VaP has a characteristic motor and non-motor profile, with impaired QoL, white matter, and transcranial sonography abnormalities that differentiate it from PD. Further studies are warranted to explore the role of vascular lesions in the pathogenesis of VaP.
Trial registration: The registered identifier NCT04308135 on clinical-Trial.gov. Registered on 03/12/2020.
MeSH term(s) Humans ; Parkinson Disease ; Quality of Life/psychology ; Case-Control Studies ; Postural Balance ; Time and Motion Studies ; Ultrasonography, Doppler, Transcranial
Language English
Publishing date 2024-02-06
Publishing country England
Document type Journal Article
ZDB-ID 2041347-6
ISSN 1471-2377 ; 1471-2377
ISSN (online) 1471-2377
ISSN 1471-2377
DOI 10.1186/s12883-024-03556-9
Database MEDical Literature Analysis and Retrieval System OnLINE

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