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Open Access 01-12-2024 | Research

The clinical and neuroimaging differences between vascular parkinsonism and Parkinson’s disease: a case-control study

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

Published in: BMC Neurology | Issue 1/2024

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.

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Title: The clinical and neuroimaging differences between vascular parkinsonism and Parkinson’s disease: a case-control study
Authors: Peter George
Tamer Roushdy
Mai Fathy
Eman Hamid
Yosra Abdelzaher Ibrahim
Mahmoud El-Belkimy
Mohamed Ossama Abdulghani
Ali Shalash
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2024
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-024-03556-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The clinical and neuroimaging differences between vascular parkinsonism and Parkinson’s disease: a case-control study

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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