Clinicoradiological comparison between vascular parkinsonism and Parkinson's disease.
J Neurol Neurosurg Psychiatry
; 86(5): 547-53, 2015 May.
Article
en En
| MEDLINE
| ID: mdl-25006209
ABSTRACT
OBJECTIVE:
To compare the clinical and radiological features of vascular parkinsonism (VP) and Parkinson's disease (PD).METHODS:
Cross-sectional study where 15 patients with VP (8 (53.3%) men; aged 75.7 ± 10.4 years) and 30 patients with PD (17 (56.7%) men; aged 67.3 ± 7.5 years) underwent motor and cognitive evaluation and brain MRI.RESULTS:
Patients with VP were, on average, 8.4 years older (p = 0.004); all had arterial hypertension. They presented with a sudden onset of parkinsonism (80%) and a rapidly progressive clinical course (53.3%). Predominant lower body parkinsonism (p<0.001), postural instability (p=0.003) with freezing of gait (p<0.001) and falls (p<0.001), urinary incontinence (p < 0.001) and pyramidal signs (p<0.001) were more common in patients with VP. Movement Disorders Society's Unified PD Rating Scale (MDS-UPDRS) scores were higher in patients with VP (p=0.005 in 'OFF' state and p<0.001 in 'ON' state). They had greater cognitive impairment and 12 (80%) fulfilled diagnostic criteria for probable vascular dementia. Most patients with VP had brain MRI changes multiple lacunar infarcts (66.7%) or extensive white matter disease (26.7%).CONCLUSIONS:
VP can be clinically distinguished from PD based on sudden onset of parkinsonism at an older age, characterised by lower body predominance, urinary incontinence, pyramidal signs, postural instability with freezing of gait and falls, and dementia.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
/
Enfermedad de Parkinson Secundaria
Tipo de estudio:
Diagnostic_studies
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Observational_studies
/
Prevalence_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Año:
2015
Tipo del documento:
Article
País de afiliación:
Brasil