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.
BACKGROUND: The registered identifier NCT04308135 on clinical-Trial.gov. Registered on 03/12/2020.
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.
BACKGROUND: The registered identifier NCT04308135 on clinical-Trial.gov. Registered on 03/12/2020.
摘要：
背景：帕金森病（PD）和血管性帕金森病（VaP）具有高度重叠的表型，和不同的预后。本研究全面调查了临床,脑MRI和经颅超声在VaP和PD之间的差异。
方法：48例PD患者，27例VaP患者，与29名健康对照者进行比较。所有患者均使用MDS-UPDRS进行评估，伯格平衡量表（BBS），十米步行测试（10-MWT），时间和去测试，和非运动症状量表。贝克抑郁量表，PD问卷-39，国际尿失禁量表，认知评估量表，MRI脑和经颅彩色编码多普勒。该研究于2020年3月12日在clinical-trial.gov（NCT04308135）上注册。
结果：VaP患者的发病年龄明显较大，疾病持续时间较短，较低的药物剂量和左旋多巴反应性，较高的开和离轴分数，打开和关闭BBS,PIGD的分数更高，刚性,运动迟缓和总运动MDS-UPDRS，较低的On和Off震颤，下半优势，不对称表现和对称指数低于PD患者。除知觉问题/幻觉外，VaP患者的非运动症状量表（NMSS）比对照组更差，但除排尿功能障碍外，症状比PD患者更好。VaP患者的生活质量（QoL）受损，并与运动功能和NMS相关。VaP组白质病变和脑萎缩显著增高，与PD组相比，黑质的高回声性较低，脑血管阻力和血管反应性受损更多。
结论：VaP具有特征性的运动和非运动特征，QoL受损，白质,和经颅超声检查异常将其与PD区分开。血管病变在VaP发病机制中的作用有待进一步研究。
背景：clinical-trial.gov上的注册标识符NCT04308135于2020年3月12日注册。
方法：48例PD患者，27例VaP患者，与29名健康对照者进行比较。所有患者均使用MDS-UPDRS进行评估，伯格平衡量表（BBS），十米步行测试（10-MWT），时间和去测试，和非运动症状量表。贝克抑郁量表，PD问卷-39，国际尿失禁量表，认知评估量表，MRI脑和经颅彩色编码多普勒。该研究于2020年3月12日在clinical-trial.gov（NCT04308135）上注册。
结果：VaP患者的发病年龄明显较大，疾病持续时间较短，较低的药物剂量和左旋多巴反应性，较高的开和离轴分数，打开和关闭BBS,PIGD的分数更高，刚性,运动迟缓和总运动MDS-UPDRS，较低的On和Off震颤，下半优势，不对称表现和对称指数低于PD患者。除知觉问题/幻觉外，VaP患者的非运动症状量表（NMSS）比对照组更差，但除排尿功能障碍外，症状比PD患者更好。VaP患者的生活质量（QoL）受损，并与运动功能和NMS相关。VaP组白质病变和脑萎缩显著增高，与PD组相比，黑质的高回声性较低，脑血管阻力和血管反应性受损更多。
结论：VaP具有特征性的运动和非运动特征，QoL受损，白质,和经颅超声检查异常将其与PD区分开。血管病变在VaP发病机制中的作用有待进一步研究。
背景：clinical-trial.gov上的注册标识符NCT04308135于2020年3月12日注册。
