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Symptoms and Magnetic Resonance Imaging Analysis of Parkinsonism in Cerebral Small Vessel Disease
Vol 37, Issue 3, 2023
Abstract
Objective: In this study, we aimed to explore the features of motor symptoms, non-motor symptoms, and magnetic resonance imaging (MRI) of vascular parkinsonism (VP) in patients with cerebral small vessel disease (CSVD). Methods: The clinical data of consecutive patients who visited the Neurological Department of the Second Hospital of Tianjin Medical University were collected—We collected 40 cases of CSVD patients who met the diagnostic criteria of VP as the CSVD-VP group, at the same time, 46 patients without VP symptoms were collected as the control group (CSVD group). Several scales were used to evaluate the patients’ motor and non-motor functions, and all patients underwent 3.0T MRI. Results: The rate of diabetes, cerebral infarction, and hypercholesterolemia in the CSVD-VP group was significantly higher than that in the CSVD group (p < 0.05). The mean Barthel index of the CSVD-VP group was 72.00 (10.05), which was significantly lower than that of the CSVD group 82.75 (8.39) (p < 0.05). Among the least scoring items were urinary incontinence and difficulty walking up and down stairs. The total score of Unified Parkinson’s Disease Rating Scale (UPDRS) III in the CSVD-VP group was 16.53 (5.89), which was significantly higher than that in the CSVD group 3.51 (2.05) (p < 0.05). The scores of Tinetti balance 10.15 (2.15) and gait 9.03 (1.45) in the CSVD-VP group were significantly lower than those in the CSVD group (p < 0.05). The scores of Mini-Mental State Examination 23.85 (2.41) and Montreal Cognitive Assessment 21.35 (2.50) in the CSVD-VP group were significantly lower than those in the CSVD group 25.00 (2.00) and 23.00 (1.99), respectively (p < 0.05). Lacunes and white matter lesion (Fazekas ≥2) in the CSVD-VP group were more significant than those in the CSVD group (p < 0.05). Conclusions: Patients with CSVD-VP had a lower daily living ability score and higher UPDRS III score than those with CSVD alone, the symptoms of parkinsonism in the CSVD-VP patients were accompanied by cognitive dysfunction, urinary incontinence, anxiety, depression, and other non-motor symptoms. The MRI scans of CSVD-VP patients had more obvious lacunar infarction and white matter hyperintensities around the basal ganglia.
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Supporting Agencies
Copyright (c) 2023 Ping Zhao, Xin Li, Yumeng Gu, Wenjun Feng, Xiaolin Tian, Xiaoshuang Xia, Yanfen Du
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Medical Genetics, University of Torino Medical School, Italy

Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy