血管性帕金森综合征的研究进展

doi:10.3969/j.issn.1673-5765.2022.04.004

摘要/Abstract

摘要： 血管性帕金森综合征（vascular parkinsonism，VaP）是临床上常见的继发性帕金森综合征的一种，由脑小血管损伤引起基底节神经元网络缺氧、代谢异常以及神经微环境的完整性破坏等导致。 VaP的临床表现与血管损伤有关，其危险因素、病因、临床表现与帕金森病（Parkinson's disease，PD）均有明显差异，但因两者存在症状上的重叠，临床存在误诊的可能。辅助检查技术的进步有助于VaP的诊断，如头颅MRI测量尾状核、基底节及皮层下区域的白质高信号（white matter hyperintensities，WMH）体积，SWI的黑质成像均可对两者进行鉴别。另外，分子影像学和基于步态时间序列的神经网络步态模式评估等新技术也有助于对VaP和PD的区分。

文章导读： VaP与PD及其他帕金森综合征虽然都存在帕金森症状，但因为病因、病理存在显著差异，其对治疗的反应也明显不同，对其发病机制、症状进行深入探索可更有效地指导临床诊疗。

关键词: 血管性帕金森综合征; 脑白质高信号; 脑小血管病; 影响因素; 磁共振成像

Abstract: Vascular parkinsonism (VaP) is a common secondary Parkinson's syndrome, which is caused by hypoxia of basal ganglia neuron network, metabolic abnormal, and destroy of neural microenvironment caused by cerebral small vessels injury. The clinical manifestations of VaP are related to vascular injury, and the risk factors, etiology and clinical manifestations of which are significantly different from that of Parkinson's disease (PD). However, as they have some common symptoms, VaP and PD may be misdiagnosed clinically. The development of auxiliary examination technology is helpful for the diagnosis of VaP. For example, the volume of white matter hyperintensity (WMH) in caudate nucleus, basal ganglia and subcortical areas measured by brain MRI, and substantia nigra imaging on SWI can help distinguish VaP from PD. In addition, some new technologies such as molecular imaging and neural network gait pattern assessment based on gait time series can also help distinguish VaP from PD.

Key words: Vascular parkinsonism; White matter hyperintensity; Cerebral small vessel disease;Influencing factor; Magnetic resonance imaging

叶益超, 玉石, 佘亚军, 方正, 王毅. 血管性帕金森综合征的研究进展[J]. 中国卒中杂志, 2022, 17(04): 346-350.

YE Yichao, YU Shi, SHE Yajun, FANG Zheng, WANG Yi. Progress of Vascular Parkinsonism[J]. Chinese Journal of Stroke, 2022, 17(04): 346-350.

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