Progress in Clinical Research of Vascular Parkinsonism

doi:10.3969/j.issn.1673-5765.2023.08.001

Abstract

Abstract: Vascular parkinsonism (VP) is a secondary parkinsonism. With the increase of aging population and the increase in patients with cerebrovascular diseases in China, the prevalence of VP will be further increased. To date, the pathogenesis of VP is still unclear, and the clinical manifestations are heterogeneous, so further studies are needed. In order to better guide clinical practice, this paper will summarize and analyze the epidemiology, clinical manifestations, imaging features, diagnosis and management of VP.

Key words: Parkinson’s disease; Vascular parkinsonism; Cerebrovascular disease

摘要： 血管性帕金森综合征（vascular parkinsonism，VP）是一种继发性的帕金森综合征。随着我国老龄人口的增加，脑血管疾病患者增多，VP患病率有可能进一步增高。VP的发病机制尚不明确，且临床表现具有较大的异质性，因此有待更深入的研究。本文将对VP的流行病学、临床表现、影像学特征以及治疗等新进展予以总结分析，以期更好地指导临床实践。

关键词: 帕金森病; 血管性帕金森综合征; 脑血管疾病

LIU Genliang, FENG Tao. Progress in Clinical Research of Vascular Parkinsonism[J]. Chinese Journal of Stroke, 2023, 18(8): 853-857.

刘亘梁, 冯涛. 血管性帕金森综合征的临床研究进展[J]. 中国卒中杂志, 2023, 18(8): 853-857.

References

[1] JELLINGER K A. Prevalence of cerebrovascular lesions in Parkinson’s disease[J]. Acta Neuropathol，2003，105（5）：415-419.
[2] VAN DER HOLST H M，VAN UDEN I W，TULADHAR A M，et al. Cerebral small vessel disease and incident parkinsonism：the RUN DMC study[J]. Neurology，2015，85（18）：1569-1577.
[3] GLASS P G，LEES A J，BACELLAR A，et al. The clinical features of pathologically confirmed vascular parkinsonism[J]. J Neurol Neurosurg Psychiatry，2012，83（10）：1027-1029.
[4] 中华医学会神经病学分会帕金森病及运动障碍学组，中国医师协会神经内科医师分会帕金森病及运动障碍专业委员会. 中国血管性帕金森综合征诊断与治疗专家共识[J]. 中华神经科杂志. 2017，50（5）：326-331.
Parkinson’s Disease & Movement Disorders
Society，Chinese Society of Neurology，Parkinson’s Disease & Movement Disorders Society，Chinese Neurology Association . Chinese experts’consensus of diagnosis and treatment of vascular parkinsonism[J]. Chin J Neurol，2017，50（5）：326-331.
[5] FITZGERALD P M，JANKOVIC J. Lower body parkinsonism：evidence for vascular etiology[J]. Mov Disord，1989，4（3）：249-260.
[6] ZIJLMANS J C，DANIEL S E，HUGHES A J，et al. Clinicopathological investigation of vascular parkinsonism，including clinical criteria for diagnosis[J]. Mov Disord，2004，19（6）：630-640.
[7] KORCZYN A D. Vascular parkinsonism--characteristics，pathogenesis and treatment[J]. Nat Rev Neurol，2015，11（6）：319-326.
[8] COLOSIMO C，MORGANTE L，ANTONINI A，et al. Non-motor symptoms in atypical and secondary parkinsonism：the PRIAMO study[J]. J Neurol，2010，257（1）：5-14.
[9] 罗倩，彭思佳，王笑瑗，等. 血管性帕金森综合征的临床特征及神经影像学研究进展[J]. 中国卒中杂志，2021，16（9）：967-970.
LUO Q，PENG S J，WANG X Y，et al. Progress of clinical and neuroimaging features of vascular parkinsonism[J]. Chin J Stroke，2021，16（9）：967-970.
[10] NARASIMHAN M，SCHWARTZ R，HALLIDAY G. Parkinsonism and cerebrovascular disease[J/OL]. J Neurol Sci，2022，433：120011[2023-02-20]. https://doi.org/10.1016/j.jns.2021.120011.
[11] CHOI S M，KIM B C，NAM T S，et al. Midbrain atrophy in vascular Parkinsonism[J]. Eur Neurol，2011，65（5）：296-301.
[12] WANG H C，HSU J L，LEEMANS A. Diffusion tensor imaging of vascular parkinsonism：structural changes in cerebral white matter and the association with clinical severity[J]. Arch Neurol，2012，69（10）：1340-1348.
[13] SALSONE M，CALIGIURI M E，VESCIO V，et al. Microstructural changes of normal-appearing white matter in vascular Parkinsonism[J/OL]. Parkinsonism Relat Disord，2019，63：60-65[2023-02-20]. https://doi.org/10.1016/j.parkreldis.2019.02.046.
[14] LEE Y H，LEE S，CHUNG S J，et al. The pattern of FP-CIT PET in pure white matter hyperintensities-related vascular parkinsonism[J/OL]. Parkinsonism Relat Disord，2021，82：1-6[2023-02-15]. https://doi.org/10.1016/j.parkreldis.2020.11.002.
[15] ZHAO X J，NIU X Y，YOU H Y，et al. Signal alteration of substantia nigra on 3. 0T susceptibility-weighted imaging in Parkinson’s disease and vascular parkinsonism[J]. Curr Med Sci，2019，39（5）：831-835.
[16] MATSUURA K，II Y，MAEDA M，et al. Neuromelanin-sensitive magnetic resonance imaging in disease differentiation for parkinsonism or neurodegenerative disease affecting the basal ganglia[J/OL]. Parkinsonism Relat Disord，2021，87：75-81[2023-02-15]. https://doi.org/10.1016/j.parkreldis.2021.05.002.
[17] CHEN Y F，TSENG Y L，LAN M Y，et al. The relationship of leukoaraiosis and the clinical severity of vascular parkinsonism[J]. J Neurol Sci，2014，346（1/2）：255-259.
[18] DUNET V，DEVERDUN J，CHARROUD C，et al. MRI volumetric morphometry in vascular parkinsonism[J]. J Neurol，2017，264（7）：1511-1519.
[19] ZIJLMANS J，EVANS A，FONTES F，et al. [123I] FP-CIT spect study in vascular parkinsonism and Parkinson’s disease[J]. Mov Disord，2007，22（9）：1278-1285.
[20] NAVARRO-OTANO J，GAIG C，MUXI A，et al. 123I-MIBG cardiac uptake，smell identification and 123I-FP-CIT SPECT in the differential diagnosis between vascular parkinsonism and Parkinson’s disease[J]. Parkinsonism Relat Disord. 2014，20（2）：192-197.
[21] HORVATH J，BURKHARD P R，BOURAS C，et al. Etiologies of parkinsonism in a century-long autopsy-based cohort[J]. Brain Pathol，2013，23（1）：28-33.
[22] REKTOR I，BOHNEN N I，KORCZYN A D，et al. An updated diagnostic approach to subtype definition of vascular parkinsonism-recommendations from an expert working group[J/OL]. Parkinsonism Relat Disord，2018，49：9-16[2023-03-10]. https://doi.org/10.1016/j.parkreldis.2017.12.030.
[23] LING M J，AGGARWAL A，MORRIS J G. Dopa-responsive parkinsonism secondary to right temporal lobe haemorrhage[J]. Mov Disord，2002，17（2）：402-404.
[24] MIGUEL-PUGA A，VILLAFUERTE G，SALAS-PACHECO J，et al. Therapeutic interventions for vascular parkinsonism：a systematic review and meta-analysis[J/OL]. Front Neurol，2017，8：481[2023-02-10]. https://doi.org/10.3389/fneur.2017.00481.
[25] YIP C W，CHEONG P W，GREEN A，et al. A prospective pilot study of repetitive transcranial magnetic stimulation for gait dysfunction in vascular parkinsonism[J]. Clin Neurol Neurosurg. 2013，115（7）：887-891.
[26] MAKSIMOVICH I V. Intracerebral transcatheter laser photobiomodulation therapy in the treatment of Binswanger’s disease and vascular parkinsonism：research and clinical experience[J]. Photobiomodul Photomed Laser Surg，2019，37（10）：606-614.