Progress of Clinical and Neuroimaging Features of Vascular Parkinsonism

doi:10.3969/j.issn.1673-5765.2021.09.015

Abstract

Abstract: Vascular parkinsonism (VaP) is a secondary parkinsonism caused by cerebral vascular disorders. It has many similar clinical characteristics with Parkinson's disease (PD). The main clinical features of VaP are lower limb dyskinesia, accompanied by pyramidal tract syndrome, pseudobulbar paralysis, dementia, urinary incontinence, etc. This article reviewed the progress of clinical and neuroimaging features of VaP, to deepen the understanding of VaP. The pathogenesis of VaP is still unclear, and further research is needed to better dignose and treat VaP.

Key words: Vascular parkinsonism; Clinical feature; Motor symptom; Non-motor symptom;
Neuroimaging; 123I-metaiodobenzylguanidine; 123I-ioflupane single photon emission computed
tomography

摘要： 血管性帕金森综合征（vascular parkinsonism，VaP）是由脑血管疾病引起的继发性帕金森综合征，与帕金森病（Parkinson's disease，PD）有类似的临床特点，临床表现以下半身运动障碍为主，常伴有锥体束征、假性延髓麻痹、痴呆、失禁等。为进一步认识VaP，本文就其临床特征、神经影像学进展进行综述。VaP的发病机制尚未完全明确，临床上缺乏确切的诊断标准，有必要进行更深入的研究，以更好地诊治VaP。

关键词: 血管性帕金森综合征; 临床特征; 运动症状; 非运动症状; 神经影像; 间碘苯甲呱; 碘氟潘单光子发射计算机断层扫描

LUO Qian, PENG Si-Jia, WANG Xiao-Yuan, TANG Yu-Feng, WU Yun-Cheng. Progress of Clinical and Neuroimaging Features of Vascular Parkinsonism[J]. Chinese Journal of Stroke, 2021, 16(09): 967-970.

罗倩, 彭思佳, 王笑瑗, 唐宇凤, 吴云成. 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(09): 967-970.

References

[1] CRITCHLEY M. Arteriosclerotic parkinsonism[J].
Brain，1929，52（1）：23-83.
[2] FITZGERALD P M，JANKOVIC J. Lower body
parkinsonism：evidence for vascular etiology[J]. Mov
Disord，1989，4（3）：249-260.
[3] GUPTA D，KURUVILLA A. Vascular parkinsonism：
what makes it different?[J]. Postgrad Med J，2011，87
（1034）：829-836.
[4] WINIKATES J，JANKOVIC J. Clinical correlates of
vascular parkinsonism[J]. Arch Neurol，1999，56（1）：
98-102.
[5] SIBON I，FENELON G，QUINN N P，et al. Vascular
parkinsonism[J]. J Neurol，2004，251（5）：513-524.
[6] RAMPELLO L，ALVANO A，BATTAGLIA G，et
al. Different clinical and evolutional patterns in late
idiopathic and vascular parkinsonism[J]. J Neurol，2005，
252（9）：1045-1049.
[7] 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.
[8] 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[2020-09-02]. https：//doi.org/10.1016/
j.parkreldis.2017.12.030.
[9] FERREIRA F，GAGO M F，BICHO E，et al. Gait
stride-to-stride variability and foot clearance pattern
analysis in idiopathic Parkinson’s disease and vascular
parkinsonism[J/OL]. J Biomech，2019，92：98-104[2020-
09-02]. https：//doi.org/10.1016/j.jbiomech.2019.05.039.
[10] UDAGEDARA T B，GOONERATNE I K. Jaw tremor：
a manifestation of vascular parkinsonism?-A case
report[J]. BMC Neurol，2018，18（1）：92.
[11] VALE T C，CARAMELI P，CARDOSO F.
Clinicoradiological comparison between vascular
parkinsonism and Parkinson’s disease[J]. J Neurol
Neurosurg Psychiatry，2015，86（5）：547-553.
[12] SANTANGELO G，VITALE C，TROJANO L，et al.
Differential neuropsychological profiles in parkinsonian
patients with or without vascular lesions[J]. Mov Disord，
2010，25（1）：50-56.
[13] 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.
[14] FERESHTEHNEJAD S M，LÖKK J. Orthostatic
hypotension in patients with Parkinson's disease
and atypical parkinsonism[J/OL]. Parkinsons
Dis，2014，2014：475854[2020-09-02]. https：//doi.
org/10.1155/2014/475854.
[15] KORCZYN A D. Vascular parkinsonism-characteristics，
pathogenesis and treatment[J]. Nat Rev Neurol，2015，11
（6）：319-326.
[16] OKUDA B，KAWABATA K，TACHIBANA H，et al.
Primitive reflexes distinguish vascular parkinsonism
from Parkinson's disease[J]. Clin Neurol Neurosurg，
2008，110（6）：562-565.
[17] KALRA S，GROSSET D G，BENAMER H T.
Differentiating vascular parkinsonism from idiopathic
Parkinson’s disease：a systematic review[J]. Mov Disord，
2010，25（2）：149-156.
[18] DUNET V，DEVERDUN J，CHARROUD C，et al. MRI
volumetric morphometry in vascular parkinsonism[J]. J
Neurol，2017，264（7）：1511-1519.
[19] ANTONINI A，VITALE C，BARONE P，et al. The
relationship between cerebral vascular disease and
parkinsonism：the VADO study[J]. Parkinsonism Relat
Disord，2012，18（6）：775-780.
[20] ZHAO X J，NIU X Y，YOU H Y，et al. Signal
alteration of substantia nigra on 3. 0T susceptibilityweighted
imaging in Parkinson’s disease and vascular
parkinsonism[J]. Curr Med Sci，2019，39（5）：831-835.
[21] NUVOLI S，SPANU A，PIRAS M R，et al. 123I-ioflupane
brain SPECT and 123I-MIBG cardiac planar scintigraphy
combined use in uncertain parkinsonian disorders[J/OL].
Medicine（Baltimore），2017，96（21）：e6967[2020-09-
02]. https：//doi.org/10.1097/MD.0000000000006967.
[22] 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.
[23] BRIGO F，MATINELLA A，ERRO R，et al. [¹²³I]
FP-CIT SPECT（DaTSCAN）may be a useful tool to
differentiate between Parkinson’s disease and vascular
or drug-induced parkinsonisms：a meta-analysis[J/OL].
Eur J Neurol，2014，21（11）：1369-e90[2020-09-02].
https：//doi.org/10.1111/ene.12444.
[24] LEE Y H，LEE S，CHUNG S J，et al. The pattern of FPCIT
PET in pure white matter hyperintensities-related
vascular parkinsonism[J/OL]. Parkinsonism Relat Disord，
2021，82：1-6[2020-09-02]. https：//doi.org/10.1016/
j.parkreldis.2020.11.002.