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Differentiating vascular parkinsonism from idiopathic Parkinson's disease: a systematic review.
Mov Disord. 2010 Jan 30; 25(2):149-56.MD

Abstract

Vascular parkinsonism (VP) remains a loose constellation of various clinical features. We systematically reviewed studies comparing clinical, neuroimaging and other investigations that might distinguish VP from idiopathic Parkinson's disease (PD). Medline, Embase, Cinahl (R), and PsycINFO were searched by querying appropriate key words. Reports were included if the study population contained comparative findings between patients with VP and PD. Twenty-five articles fulfilled the selection criteria. Patients with VP were older, with a shorter duration of illness, presented with symmetrical gait difficulties, were less responsive to levodopa, and were more prone to postural instability, falls, and dementia. Pyramidal signs, pseudobulbar palsy, and incontinence were more common in VP. Tremor was not a main feature of VP. Structural neuroimaging was more likely to be abnormal in VP (90-100% of cases) than in PD (12-43% of cases), but there was no specific abnormal structural imaging pattern for VP. Two studies of presynaptic striatal dopamine transporters (using single photon emission computed tomography) showed a significant reduction in striatal uptake ratios in PD but not in VP, whereas another study found that only the mean asymmetry index was significantly lower in VP. Various other investigations, including alternative imaging techniques, electrophysiological, and neuropsychological studies, are reported, but the diverse diagnostic criteria used makes it difficult to reach any firm conclusions. The development of accepted international diagnostic criteria for VP is urgently needed to facilitate further studies.

Authors+Show Affiliations

Department of Neurology, Royal Infirmary, University Hospital of North Staffordshire, Stoke on Trent, United Kingdom. kalraseema@doctors.org.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

20077476

Citation

Kalra, Seema, et al. "Differentiating Vascular Parkinsonism From Idiopathic Parkinson's Disease: a Systematic Review." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 25, no. 2, 2010, pp. 149-56.
Kalra S, Grosset DG, Benamer HT. Differentiating vascular parkinsonism from idiopathic Parkinson's disease: a systematic review. Mov Disord. 2010;25(2):149-56.
Kalra, S., Grosset, D. G., & Benamer, H. T. (2010). Differentiating vascular parkinsonism from idiopathic Parkinson's disease: a systematic review. Movement Disorders : Official Journal of the Movement Disorder Society, 25(2), 149-56. https://doi.org/10.1002/mds.22937
Kalra S, Grosset DG, Benamer HT. Differentiating Vascular Parkinsonism From Idiopathic Parkinson's Disease: a Systematic Review. Mov Disord. 2010 Jan 30;25(2):149-56. PubMed PMID: 20077476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differentiating vascular parkinsonism from idiopathic Parkinson's disease: a systematic review. AU - Kalra,Seema, AU - Grosset,Donald G, AU - Benamer,Hani T S, PY - 2010/1/16/entrez PY - 2010/1/16/pubmed PY - 2010/6/17/medline SP - 149 EP - 56 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 25 IS - 2 N2 - Vascular parkinsonism (VP) remains a loose constellation of various clinical features. We systematically reviewed studies comparing clinical, neuroimaging and other investigations that might distinguish VP from idiopathic Parkinson's disease (PD). Medline, Embase, Cinahl (R), and PsycINFO were searched by querying appropriate key words. Reports were included if the study population contained comparative findings between patients with VP and PD. Twenty-five articles fulfilled the selection criteria. Patients with VP were older, with a shorter duration of illness, presented with symmetrical gait difficulties, were less responsive to levodopa, and were more prone to postural instability, falls, and dementia. Pyramidal signs, pseudobulbar palsy, and incontinence were more common in VP. Tremor was not a main feature of VP. Structural neuroimaging was more likely to be abnormal in VP (90-100% of cases) than in PD (12-43% of cases), but there was no specific abnormal structural imaging pattern for VP. Two studies of presynaptic striatal dopamine transporters (using single photon emission computed tomography) showed a significant reduction in striatal uptake ratios in PD but not in VP, whereas another study found that only the mean asymmetry index was significantly lower in VP. Various other investigations, including alternative imaging techniques, electrophysiological, and neuropsychological studies, are reported, but the diverse diagnostic criteria used makes it difficult to reach any firm conclusions. The development of accepted international diagnostic criteria for VP is urgently needed to facilitate further studies. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/20077476/Differentiating_vascular_parkinsonism_from_idiopathic_Parkinson's_disease:_a_systematic_review_ L2 - https://doi.org/10.1002/mds.22937 DB - PRIME DP - Unbound Medicine ER -