scholarly journals Ultrasonographic Changes in Brain Hemodynamics in Patients with Parkinson’s Disease and Risk Factors for Cerebrovascular Disease: A Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Rodrigo Tavares Brisson ◽  
Rita de Cássia Leite Fernandes ◽  
Josevânia Fulgêncio de Lima Arruda ◽  
Liene Duarte Silva ◽  
Marco Antônio Sales Dantas de Lima ◽  
...  

Recent epidemiological studies have revealed a correlation between atypical features and worse functional outcomes in Parkinson’s disease (PD) patients with cerebrovascular disease (CVD). We aimed to evaluate the brain hemodynamics of PD patients with risk factors for CVD using Doppler ultrasonography. In this prospective pilot study, we randomly included 27 outpatients diagnosed with PD. Transcranial color-coded sonography (TCCS) examinations were performed, obtaining measurements of middle cerebral artery mean flow velocities (Vm), the resistance index (RI), and the pulsatility index (PI). The breath-holding index (BHI) was used to assess cerebrovascular reactivity (cVR). Standardized functional scales (UPDRS III, Hoehn & Yahr scale, and MoCA) were administered. The patients were divided into two groups: those with two or more vascular risk factors (PDvasc) and those with fewer than two vascular risk factors (PDnvasc). Patients in the PDvasc group showed higher PI (1.00 vs. 0.85; p = 0.020 ), RI (0.59 vs. 0.5; p = 0.05 ), H&Y mean (2.4 vs. 1.4; p = 0.036 ), higher frequency of altered cVR (90.9% vs. 25.0%; p = 0.001 ), and lower BHI (0.46 vs. 1.01; p = 0.027 ). We also divided the patients in other two groups: one with patients with classical and another with akinetic-rigid PD clinical type. Patients with the akinetic-rigid type of PD had significantly higher RI (0.60 vs. 0.51; p = 0.03 ), PI (0.99 vs. 0.77; p = 0.03 ), higher frequency of altered cVR (80% vs. 35%; p = 0.02 ), and lower BHI (0.48 vs. 0.96; p = 0.05 ) than patients with classic-type PD. We concluded that TCCS displays impaired cerebrovascular reactivity and a more severe disease pattern in Parkinsonian patients with two or more risk factors for CVD and in the akinetic-rigid type. Doppler ultrasonography may be a useful tool in a clinical setting to investigate PD patients.

2018 ◽  
Vol 25 (4) ◽  
pp. 637-643 ◽  
Author(s):  
R. Ou ◽  
Q. Wei ◽  
Y. Hou ◽  
X. Yuan ◽  
W. Song ◽  
...  

2016 ◽  
Vol 51 (2) ◽  
pp. 563-570 ◽  
Author(s):  
Andrea Pilotto ◽  
Rosanna Turrone ◽  
Inga Liepelt-Scarfone ◽  
Marta Bianchi ◽  
Loris Poli ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bilge Kocer ◽  
Hayat Guven ◽  
Isik Conkbayir ◽  
Selim Selcuk Comoglu ◽  
Sennur Delibas

Factors related with hyperhomocysteinemia (HHcy) and the impact of HHcy in Parkinson’s disease (PD) are not well understood. We investigated the factors associated with increased levels of homocysteine (Hcy) and the relationship between HHcy and motor symptoms, cognitive status, and vascular risk in patients with Parkinson’s disease. Among 60 patients (29 males, 48.3%) with PD, the stage of the disease, the severity of clinical symptoms, and the patients’ cognitive status were measured using a modified Hoehn and Yahr Staging Scale (mHY), Unified Parkinson’s Disease Rating Scale (UPDRS) II and III, and Mini-Mental State Examination (MMSE), respectively. Patients were also noted for having dyskinesia and hallucinations. Serum vitamin B12, folic acid, and plasma Hcy ​​levels were measured. Furthermore, the presence of vascular risk factors was recorded. Finally, we investigated carotid artery intima-media thickening and stenosis using colour Doppler ultrasonography as well as the presence of ischemic lesions using brain imaging techniques. Plasma Hcy ​​levels were higher with advanced age and in males. In addition, there was an inverse relationship between Hcy ​​and vitamin B12 levels. There was no correlation between HHcy and the stage of the disease, severity of motor symptoms, cognitive status as assessed by the MMSE, vascular risk factors, carotid artery atherosclerotic findings, and ischemic brain lesions. Plasma Hcy levels may rise due to several factors in PD. However, the resulting HHcy has no significant effect on the clinical picture in terms of motor features, cognitive status, and vascular diseases.


2017 ◽  
Vol 62 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Kelvin KW Cheng ◽  
Diane MA Swallow ◽  
Katherine A Grosset ◽  
Donald G Grosset

Background and aims Vascular disease is a common comorbidity in Parkinson’s disease patients. Statins are potentially neuroprotective for Parkinson’s disease through non-vascular mechanisms. We investigated prevailing statin use in a Parkinson’s disease cohort. Methods and results Data on diagnostic indication for statins, anti-Parkinson therapy, vascular risk factors, and statin prescription, were obtained from electronic medical record review for consecutive Parkinson’s disease patients. The ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network system was used to calculate future cardiovascular risk and identify those warranting statin use. Of 441 patients included, 59.9% were male, with a mean age of 68.9 years (standard deviation 10.3). One hundred and seventy-four (39.5%) patients had at least one diagnostic indication for statin use, of whom 136 (78.2%) were prescribed a statin. In the 267 (60.5%) cases without a diagnostic indication, 54 (20.2%) were excluded owing to age limitations defined in ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network. Of the remaining 213, 62 (29.1%) had an ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network score in the recommended range for statin therapy, of whom 15 (24.1%) were prescribed statins. Conclusion There is suboptimal implementation of statin therapy in Parkinson’s disease patients. Given the possible neuroprotective effects of statins in Parkinson’s disease in addition to reducing cardiovascular risk, reasons for suboptimal implementation warrant further investigation.


Sign in / Sign up

Export Citation Format

Share Document