Abstract
Dementia is one of the most disabling non-motor symptoms in Parkinson’s disease (PD). Unlike in Alzheimer’s disease, the vascular pathology in PD is less documented. Due to the uncertain role of commonly investigated metabolic or vascular factors, e.g., hypertension or diabetes, other factors corresponding to PD dementia have been proposed. Associated dysautonomia and dopaminergic treatment seem to have an impact on diurnal blood pressure (BP) variability, which may presumably contribute to white matter hyperintensities (WMH) development and cognitive decline. We aim to review possible vascular and metabolic factors: Renin-angiotensin-aldosterone system, vascular endothelial growth factor (VEGF), hyperhomocysteinemia (HHcy), as well as the dopaminergic treatment, in the etiopathogenesis of PD dementia. Additionally, we focus on the role of polymorphisms within the genes for catechol-O-methyltransferase (COMT), apolipoprotein E (APOE), vascular endothelial growth factor (VEGF), and for renin-angiotensin-aldosterone system components, and their contribution to cognitive decline in PD. Determining vascular risk factors and their contribution to the cognitive impairment in PD may result in screening, as well as preventive measures.
Highlights
Parkinson’s disease (PD) is a neurodegenerative disorder with a wide spectrum of motor and non-motor symptoms
White matter hyperintensities were more severe in patients carrying the DD than ID (p = 0.01) or II genotype (p = 0.009) and the correlation remained significant after a correction for cardiovascular risk factors, suggesting other mechanisms contributing to white matter hyperintensities (WMH) development
There is a growing demand to determine factors predisposing to the development of PD dementia
Summary
Parkinson’s disease (PD) is a neurodegenerative disorder with a wide spectrum of motor (bradykinesia, tremor, rigidity, loss of postural stability) and non-motor (cognitive decline, depression, dysautonomia, psychosis) symptoms. Parkinson’s disease dementia mostly affects the executive and visuospatial functions, as well as attention. As a result of an 8-year prospective study, the cumulative prevalence of dementia was assessed to be 78% [3]. According to a 5-year prospective study in more than 400 patients with PD, the risk factors for dementia included older age, longer disease duration, later age-at-onset and higher daily levodopa (L-dopa) dosage [4]. In contrast to Alzheimer’s disease, vascular contribution to PD dementia is not so obvious. The authors present the current state of information about the role of BP variability and other vascular risk factors, as well as selected genetic polymorphisms, in the pathogenesis of PD dementia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
