ASSOCIATION BETWEEN CEREBRAL SMALL VESSEL DISEASE AND MILD MOTOR PARKINSONIAN SIGNS IN PATIENTS WITH LACUNAR STROKES AND TRANSIENT ISCHEMIC ATTACKS

Abstract

Background: Both cerebral small vessel disease (SVD) and Mild Parkinsonian signs (MPS) are serious conditions affecting elderly patient, but, the association between them remain unclear. Objective: Examine the association between SVD, Total SVD burden and MPS in patients with Transient Ischemic Attacks (TIA) and Lacunar Strokes. Patients and Methods: We performed a cross-sectional study among 36 patients admitted with either TIA or Lacunar Stroke, but not known to have Parkinson’s disease or Parkinsonism. Patients were recruited from Al-Azhar University Hospitals during the period from June, 2016 to May 2018. Mean age was 73.38 ± 8.3 years, 58.3% males. MPS was evaluated via Unified Parkinson's Disease Rating Scale Part III. Brain MRI was used to determine SVD (lacunar infarctions [LIs], white matter hyperintensities [WMH], cerebral microbleeds [CMBs], and Enlarged Perivascular spaces [EPVSs]). Total SVD score was calculated based upon presence/absence of these four SVD markers. Results: In a multivariate analysis, we found that the presence of LIs, WMHs, CMBs, and total SVD score were significantly associated with MPS, whereas EPVSs were not. We found a strong correlation between SVD score & MPS score. We also found a significant association between total SVD score and Rigidity & Bradykinesia. GFR was found to significantly correlate with SVD score & MPS score. Conclusion: Our results provided additional evidence that SVD and especially total SVD burden, might be a surrogate marker for MPS and support the support the hypothesis of a vascular contribution to MPS in older adults.