Cerebrovascular Pathologies Tied to Mild Parkinsonian Signs

Macroscopic infarcts, microinfarcts, arteriolosclerosis tied to parkinsonian signs in old age

FRIDAY, Sept. 2 (HealthDay News) -- Cerebrovascular pathologies, such as macroscopic infarcts, microinfarcts, and arteriolosclerosis, are associated with mild parkinsonian signs in old age, particularly parkinsonian gait, according to a study published online Sept. 1 in Stroke.

Aron S. Buchman, M.D., from the Rush University Medical Center in Chicago, and colleagues investigated whether cerebrovascular pathologies are related to parkinsonian signs. Samples from brain autopsies were assessed from 418 deceased patients who underwent evaluation of parkinsonian signs with a modified version of the motor section of the Unified Parkinson's Disease Rating Scale.

The investigators identified macroscopic infarcts in 149 cases (more than 35 percent). Pathologies not detected by conventional brain imaging were revealed in nearly 30 percent of cases without macroscopic infarcts: 33 microinfarcts (7.9 percent), 62 cases of arteriolosclerosis (14.8 percent), and 24 cases of both (5.7 percent). Higher global parkinsonian scores were correlated with macroscopic infarcts, specifically multiple cortical and one or more subcortical macroscopic infarcts. The presence of multiple and cortical microinfarcts was correlated with the global parkinsonian score. An association was found between arteriolosclerosis and the global parkinsonian score, but this effect was reduced and was no longer significant after accounting for infarcts. Each of the pathologies was significantly correlated with parkinsonian gait, with subcortical macroscopic and microinfarcts specifically correlating with the severity of parkinsonian gait.

"Cerebrovascular pathologies, including macroscopic infarcts, microinfarcts, and arteriolosclerosis, are common in older persons and may be unrecognized common etiologies of mild parkinsonian signs, especially parkinsonian gait, in old age," the authors write.

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