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Cerebral Vasoreactivity and Neuropsychiatric Features in Parkinson’s disease.

M. Cansino Torres, D. Ortiz Zacarias, S. Castillo Torres, R. Lopez Soto, J. Trejo Ayala, A. Infante Valenzuela, F. Gongora Rivera, B. Chavez Luevanos, I. Estrada Bellmann (Monterrey, Mexico)

Meeting: 2025 International Congress

Keywords: Anxiety, Depression, Parkinson’s

Category: Parkinson's Disease: Cognition / Psychiatric Manifestations / Lewy Body Dementia

Objective: To determine cerebral vasoreactivity (CVR) in Parkinson’s disease (PD) and its association with the neuropsychiatric features of the disease.

Background: Non-motor symptoms in PD are considered clinical biomarkers in the premotor phases of PD1. Of these, neuropsychiatric symptoms are highly prevalent2. Higher rates of anxiety, pessimism, and suicidal ideation, as well as feelings of guilt and self-reproach, have been reported in patients with PD compared to patients without PD3. There is a higher prevalence of impulse control disorders and psychosis in males4,5, and depression in females5,6. CVR is a noninvasive marker of cerebrovascular disease; its dysfunction is associated with greater functional impairment in PD7. Dysfunction in CVR in PD remains a subject of debate.

Method: A cross-sectional study was performed at the outpatient Movement Disorders Clinic of our Hospital recruiting patients with a clinical diagnosis of PD. Patients underwent through clinical evaluation with MDS-UPDRS (I, III), SCL-90-R and MoCA scales, and transcranial Doppler ultrasound (TCD) to evaluate CVR. CVR impairment was defined as a score <5%. Severity of neuropsychiatric features (SCL-90) was defined as a normalized T score >63. A p-value ≤0.05 is statistically significant.

Results: Fifty-one patients were included, 62.7% (n=32) male, general population with a median age of 66 years (IQR 57-69), median age of onset of symptoms 58 years (IQR 42-63) and of diagnosis of PD 57 years (IQR 44.5-62.25). The median MDS-UPDRS score was 58 (IQR 35-77) and median H&Y score was 2 (IQR 2-4) [Table 1]. CVR impairment in 31 (60.7%), there was statistical trend toward better CVR in females, however, this was not statistically significant (p=0.065). The model identified that the MoCA score was significantly associated with CVR (p=0.017), while the NMSS showed a trend toward significance (p=0.065). For systolic CVR, a contingency table was created between the presence of psychopathological symptoms versus the presence of CVR impairment. Statistical significance was only evident in paranoid ideation (p=0.029) [Table 2].

Conclusion: Our study highlights the potential influence of CVR impairment on non-motor symptoms, suggesting the need to evaluate the impact of motor, non-motor and cognitive symptoms on the vascular pathophysiology of PD, taking into account the role of biological sex.

Table 1.

Table 1.

Table 2.

Table 2.

References: 1. Rodríguez-Blázquez C, Schrag A, Rizos A, Chaudhuri KR, Martinez-Martin P, Weintraub D. Prevalence of non-motor symptoms and non-motor fluctuations in Parkinson’s disease using the MDS-NMS. Mov Disord Clin Pract. 2020;8:231-239.
2. Rodríguez-Violante M, Velásquez-Pérez L, Cervantes-Arriaga A. Incidence rates of Parkinson’s disease in Mexico: Analysis of 2014-2017 statistics. Revista Mexicana de Neurociencia. 2019;20(3):136-40. https://doi.org/10.24875/RMN.M19000043
3. Leentjens A: Depression in Parkinson’s disease: conceptual issues and clinical challenges. J Geriatr Psychiatry Neurol 2004; 17:120–126.
4. Silvia Cerri, Liudmila Mus and Fabio Blandini. Parkinson’s Disease in Women and Men: What’s the Difference? Journal of Parkinson’s Disease 9 (2019) 501–515.
5. D. Georgiev, K. Hamberg, M. Hariz, L. Forsgren. Gender differences in Parkinson’s disease: A clinical perspective. Acta Neurol Scand. 2017 Dec;136(6):570-584. https://doi.org/10.1111/ane.12796
6. Brisson, R. T., Fernandes, R. C. L., Arruda, J. F. L., Rocha, T. C. C. D. S. M., Santos, N. G. D., Silva, L. D., de Lima, M. A. S. D., & de Rosso, A. L. Z. Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study. Brain sciences, 2023; 13(5), 709. https://doi.org/10.3390/brainsci13050709
7. Zamani, B., Mehrabani, M., Fereshtehnejad, S. M., & Rohani, M. Evaluation of cerebral vasomotor reactivity in Parkinson’s disease: is there any association with orthostatic hypotension? Clinical neurology and neurosurgery. 2011; 113(5), 368–372. https://doi.org/10.1016/j.clineuro.2010.12.014

To cite this abstract in AMA style:

M. Cansino Torres, D. Ortiz Zacarias, S. Castillo Torres, R. Lopez Soto, J. Trejo Ayala, A. Infante Valenzuela, F. Gongora Rivera, B. Chavez Luevanos, I. Estrada Bellmann. Cerebral Vasoreactivity and Neuropsychiatric Features in Parkinson’s disease. [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/cerebral-vasoreactivity-and-neuropsychiatric-features-in-parkinsons-disease/. Accessed October 5, 2025.
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