Objective: Compare motor and non-motor symptoms between VP and PD patients.

Background: VP is usually described as “lower-body parkinsonism”, with early gait difficulties and postural instability leading to a high rate of falls. Considering non-motor symptoms, VP has high prevalence of fatigue, psychiatric symptoms and memory/attention impairment.

Method: Cross-sectional comparative study of 49 patients (VP: 16 and PD: 33) with clinically suspected VP (Zijlmans et al and/or Winikates and Jankovic scales) and PD (UK Parkinson´s Disease Society Brain Bank Clinical diagnostic criteria) patients observed in the Movement Disorder Unit of Centro Hospitalar de Trás-os-Montes e Alto Douro since 2015. Analyses were performed with the use of SPSS Statistics, version 25.0.

Results: In 49 patients, 55.1% were male. Patients with VP had older ages and shorter duration of disease as compared to the PD patients. Hoehn and Yahr scale (H&Y) was significantly superior in the VP patients (p<0.01). Considering UPDRS scores, the mean total score in the VP patients (65.19±19.481) was significantly higher than in the PD patients (53.48±14.695) (p=0.023), especially when considering the motor aspects of the daily living, UPDRS part II (p=0.046). Moreover, VP patients showed a higher prevalence of non-motor symptoms, mainly related the sleep/fatigue and mood/cognition disturbances (although with no statistical value). The quality of life, evaluated using the PDQ-39 scale, was more affected in the VP patients as compared to the PD patients (with no significant differences).

Conclusion: We found higher and statistically significant H&Y and UPDRS part II scores in the VP patients, compared to PD patients. In our analysis, non-motor symptoms prevalence had no statically differences between both diseases. These demonstrates a higher prevalence/severity of motor symptoms in the VP patients, concordant with that reported in the literature.

References: P.G. Glass, A.J. Lees, A. Bacellar, J. Zijlmans, R. Katzenschlager, L. Silveira-Moriyama, The clinical features of pathologically confirmed vascular parkinsonism, J. Neurol. Neurosurg. Psychiatr. 83 (2012): 1027-1029. Rektor I et al. An updated diagnostic approach to subtype definition of vascular parkinsonism e Recommendations from an expert working group. Parkinsonism Relat Disord. (2017) Dec 29. 1-8. Rampello L, Alvano A, Battaglia G, Raffaele R, Vecchio I, Malaguarnera M. Different clinical and evolutional patterns in late idiopathic and vascular parkinsonism. J Neurol 2005; 252: 1045-1049. Kalra S, Grosset D, Benamer H. Differentiating Vascular Parkinsonism from Idiopathic Parkinson’s Disease: A Systematic Review. Movement Disorders 2010; 25:149-156. Gupta D, Kuruvilla A. Vascular parkinsonism: what makes it different? Postgrad Med J 2011; 87:829-836. Korczyn A. Vascular parkinsonism – characteristics, pathogenesis and treatment. Nat Rev Neurol 2015. Berganzo K, Tijero B, González-Eizaguirre A, Somme J, Lezcano E, Gabilondo I, et al. Motor and non-motor symptoms of Parkinson’s disease and their impact on quality of life and on different clinical subgroups. Neurología 2016; 31:585-591.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-and-non-motor-symptoms-differences-between-vascular-parkinsonism-vp-and-parkinsons-disease-pd-patients-in-early-stages/