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Vascular Parkinsonism: deconstructing a syndrome

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dc.contributor.author Vizcarra, Joaquin A.
dc.contributor.author Lang, Anthony E.
dc.contributor.author Sethi, Kapil D.
dc.contributor.author Espay, Alberto J.
dc.date.accessioned 2019-02-06T14:59:07Z
dc.date.available 2019-02-06T14:59:07Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5540
dc.description.abstract Progressive ambulatory impairment and abnormal white matter (WM) signal on neuroimaging come together under the diagnostic umbrella of vascular parkinsonism (VaP). A critical appraisal of the literature, however, suggests that (1) no abnormal structural imaging pattern is specific to VaP; (2) there is poor correlation between brain MRI hyperintensities and microangiopathic brain disease and parkinsonism from available clinicopathologic data; (3) pure parkinsonism from vascular injury ("definite" vascular parkinsonism) consistently results from ischemic or hemorrhagic strokes involving the SN and/or nigrostriatal pathway, but sparing the striatum itself, the cortex, and the intervening WM; and (4) many cases reported as VaP may represent pseudovascular parkinsonism (e.g., Parkinson's disease or another neurodegenerative parkinsonism, such as PSP with nonspecific neuroimaging signal abnormalities), vascular pseudoparkinsonism (e.g., akinetic mutism resulting from bilateral mesial frontal strokes or apathetic depression from bilateral striatal lacunar strokes), or pseudovascular pseudoparkinsonism (e.g., higher-level gait disorders, including normal-pressure hydrocephalus with transependimal exudate). These syndromic designations are preferable over VaP until pathology or validated biomarkers confirm the underlying nature and relevance of the leukoaraiosis. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Movement Disorders
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Cerebrovascular Disorders/classification/pathology/physiopathology en_US
dc.subject higher-level gait disorder en_US
dc.subject normal-pressure hydrocephalus en_US
dc.subject Parkinsonian Disorders/classification/pathology/physiopathology en_US
dc.subject Syndrome en_US
dc.subject vascular parkinsonism en_US
dc.subject white matter ischemic disease en_US
dc.title Vascular Parkinsonism: deconstructing a syndrome en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1002/mds.26263
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.25
dc.relation.issn 1531-8257


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