Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study
Background: A correlation between worse functional outcomes in Parkinson’s disease (PD) patients with cerebrovascular disease (CVD) or the Akinetic-rigid phenotype has been argued in recent studies. We aimed to evaluate the association of cerebral hemodynamics impairments, assessed by Transcranial C...
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MDPI AG
2023-04-01
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| Series: | Brain Sciences |
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| author | Rodrigo Tavares Brisson Rita de Cássia Leite Fernandes Josevânia Fulgêncio de Lima Arruda Thiffanny Cristini Cassiano da S. M. Rocha Nathália de Góes Duarte Santos Liene Duarte Silva Marco Antônio Sales Dantas de Lima Ana Lucia Zuma de Rosso |
| author_facet | Rodrigo Tavares Brisson Rita de Cássia Leite Fernandes Josevânia Fulgêncio de Lima Arruda Thiffanny Cristini Cassiano da S. M. Rocha Nathália de Góes Duarte Santos Liene Duarte Silva Marco Antônio Sales Dantas de Lima Ana Lucia Zuma de Rosso |
| author_sort | Rodrigo Tavares Brisson |
| collection | DOAJ |
| description | Background: A correlation between worse functional outcomes in Parkinson’s disease (PD) patients with cerebrovascular disease (CVD) or the Akinetic-rigid phenotype has been argued in recent studies. We aimed to evaluate the association of cerebral hemodynamics impairments, assessed by Transcranial Color-coded Doppler sonography (TCCS), on PD patients with different phenotypes of the disease and with risk factors for CVD. Methodology: Idiopathic PD patients (n = 51) were divided into motor subtypes: Akinetic-rigid (AR) (n = 27) and Tremor-dominant (TD) (n = 24) and into two groups regarding vascular risk factors: when ≥2 were present (PDvasc) (n = 18) and <2 (PDnvasc) (n = 33). In a parallel analysis, the Fazekas scale on brain magnetic resonance imaging (MRI) was applied to a sample to assess the degree of leukoaraiosis. TCCS examinations were prospectively performed obtaining middle cerebral artery Mean Flow Velocities (Vm), Resistance Index (RI), and Pulsatility Index (PI). The Breath-Holding Index (BHI) was calculated to assess cerebrovascular reactivity (cVR). Standardized functional scales were administered (UPDRS III and Hoehn&Yahr). Results: The phenotype groups were similar in age, disease duration and demographic parameters, but there were significantly higher H&Y scores than TD group. cVR was impaired in 66.7% of AR vs. 37.5% of TD. AR group exhibited lower BHI (0.53 ± 0.31 vs. 0.91 ± 0.62; <i>p</i> = 0.000), lower Vm after apnea (44.3 ± 9.0 cm/s vs. 53.4 ± 11.4 cm/s; <i>p</i> = 0.003), higher PI (0.91 ± 0.26 vs. 0.76 ± 0.12; <i>p</i> = 0.000) and RI (0.58 ± 0.11 vs. 0.52 ± 0.06; <i>p</i> = 0.021). PDvasc group showed higher PI (0.98 vs. 0.76; <i>p</i> = 0.001) and higher frequency of altered cVR (72.2% vs. 42.2%; <i>p</i> = 0.004). There was a significant predominance of higher values on Fazekas scale in the PDvasc group. We found no difference between the Fazekas scale when comparing motor subtypes groups but there was a trend toward higher scores in the AR phenotype. Conclusions: TCCS, a cost-effective method, displayed impaired cVR in Parkinsonian patients with risk factors for CVD with higher degree of MRI leukoaraiosis. PD patients with the AR disease phenotype also presented impaired cVR on TCCS and greater functional impairment, although with just a trend to higher scores on MRI Fazekas. |
| first_indexed | 2024-03-11T03:53:37Z |
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| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-11T03:53:37Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-44693393387844718dadbef9a4eb50f12023-11-18T00:41:42ZengMDPI AGBrain Sciences2076-34252023-04-0113570910.3390/brainsci13050709Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional StudyRodrigo Tavares Brisson0Rita de Cássia Leite Fernandes1Josevânia Fulgêncio de Lima Arruda2Thiffanny Cristini Cassiano da S. M. Rocha3Nathália de Góes Duarte Santos4Liene Duarte Silva5Marco Antônio Sales Dantas de Lima6Ana Lucia Zuma de Rosso7Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilDepartment of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, BrazilBackground: A correlation between worse functional outcomes in Parkinson’s disease (PD) patients with cerebrovascular disease (CVD) or the Akinetic-rigid phenotype has been argued in recent studies. We aimed to evaluate the association of cerebral hemodynamics impairments, assessed by Transcranial Color-coded Doppler sonography (TCCS), on PD patients with different phenotypes of the disease and with risk factors for CVD. Methodology: Idiopathic PD patients (n = 51) were divided into motor subtypes: Akinetic-rigid (AR) (n = 27) and Tremor-dominant (TD) (n = 24) and into two groups regarding vascular risk factors: when ≥2 were present (PDvasc) (n = 18) and <2 (PDnvasc) (n = 33). In a parallel analysis, the Fazekas scale on brain magnetic resonance imaging (MRI) was applied to a sample to assess the degree of leukoaraiosis. TCCS examinations were prospectively performed obtaining middle cerebral artery Mean Flow Velocities (Vm), Resistance Index (RI), and Pulsatility Index (PI). The Breath-Holding Index (BHI) was calculated to assess cerebrovascular reactivity (cVR). Standardized functional scales were administered (UPDRS III and Hoehn&Yahr). Results: The phenotype groups were similar in age, disease duration and demographic parameters, but there were significantly higher H&Y scores than TD group. cVR was impaired in 66.7% of AR vs. 37.5% of TD. AR group exhibited lower BHI (0.53 ± 0.31 vs. 0.91 ± 0.62; <i>p</i> = 0.000), lower Vm after apnea (44.3 ± 9.0 cm/s vs. 53.4 ± 11.4 cm/s; <i>p</i> = 0.003), higher PI (0.91 ± 0.26 vs. 0.76 ± 0.12; <i>p</i> = 0.000) and RI (0.58 ± 0.11 vs. 0.52 ± 0.06; <i>p</i> = 0.021). PDvasc group showed higher PI (0.98 vs. 0.76; <i>p</i> = 0.001) and higher frequency of altered cVR (72.2% vs. 42.2%; <i>p</i> = 0.004). There was a significant predominance of higher values on Fazekas scale in the PDvasc group. We found no difference between the Fazekas scale when comparing motor subtypes groups but there was a trend toward higher scores in the AR phenotype. Conclusions: TCCS, a cost-effective method, displayed impaired cVR in Parkinsonian patients with risk factors for CVD with higher degree of MRI leukoaraiosis. PD patients with the AR disease phenotype also presented impaired cVR on TCCS and greater functional impairment, although with just a trend to higher scores on MRI Fazekas.https://www.mdpi.com/2076-3425/13/5/709Parkinson’s diseasecerebrovascular diseasecerebral vasoreactivityultrasound applicationcerebral hemodynamics |
| spellingShingle | Rodrigo Tavares Brisson Rita de Cássia Leite Fernandes Josevânia Fulgêncio de Lima Arruda Thiffanny Cristini Cassiano da S. M. Rocha Nathália de Góes Duarte Santos Liene Duarte Silva Marco Antônio Sales Dantas de Lima Ana Lucia Zuma de Rosso 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 Parkinson’s disease cerebrovascular disease cerebral vasoreactivity ultrasound application cerebral hemodynamics |
| title | Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study |
| title_full | Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study |
| title_fullStr | Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study |
| title_full_unstemmed | Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study |
| title_short | Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson’s Disease: Interim Analysis of a Cross-Sectional Study |
| title_sort | altered cerebral vasoreactivity on transcranial color coded sonography related to akinetic rigid phenotype of parkinson s disease interim analysis of a cross sectional study |
| topic | Parkinson’s disease cerebrovascular disease cerebral vasoreactivity ultrasound application cerebral hemodynamics |
| url | https://www.mdpi.com/2076-3425/13/5/709 |
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