FitzGerald and Jankovic 29 /1989 |
Hospital-based cross-sectional (tertiary referral
center) |
10 VP 100 PD |
Marked gait difficulty with lack of or with only
minimal upper limb involvement (i.e. lower body parkinsonism) |
Patients with VP have a significantly shorter symptom
duration, present with gait difficulty, have less levodopa responsiveness. There is
no difference in risk factors, except for hypertension. |
Zijlmans et al. 30 /1995 |
Cross-sectional |
15 VP 15 DP |
Parkinsonism with dominant frontal gait disorder, aged
>60 years, and the exclusion of other secondary parkinsonism types |
There is no difference between patients with VP and
patients with PD or hypertensive controls in age or BP. Patients with VP have more
subcortical lesions than patients with PD. A cutoff of 0.6% lesioned ischemic brain
volume is suggested. Clinical severity is not correlated with lesion volume or
location. |
Yamanouchi and Nagura 31 /1997 |
Clinicopathological |
24 VP 30 PD c
|
Parkinsonism with evidence of cerebrovascular lesions
and lack of depigmentation or Lewy bodies in the substantia nigra |
Of the patients with VP, 17% of the patients had
tremor (versus 73% of the PD patients), 38% of the patients had hemiparesis, and 63%
of the patients had pyramidal signs (versus 0% in the PD patients). One-half of the
patients with VP had pseudobulbar palsy; 27% of patients with PD had dysphasia or
dysarthria. Dementia was present in 71% of patients with VP and 43% of patients with
PD. Only one-fifth of the patients with VP showed a transient response to levodopa.
Asymmetry of limb rigidity was present in 29% of the patients with VP versus 73% of
the patients with PD. There was no difference in gait disorders between VP and
PD. |
Winikates and Jankovic 2 /1999 |
Retrospective, cross-sectional, hospital-based |
69 VP 277 PD |
Patients with parkinsonism and a vascular score of 2
points or more on a vascular rating scale a
|
Patients with VP were significantly older and had gait
difficulty, less levodopa responsiveness, symmetrical predominant lower body
involvement, postural instability, falls, dementia, corticospinal findings,
incontinence, and pseudobulbar palsy. |
Demirkiran et al. 32 /2001 |
Review of medical records, cross-sectional |
16 VP 50 PD |
Parkinsonism, presence of vascular lesions on brain
MRI, and the exclusion of other causes of secondary parkinsonism |
Patients with VP were significantly older, had a
shorter disease duration, had a gait disorder as the most frequent initial symptom,
and 38% of the patients were levodopa responsive. Vascular risk factors were more
common in patients with VP. Postural instability, freezing, gait disturbance,
pyramidal signs, postural tremor were significantly more prevalent in VP. Patients
with VP have more prominent features in the lower limbs. |
Rampello et al. 33 /2005 |
Hospital-based cohort |
39 VP 28 PD b
|
Parkinsonism with vascular lesions on brain MRI |
Patients with VP were older and 29% of the patients
were levodopa responsive. Vascular risk factors, postural tremor, gait disorder,
pyramidal signs, and lower body predominance more frequent in VP. The UPDRS scores
at baseline were higher in patients with VP than in patients with PD. After 2 years,
patients with VP had greater lower limb involvement than patients with PD. |
Okuda et al. 34 /2008 |
Cross-sectional |
55 VP 132 PD |
Lower body parkinsonism with frontal gait disorder,
postural instability, lack of resting tremor, symmetrical progression, poor response
to levodopa, and multiple basal ganglia or subcortical infarctions |
There was no difference in age or MMSE score between
patients with VP, PD, and hypertensive controls. Primitive reflexes (i.e. snout,
palmomental), jaw jerk, Hoffmann’s score, and extensor plantar response were
significantly higher in VP. |