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Small Vessel Disease in Parkinson's Can Lead to Worsening Motor Impairment

Small vessel disease (SVD) was correlated with greater motor impairment in autopsy-determined Parkinson’s disease (PD), according to a paper published in the October 13 online edition of the Journal of Clinical Neuroscience. “Our study suggests that neurologists treating patients with PD should proactively manage their patient’s vascular risk factors, which may reduce gait and cognitive impairment, two of the main clinical features that undermine wellbeing and independence in patients with PD,” lead investigator Jillian Kril, PhD, professor of neuropathology at the University of Sydney Medical School in Australia, told Neurology Today in an email. She also suggested obtaining magnetic resonance imaging of the brain to determine the presence of SVD. “Parkinsonism can be caused by either PD, which is a synucleinopathy (abnormal protein accumulation) or vascular pathology — either infarcts or SVD, although vascular parkinsonism is rarer than PD. We hypothesized that small vessel cerebrovascular disease could be a contributor to PD,” said Dr. Kril. However, she noted that previous studies of the association between vascular disease and PD have produced conflicting results. For example, Dr. Kril and her colleagues in Australia conducted an earlier study with the same PD population as the current study but with a control group. They found that both SVD and vascular risk factor were greater in the controls than the patients with PD. But other studies pertaining to Alzheimer’s disease and Parkinson’s disease have shown that cognition is worse in patients with SVD and vascular pathology. And so Dr. Kril and her colleagues conducted the current study to determine whether SVD makes the motor or cognitive functions worse in PD patients.