Vascular Parkinson’s (VP) disease is a condition that occurs due to one or more small strokes in a specific area of the brain. These strokes result from a reduced blood supply. It often affects the lower body, leading to difficulty maintaining balance and walking.
VP presents similarly to Parkinson’s disease (PD) but is a separate condition.
Although PD has similar symptoms, the symptoms of VP tend to predominantly affect the lower body.
The condition occurs as a result of stroke-induced brain damage to areas of the brain that control certain aspects of movement.
This article discusses what VP is, how it compares with PD, and what symptoms a person can expect. It also looks at the causes of VP and how a doctor treats the condition.
Parkinsonism is the term for a group of neurological disorders that are similar to PD but with additional symptoms or alternate causes.
VP is one of three main types of parkinsonism. It has an association with cerebrovascular disease and develops when strokes affect a specific area of the brainstem called the basal ganglia, which is involved in motor coordination and muscle tone.
A 2018 article published in Frontiers in Neurology identifies three subsets of VP, which include:
- Acute or delayed progressive onset form: This means the symptoms worsen over time and can appear suddenly after the cerebrovascular event or some time after.
- Vascular parkinsonism of insidious onset: This means the onset of the condition is gradual.
- Mixed neurodegenerative parkinsonism and cerebrovascular disease: This means there is a diagnostic overlap with another neurodegenerative condition.
The two other main types of parkinsonism include drug-induced parkinsonism and idiopathic parkinsonism. In drug-induced parkinsonism, symptoms develop as a result of certain medications. Idiopathic parkinsonism means the cause of the symptoms is unknown.
The symptoms of VP may come on suddenly and without warning. However, they can also develop gradually over weeks or months after the stroke.
In some cases, the stroke may not have caused symptoms, but a person may notice that they have developed a tremor of the arm or leg or balance problems.
The symptoms of VP typically affect the lower body. This can result in:
- wide-based walking
- a shuffling or freezing gait
VP can cause a person to experience resting tremors and stiffness that affects the arms, legs, or both.
People may also experience problems with sleep and depression.
How do the symptoms differ from PD?
A major difference between VP and PD is that PD usually affects both sides of the body, and VP usually affects one side of the body.
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VP happens when a reduced blood supply to the brain causes one or more strokes that damage the basal ganglia.
As VP has a vascular origin, there are several risk factors that could increase a person’s chances of having a VP-inducing stroke. These factors include:
- diabetes mellitus
- high blood pressure
- various types of heart disease, such as coronary artery disease and other arrhythmias
- a family history of stroke
- sleep apnea
Other risk factors include:
- a personal history of stroke
- high BMI
- high cholesterol
Treatment involves easing symptoms and reducing the risk factors of stroke.
A healthcare professional may prescribe medications that typically treat PD, such as levodopa. Although this may help to treat stiffness and slowness, it does not appear to be significantly beneficial.
A 2017 review indicates that VP responds poorly to levodopa, only showing a response in about
Physical and occupational therapy can help relieve discomfort and stiffness and make walking and moving easier. A person may also use a cane or mobility scooter if they find walking too difficult.
A physiotherapist may provide exercises that a person can do at home to maintain muscle tone and reduce the risk of falls.
Other forms of treatment involve managing risk factors that could cause another stroke. These include:
- managing conditions such as high blood pressure and diabetes
- taking part in physical exercise
- stopping smoking
- reducing alcohol intake
- eating a healthy diet
If a person suspects they have symptoms of depression, they should seek advice from a healthcare professional.
VP is a chronic condition, meaning it will not go away. However, a person may be able to prevent the condition from worsening by working closely with their medical team and maintaining a healthy lifestyle.
According to a study in Parkinsonism & Related Disorders, having any form of parkinsonism reduces a person’s life expectancy, especially if the diagnosis occurs before a person reaches 70 years old.
To get a diagnosis, a person can visit a primary care doctor. They may fully manage the condition or refer the person to a neurologist.
If a person does not improve with standard treatment, a doctor may refer them to a movement disorder specialist (MDS). An MDS has completed specialist training in PD and other movement disorders.
There is no specific diagnostic test for VP. However, a medical professional will review a person’s medical history, ask about symptoms, and perform a physical examination.
It is often difficult to distinguish between different types of parkinsonism due to the similarity of their symptoms.
To help diagnose VP, the doctor may request brain imaging. A 2019 review suggests that brain imaging can help differentiate VP from other forms of parkinsonism, such as PD.
PD is a progressive, neurodegenerative condition that causes uncontrollable movements, such as:
- resting tremor
- difficulty with balance and coordination
Whereas PD affects the entire body, VP has a more noticeable effect on the lower body.
PD develops due to a combination of environmental and genetic factors leading to the loss of nerve cells in specific brain regions. This results in lower levels of dopamine, which is a hormone that plays a role in regulating body movement.
VP is vascular in origin and causes sudden damage to the same area of the brain that PD affects.
If a person is experiencing tremors, issues with controlling their movement, trouble walking, or stiffness, they should seek advice from a healthcare professional.
Any person experiencing symptoms of parkinsonism should arrange an appointment to speak with a primary care doctor.
A person should seek emergency medical attention for any symptoms of stroke.
VP is a type of parkinsonism that develops as a result of one or more strokes that occur due to a blockage of blood flow to the brain.
Symptoms are more prominent in the lower body and can include wide-based walking, a shuffling or freezing gait, and falls. As the condition progresses, a person may also develop incontinence, problems with sleep, and depression.
Medications to treat PD are not significantly beneficial for VP. Treatment will involve physical and occupational therapy, along with medications and lifestyle changes to prevent another stroke.