Lower Body Parkinsonism Patients: Increased Blood Flow in Posterior Cerebral Arteries

Introduction: Lower Body Parkinsonism (LBP) is a bilateral, symmetric lower limbs Parkinsonism without a resting tremor, a poor L-dopa response and with a minimal upper limbs involvement. Patients usually demonstrate gait difficulties due to freezing gait and falls, causing a major grade of disability when compared to idiopathic Parkinson's Disease patients (PD). Small vessel disease has been related to the pathophysiology of this type of secondary Parkinsonism. We decided to study the hemodynamic characteristics of the cerebral arteries of patients affected with LBP and compare them to PD patients using a Transcranial Doppler. Patients and Methods: We enrolled 12 LBP, 15 PD patients and 15 agematched healthy control subjects. A Transcranial Doppler was performed on patients and subjects in order to determine the systolic and diastolic velocities and pulsatility index (PI) in the anterior and posterior circuit cerebral arteries. Results: The LBP patients consisted of 7 men and 5 females; mean age 74 years; Hoenh and Yarh stages 2 and 3. PD patients consisted of 9 males and 6 females; mean age 70 years; Hoehn and yahr stages 2 and 3. LBP patients showed a mean systolic velocity of 193 cm/s, diastolic velocity 64cm/s and PI 2.22 (p: 0.01) in the Posterior Cerebral Arteries (PCA), The remaining cerebral arteries showed normal velocities and PI in LBP and PD patients as well as in normal subjects. Conclusion: The LBP patients of this study showed a statistically significant difference in the mean systolic velocity and PI of the PCA compared to PD patients and normal subjects.