Parkinson's disease is Subtly Distinguishable from Vascular Parkinsonism as shown by their Variable Ranges of Sensitivity to Dopaminergic Therapy

Abstract

Cerebrovascular Disease (CVD) has been found widely in population, even in patients with Parkinson’s Disease (PD) who are defined according to current criteria-idiopathic PD began in younger ages (for example 45-65 years age range). In fact it is remarkable even if neglected that physicians detect as a common finding a high cerebrovascular lesion burden in older patients apparently as nonspecific feature due to age and independent of the PD disease itself. This data are generally ignored by clinicians and researchers according to the classic criterion based on response to drug (dopaminergic therapy) to give elements of certainty about the diagnosis of PD; then they declassify clinical cases not responding to drug therapy to Vascular Parkinsonism (VP), assuming that the latter is not or poorly sensitive to dopaminergic therapy. The author hypothesizes that vascular defect would produce, with an unknown mechanism, a presynaptic damage which would explain the greater frequency of vascular damage in patients with PD compared to other diseases related to movement disorders.