Treatment of Vascular Parkinsonism: A Systematic Review
Background and aims: Although the distinction between vascular parkinsonism (VP) and idiopathic Parkinson’s disease (IPD) is widely described, it is not uncommon to find parkinsonisms with overlapping clinical and neuroimaging features even in response to levodopa treatment. In addition, several tre...
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| Format: | info:eu-repo/semantics/article |
| Language: | English |
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MDPI
2023
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| Online Access: | http://hdl.handle.net/10835/14449 |
| _version_ | 1789408390293749760 |
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| author | Toro-Pérez, Cristina del Guevara-Sánchez, Eva Martínez Sánchez, Patricia |
| author_facet | Toro-Pérez, Cristina del Guevara-Sánchez, Eva Martínez Sánchez, Patricia |
| author_sort | Toro-Pérez, Cristina del |
| collection | DSpace |
| description | Background and aims: Although the distinction between vascular parkinsonism (VP) and idiopathic Parkinson’s disease (IPD) is widely described, it is not uncommon to find parkinsonisms with overlapping clinical and neuroimaging features even in response to levodopa treatment. In addition, several treatments have been described as possible adjuvants in VP. This study aims to update and analyze the different treatments and their efficacy in VP. Methods: A literature search was performed in PubMed, Scopus and Web of Science for studies published in the last 15 years until April 2022. A systematic review was performed. No meta-analysis was performed as no new studies on response to levodopa in VP were found since the last systematic review and meta-analysis in 2017, and insufficient studies on other treatments were located to conduct it in another treatment subgroup. Results: Databases and other sources yielded 59 publications after eliminating duplicates, and a total of 12 original studies were finally included in the systematic review. The treatments evaluated included levodopa, vitamin D, repetitive transcranial magnetic stimulation (rTMS) and intracerebral transcatheter laser photobiomodulation therapy (PBMT). The response to levodopa was lower in patients with VP with respect to IPD. Despite this, there has been described a subgroup of patients with good response, it being possible to identify them by means of neuroimaging techniques and the olfactory identification test. Other therapies showed encouraging results in studies with some risk of bias. Conclusions: The response of VP to different therapeutic strategies is modest. However, there is evidence that a subgroup of patients can be identified as more responsive to L-dopa based on clinical and neuroimaging criteria. This subgroup should be treated with L-dopa at appropriate doses. New therapies such as vitamin D, rTMS and PBMT warrant further studies to demonstrate their efficacy. |
| format | info:eu-repo/semantics/article |
| id | oai:repositorio.ual.es:10835-14449 |
| institution | Universidad de Cuenca |
| language | English |
| publishDate | 2023 |
| publisher | MDPI |
| record_format | dspace |
| spelling | oai:repositorio.ual.es:10835-144492023-04-12T19:18:08Z Treatment of Vascular Parkinsonism: A Systematic Review Toro-Pérez, Cristina del Guevara-Sánchez, Eva Martínez Sánchez, Patricia vascular parkinsonism treatment therapy systematic review levodopa vitamin D repetitive transcranial magnetic stimulation intracerebral transcatheter laser photobiomodulation Background and aims: Although the distinction between vascular parkinsonism (VP) and idiopathic Parkinson’s disease (IPD) is widely described, it is not uncommon to find parkinsonisms with overlapping clinical and neuroimaging features even in response to levodopa treatment. In addition, several treatments have been described as possible adjuvants in VP. This study aims to update and analyze the different treatments and their efficacy in VP. Methods: A literature search was performed in PubMed, Scopus and Web of Science for studies published in the last 15 years until April 2022. A systematic review was performed. No meta-analysis was performed as no new studies on response to levodopa in VP were found since the last systematic review and meta-analysis in 2017, and insufficient studies on other treatments were located to conduct it in another treatment subgroup. Results: Databases and other sources yielded 59 publications after eliminating duplicates, and a total of 12 original studies were finally included in the systematic review. The treatments evaluated included levodopa, vitamin D, repetitive transcranial magnetic stimulation (rTMS) and intracerebral transcatheter laser photobiomodulation therapy (PBMT). The response to levodopa was lower in patients with VP with respect to IPD. Despite this, there has been described a subgroup of patients with good response, it being possible to identify them by means of neuroimaging techniques and the olfactory identification test. Other therapies showed encouraging results in studies with some risk of bias. Conclusions: The response of VP to different therapeutic strategies is modest. However, there is evidence that a subgroup of patients can be identified as more responsive to L-dopa based on clinical and neuroimaging criteria. This subgroup should be treated with L-dopa at appropriate doses. New therapies such as vitamin D, rTMS and PBMT warrant further studies to demonstrate their efficacy. 2023-03-23T16:27:45Z 2023-03-23T16:27:45Z 2023-03-14 info:eu-repo/semantics/article 2076-3425 http://hdl.handle.net/10835/14449 10.3390/brainsci13030489 en https://www.mdpi.com/2076-3425/13/3/489 Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess MDPI |
| spellingShingle | vascular parkinsonism treatment therapy systematic review levodopa vitamin D repetitive transcranial magnetic stimulation intracerebral transcatheter laser photobiomodulation Toro-Pérez, Cristina del Guevara-Sánchez, Eva Martínez Sánchez, Patricia Treatment of Vascular Parkinsonism: A Systematic Review |
| title | Treatment of Vascular Parkinsonism: A Systematic Review |
| title_full | Treatment of Vascular Parkinsonism: A Systematic Review |
| title_fullStr | Treatment of Vascular Parkinsonism: A Systematic Review |
| title_full_unstemmed | Treatment of Vascular Parkinsonism: A Systematic Review |
| title_short | Treatment of Vascular Parkinsonism: A Systematic Review |
| title_sort | treatment of vascular parkinsonism: a systematic review |
| topic | vascular parkinsonism treatment therapy systematic review levodopa vitamin D repetitive transcranial magnetic stimulation intracerebral transcatheter laser photobiomodulation |
| url | http://hdl.handle.net/10835/14449 |
| work_keys_str_mv | AT toroperezcristinadel treatmentofvascularparkinsonismasystematicreview AT guevarasanchezeva treatmentofvascularparkinsonismasystematicreview AT martinezsanchezpatricia treatmentofvascularparkinsonismasystematicreview |