Objective: Determine and compare lower body predominance and balance between Vascular Parkinsonism (VP) and Parkinson’s Disease (PD)patients in a hospital-based sample.

Background: Despite the recognition of VP as a distinct entity differential diagnosis from Parkinsonian syndromes remains difficult. Some features have been described as more specific for VP like lower body signs and symptoms leading to postural instability and balance impairment.

Method: We prospectively enrolled 49 patients, 16 with VP and 33 with PD. Analyses included clinical features, total, upper and lower extremities UPDRS III scores and validated balance scales: Berg Balance scale (BBS) and Falls Efficacy scale (FES).

Results: Patients had a mean age of 75 years old and 55% were male. Age of symptoms onset were higher for VP patients (p<0,05). Lower extremity UPDRS III score was higher in VP patients (p<0,05) and there were no statistical differences when using UPDRS-III total score. Mean total number of falls was higher in VP patients (p<0,01). Concerning balance, VP patients had worse scores for BBS and FES (p<0,05 and p<0,01, respectively). There was a positive correlation between number of falls and UPDRS-III score (total and lower extremity scores, p<0,05) and a negative correlation between number of falls and both balance scales (p<0,01). Negative correlation was also found between BBS and FES scales and UPDRS III scores (total and lower extremity score, p<0,05), but not with upper extremity UPDRS III score.

Conclusion: VP patients had more lower body signs and symptoms accordingly to lower extremity UPRDS III and balance scale scores. Validated balance scales can be useful for differential diagnosis.

References: Kalra, S, et al. Differentiating Vascular Parkinsonism from Idiopathic Parkinson’s Disease: A Systematic Review. Movement Disorders. 2010; 25 (2):149–156. Rektor I et al. An updated diagnostic approach to subtype definition of vascular parkinsonism e Recommendations from an expert working group. Parkinsonism Relat Disord. (2017) Dec 29. 1-8 P.G. Glass, A.J. Lees, A. Bacellar, J. Zijlmans, R. Katzenschlager, L. Silveira-Moriyama, The clinical features of pathologically confirmed vascular parkinsonism, J. Neurol. Neurosurg. Psychiatr. 83 (2012): 1027-1029. Melo CA. Adaptação cultural e validação da escala “Falls Efficacy Scale” de Tinnetti. Vol 1, n.º 2. http://hdl.handle.net/10400.26/8721 Tinetti, M. A., Richman, D., Powell, L. (1990). Falls Efficacy as a measure of fear of falling, Journal of Gerontology, 45(6), 239-243. Berg K, Wood-Dauphinee S, Williams JI, Maki, B: Measuring balance in the elderly: Validation of an instrument. Can. J. Pub. Health, July/August supplement 2:S7-11, 1992.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vascular-parkinsonism-and-parkinsons-disease-clinical-differences-concerning-balance-impairment/