Objective: To identify risk factors and TOAST pathogenic subtypes of ischemic stroke (IS) in patients with Parkinson’s disease (PD) .

Background: Several studies revealed a increased risk of stroke in previously diagnosed Parkinson’s disease patients, then in general population, but there has been no attempts done to identify pathogenic subtype of ischemic stroke in these patients population. Finding associated risk factors and pathogenic ischemic stroke subtypes will influence prevention, management, and prognosis of the disorder.

Method: We examined 28 previously diagnosed Parkinson’s disease patients with acute IS (42% men, 58% women: mean age 74 ± 8 yy.) to identify  risk factors and subtypes of IS in PD patients. Patients were receiving levodopa/carbidopa or levodopa/benserazide combination. All patients underwent CT or MRI, 24 hours holter monitoring,  doppler ultrasound of brachiocephalic arteries (BCA), echocardiography. Neurological deficit was evaluated by NIH Stroke Scale (NIHSS). Ischemic strokes were classified according to the TOAST criteria into 5 categories (large artery atherosclerosis/atherotrombotic, small artery/lacunar, cardioembolic, other, undetermined/cryptogenic).

Results: Atrial fibrillation was detected in 68%  patients, diabetes mellitus–25%,hypertension in 21% ischemic heartdisease-36%,congestive heart failure-28%,BCA atherosclerosis-32%,chronic kidney disease–61%patients. Cardioembolic stroke was diagnosed in 60%,lacunar-8%,atherothrombotic in 18% patients  and cryptogenic in 14%. Patient with Cardioembolic stroke patients more often suffer from atrial fibrillation then other subtypes(78%vs22% p<0,001)
Cardioembolic stroke PD patients had more severe neurological deficits comparing with non-cardioembolic stroke PD patient, NIHSS 9(7;11) vs5(4;7),p=0,001.

Conclusion: PD patients had broad range of IS risk factors, which can lead to various subtype of IS. In our study most prevalent IS risk factors in PD patient was atrial fibrillation, which cause consequently cardioembolic stroke. Cardioembolic stroke PD patients had more severe neurological deficits than non-cardioembolic stroke PD patient. Further studies are required to understand epidemiology and risk factors of ischemic stroke patients with Parkinson’s disease, which may have big impact on prevention, management, and prognosis of the stroke in these patients population.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-factors-and-subtypes-of-ischemic-stroke-in-patients-with-parkinsons-disease/