Cortical excitability changes in patients of vascular parkinsonism with cognitive impairment

• Published in: Parkinsonism & related disorders 2023-11, Vol.116, p.105869-105869, Article 105869
• Main Authors: Agrawal, Aakash, Bhattacharya, Amitabh, Kamble, Nitish, Mailankody, Pooja, Yadav, Ravi, Pal, Pramod Kumar
• Format: Article
• Language: English
• Subjects: Cognition; Cortical excitability; Intracortical facilitation; Short-interval intracortical inhibition; Transcranial magnetic stimulation; Vascular parkinsonism
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2023.105869

Vascular parkinsonism (VaP), type of lower body parkinsonism, occurs in relation to ischemic cerebrovascular disease. It can be associated with cognitive impairment. We aimed to study the cortical excitability changes in these patients using transcranial magnetic stimulation (TMS). We included 20 patients with VaP and 22 healthy controls (HC). All subjects underwent TMS over left motor cortex with recording of resting motor threshold (RMT), central motor conduction time (CMCT), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), contralateral and ipsilateral silent period (SP) along with RMT and CMCT in the contralateral lower limb. Cognitive assessments were done using Montreal cognitive assessment (MoCA) and Addenbrooke's cognitive evaluation III (ACE III). Mean age of patients (63.90 ± 7.36 years) was comparable with controls (59.77 ± 6.94 years; p = 0.07). Duration of disease was 2.58 ± 2.57 years. The upper and lower limb RMT of patients (32.45 ± 4.81%; 57.20 ± 11.54%) was significantly low compared to HC (43.64 ± 7.73%; 69.18 ± 14.27%; p