Integrated assessment of cerebral blood flow and cerebrovascular reactivity based on functional tests data in patients with Parkinson's disease and vascular pathology

Objective. To evaluate cerebral blood flow parameters and cerebrovascular reactivity indices based on data of functional tests in patients with Parkinson's disease (PD) and vascular pathology.Material and Methods. A total of 148 people were examined, divided into 4 groups: (1) main group comprised 24 patients with idiopathic PD; (2) comparison group 1 included 21 patients with vascular parkinsonism; (3) comparison group 2 included 26 patients with a diagnosis of chronic cerebral ischemia of severity degree 2 with no signs of parkinsonism; and (4) comparison group 3 included 77 patients with PD and cerebrovascular disease. All patients received transcranial duplex scanning of cerebral blood vessels (TCD) through the temporal window (Toshiba Aplio 500, Japan, 2-2.5 MHz sector probe) using standard protocols for the assessment of blood flow velocity characteristics. An assessment of cerebrovascular reactivity (reserve) was performed using the diagnostic and treatment complex “Carbonic”. The range of cerebrovascular and vasomotor hypercapnia reactivity to hypercapnia was evaluated in the “Testing of cerebrovascular reactivity” mode.Results. A comprehensive study of cerebral blood flow parameters using functional tests suggested that the absence of changes in the cerebrovascular reactivity index (VRhyperCO2 ) observed in patients with idiopathic PD may be considered a differential diagnostic criterion for Parkinson's disease and cerebrovascular pathology with Parkinson's symptoms.