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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association v.27 no.1, 2018년, pp.153 - 161   SCIE
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Vascular Parkinsonism in a Tertiary Care Stroke Prevention Clinic and the Development of a New Screening Strategy

Manosalva, Herbert A.    (Address correspondence to Oksana Suchowersky, MD, FCCMG, FRCPC, University of Alberta, 7 –  ); Pio, Fabricio    (112 S3 Clinical Sciences Building, 11350 83 Avenue, Edmonton, AB T6G 2G3, Canada.  ); Jeerakathil, Thomas   Saqqur, Maher   Camicioli, Richard   Suchowersky, Oksana  
  • 초록  

    Objectives To determine the prevalence of vascular parkinsonism (VasP) in a stroke prevention clinic (SPC). Background VasP can be defined by an onset of parkinsonism with prominent gait problems occurring within 1 year of stroke. Methods We created a screening strategy based on the Tanner Questionnaire (TQ), a validated scale for parkinsonism, and the creation of a 4-point Five-Minute Assessment Scale (FMAS) operationalizing Zijlmans' criteria for the diagnosis of VasP. Consecutive stroke patients were screened over a 12-month period using the TQ and the FMAS. SAS statistical software was used. Results Two hundred forty patients (52.5% females) were screened (mean age of 65 years, standard deviation, 14.5). Twenty-five percent of patients had a TQ score ≥ 4 with a median FMAS of 2. In this group, 32.6% (15/46) were found to have parkinsonism. Seventeen percent (8/46) were diagnosed with VasP having an FMAS of 4. Seventy-five of the participants obtained a TQ ≤ 3, with a median FMAS of 1. Only 1 patient in this group had parkinsonism (1.9%; 1/194). Using a cutoff of 4 points in the TQ resulted in a sensitivity of 93.8%, a specificity of 86.2% for parkinsonism, and a sensitivity of 100% with a specificity of 83% for VasP. Patients with FMAS = 4 (VasP) attained higher scores in the TQ with a median of 5 (Spearman rank correlation coefficient for the TQ and the FMAS (r s ) = .447, P Conclusions We documented a prevalence of 3% (8/240) for VasP in an SPC. We propose a new, easier, and unified 2-step TQ-FMAS screening strategy for this condition.


  • 주제어

    Vascular parkinsonism .   Parkinson's disease .   drug-induced parkinsonism .   gait disorder .   stroke .   epidemiology .   new screening strategy.  

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