{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:27:42Z","timestamp":1790267262967,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: A correlation between worse functional outcomes in Parkinson\u2019s disease (PD) patients with cerebrovascular disease (CVD) or the Akinetic-rigid phenotype has been argued in recent studies. We aimed to evaluate the association of cerebral hemodynamics impairments, assessed by Transcranial Color-coded Doppler sonography (TCCS), on PD patients with different phenotypes of the disease and with risk factors for CVD. Methodology: Idiopathic PD patients (n = 51) were divided into motor subtypes: Akinetic-rigid (AR) (n = 27) and Tremor-dominant (TD) (n = 24) and into two groups regarding vascular risk factors: when \u22652 were present (PDvasc) (n = 18) and &lt;2 (PDnvasc) (n = 33). In a parallel analysis, the Fazekas scale on brain magnetic resonance imaging (MRI) was applied to a sample to assess the degree of leukoaraiosis. TCCS examinations were prospectively performed obtaining middle cerebral artery Mean Flow Velocities (Vm), Resistance Index (RI), and Pulsatility Index (PI). The Breath-Holding Index (BHI) was calculated to assess cerebrovascular reactivity (cVR). Standardized functional scales were administered (UPDRS III and Hoehn&amp;Yahr). Results: The phenotype groups were similar in age, disease duration and demographic parameters, but there were significantly higher H&amp;Y scores than TD group. cVR was impaired in 66.7% of AR vs. 37.5% of TD. AR group exhibited lower BHI (0.53 \u00b1 0.31 vs. 0.91 \u00b1 0.62; p = 0.000), lower Vm after apnea (44.3 \u00b1 9.0 cm\/s vs. 53.4 \u00b1 11.4 cm\/s; p = 0.003), higher PI (0.91 \u00b1 0.26 vs. 0.76 \u00b1 0.12; p = 0.000) and RI (0.58 \u00b1 0.11 vs. 0.52 \u00b1 0.06; p = 0.021). PDvasc group showed higher PI (0.98 vs. 0.76; p = 0.001) and higher frequency of altered cVR (72.2% vs. 42.2%; p = 0.004). There was a significant predominance of higher values on Fazekas scale in the PDvasc group. We found no difference between the Fazekas scale when comparing motor subtypes groups but there was a trend toward higher scores in the AR phenotype. Conclusions: TCCS, a cost-effective method, displayed impaired cVR in Parkinsonian patients with risk factors for CVD with higher degree of MRI leukoaraiosis. PD patients with the AR disease phenotype also presented impaired cVR on TCCS and greater functional impairment, although with just a trend to higher scores on MRI Fazekas.<\/jats:p>","DOI":"10.3390\/brainsci13050709","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T06:20:42Z","timestamp":1682317242000},"page":"709","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson\u2019s Disease: Interim Analysis of a Cross-Sectional Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Rodrigo Tavares","family":"Brisson","sequence":"first","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita de C\u00e1ssia Leite","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josev\u00e2nia Fulg\u00eancio de Lima","family":"Arruda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiffanny Cristini Cassiano da S. M.","family":"Rocha","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nath\u00e1lia de G\u00f3es Duarte","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liene Duarte","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2106-1676","authenticated-orcid":false,"given":"Marco Ant\u00f4nio Sales Dantas","family":"de Lima","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Lucia Zuma","family":"de Rosso","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.31887\/DCNS.2004.6.3\/galexander","article-title":"Biology of Parkinson\u2019s disease: Pathogenesis and pathophysiology of a multisystem neurodegenerative disorder","volume":"6","author":"Alexander","year":"2004","journal-title":"Dialogues Clin. 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