Interaction effects between vascular factors, age-associated nigrostriatal dopaminergic losses and neurodegenerations: a multisystem model of motor impairments in vascular parkinsonism

Vascular parkinsonism (VP) is a heterogeneous entity. VP is likely not the exclusive result of disruption of motor pathways by vascular lesions. Older age is a significant risk factor for VP and nigrostriatal losses of normal aging are likely to interact with vascular factors in the etiopathogenesis of parkinsonism. Furthermore, age-related prodromal neurodegenerations such as incidental Lewy bodies and amyloidopathy may also expand the spectrum of overlapping pathologies seen in VP. A multi-system model may explain motor parkinsonism in elderly subjects with VP where motor symptoms arise from a combination of vascular, aging and prodromal neurodegenerative etiologies.