Delayed-onset parkinsonism is common after isolated striatal infarcts.

Area of Science:

• Neurology
• Neuroscience
• Stroke Medicine

Background:

• Previous studies on parkinsonism after putaminal lesions were limited by adjacent brain region involvement and short follow-up.
• The true incidence and characteristics of parkinsonism following isolated striatal infarcts remain unclear.
• Lack of systematic neuroimaging in prior research limits understanding of post-stroke parkinsonism.

Purpose of the Study:

• To determine the incidence and timing of parkinsonism after isolated striatal infarcts.
• To characterize the clinical features of parkinsonism in this patient group.
• To utilize comprehensive neuroimaging and longitudinal assessments for accurate evaluation.

Main Methods:

• Prospective cohort study at Oslo University Hospital.
• Inclusion of patients with acute ischemic stroke and isolated striatal infarcts, excluding severe neurological deficits (NIHSS >= 6).
• Clinical assessments (NIHSS, MDS-UPDRS, MoCA) and neuroimaging (MRI, [123I]FP-CIT SPECT) at 3 months and 1 year.

Main Results:

• 27% of patients developed parkinsonism by 3 months, increasing to 67% by 1 year.
• Progressive motor symptom increase (MDS-UPDRS) with predominant contralateral symptoms; cognitive function remained stable (MoCA).
• Infarct volume and location influenced motor symptom development; all patients showed reduced dopaminergic uptake ([123I]FP-CIT).

Conclusions:

• This study is the first to systematically investigate delayed-onset parkinsonism after isolated striatal infarcts.
• Parkinsonism occurs more frequently than previously thought in patients with isolated striatal infarcts.
• Findings emphasize the importance of repeated assessments for detecting and managing post-stroke parkinsonism.