Cerebrovascular Hemodynamic Abnormalities in Parkinson’s Disease: A Multimodal Assessment Using CVHD and TCD

Objective This study aimed to investigate changes in cerebral hemodynamics in Parkinson’s disease (PD) patients using cerebrovascular hemodynamic detection (CVHD) and transcranial Doppler (TCD), and to explore the associated influencing factors. Methods We enrolled 75 PD patients admitted to the Department of Neurology, Third Hospital of Hebei Medical University, from January 2022 to March 2024, along with 50 healthy controls matched for the same period. General clinical data of PD patients were collected, and motor function, disease severity, and autonomic function were evaluated using the Unified Parkinson’s Disease Rating Scale Part III (UPDRS III), Hoehn-Yahr (H-Y) staging, and Scales for Outcomes in Parkinson’s Disease-Autonomic (SCOPA-AUT). CVHD-derived total cerebral function scores and TCD parameters of the middle cerebral artery (MCA), including peak systolic velocity (Vs), end-diastolic velocity (Vd), mean velocity (Vm), and pulsatility index (PI), were recorded for all participants. Clinical data and examination results were compared between the two groups, and clinical factors influencing cerebral function scores in PD patients were analyzed. Results Compared with healthy controls, PD patients exhibited a significant reduction in total CVHD cerebral function scores (t=-9.217, P < 0.001) and a statistically significant difference in the proportion of cases across different cerebral function score ranges (Z=-7.032, P < 0.001). MCA Vs, Vd, and Vm were also significantly lower in PD patients (t=-5.471, -4.701, -5.373; all P < 0.001), whereas PI was higher but not statistically significant (P > 0.05). In PD patients, UPDRS III scores, SCOPA-AUT scores, and H-Y stages were negatively correlated with cerebral function scores (r=-0.842, -0.498, -0.301; all P < 0.05). Multiple linear regression analysis identified UPDRS III as an independent influencing factor for cerebral function scores. Conclusions PD patients commonly present with mild-to-moderate CVHD abnormalities, primarily characterized by reduced cerebral perfusion, while cerebrovascular resistance remains normal with a tendency to increase. The degree of CVHD impairment is negatively correlated with UPDRS III scores, SCOPA-AUT scores, and H-Y stages, among which UPDRS III is the primary influencing factor for CVHD alterations.