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A 76-year-old woman presented with rest tremor in the right arm, global bradykinesia, rigidity in both arms and neck, and parkinsonian gait with poor response to levodopa. Neuroimaging studies revealed enhanced perivascular spaces in left striatum (Figures 1 and 2). Although commonly considered nonpathologic, when they are numerous or localized at the striatum or midbrain, they may have a role in the development of parkinsonism.1 Given their size, in this case, they might act as direct structural damage to dopaminergic terminals. Whether they could trigger neurodegeneration or might act in an additive fashion lowering the threshold for neurodegeneration to induce PD remains unclear.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and editor reviewed. The handling editor was Editor-in-Chief José Merino, MD, MPhil.
- Received November 27, 2021.
- Accepted in final form March 2, 2022.
- © 2022 American Academy of Neurology
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- Reader Response: Parkinsonism Associated With Striatal Enlarged Perivascular Spaces
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