A Silent Threat: Deep Vein Thrombosis in Early-Stage Parkinson's Disease

Abstract

Introduction: The primary clinical manifestation of venous thrombosis is discomfort in the lower extremities. Some early Parkinson's disease (PD) patients feel discomfort in the lower limbs. Venous thrombosis can risk lives by causing pulmonary embolism. This study examines the incidence of DVT in early PD patients and its correlation with different clinical and lab features.

Methods: A cross-sectional study was conducted on 117 patients with early-stage PD. Ultrasonography was employed to detect the presence of DVT. Factors such as age, gender, body mass index, lifestyle habits (smoking and drinking), medical history (hypertension, diabetes, atrial fibrillation, and tumor), and other lab tests linked to thrombosis were analyzed.

Results: In 117 patients, 11 (9.4%) had DVT, while 106 (90.6%) did not. There were no significant differences in gender, BMI, habits, medical history, or other thrombosis-related tests between both groups. However, DVT patients were older with higher d-dimer levels. They also showed an increased right substantia nigra ultrasound echo area, higher HY grades, higher UPDRS 3 scores, less improvement in UPDRS 3 scores and levodopa response.

Discussion: The primary risk factors for lower extremity venous thrombosis were found to be age, d-dimer levels, and low-dose levodopa. Therefore, for elderly patients with early-stage PD, it is crucial to conduct d-dimer and lower extremity vascular ultrasound tests. The prevention of venous thrombosis in the lower extremities of early PD patients is of utmost importance.

Keywords: Parkinson’s disease; deep vein thrombosis; early-stage; risk; ultrasonography.

Figure 1

The incidence of DVT in early-stage PD. (A) Patients without PD (80 cases) did not see DVT; (B) In patients with early-stage PD (117 cases), DVT was visible in 11 cases.

Figure 2

Representative diagrams of color Doppler ultrasound (CDFI). (A) Normal picture, color CDFI lower limb calf lateral deep vein lumen filled with blood flow signal; (B) DVT diagram, hypo echo-phore filling was seen in the lumen of the deep vein on the lower leg side, and no obvious blood flow signal was seen in CDFI; (C) DVT diagram, the echo-phore attached to the tube wall was seen in the deep vein of the lower leg side, and the blood flow filling defect was seen in the CDFI lumen. The white arrows indicate the color Doppler sampling frame we selected. The red areas represent intermuscular veins running. The scaler bar is 4 cm.

Figure 3

Clinical findings in the DVT positive and negative early-stage PD patients. D-D Level (A), SNR echo area (B), scores of UPDRS3 off (C) and UPDRS3 open (D), improvement rate (E), and H-Y stage (F) was a significant change in DVT positive early-stage PD patients. +, DVT positive early-stage PD patients, 11 cases; -, DVT negative early-stage PD patients, 106 cases. Data are presented as the mean ± SEM. *P < 0.05; **P < 0.01, ***P < 0.001.

Figure 4

Early PD patients in the course of duration and H-Y stage (A), improvement rate (B), scores of UPDRS3 off (C) and UPDRS3 open (D), LED level (E), and D-D Level (F) of relevance. The red line represents the trend line. The ordinate represents the corresponding index. The abscissa is duration. N=117. P value and the correlation coefficient in the top left corner of the picture.

Figure 5

Early PD patients in the course of age and H-Y stage (A), improvement rate(B), scores of UPDRS3 off (C) and UPDRS3 open (D), LED level(E), and D-D Level(F) of relevance. The red line represents the trend line. The ordinate represents the corresponding index. The abscissa is age. N=117. P value and the correlation coefficient in the top left corner of the picture.