title: Triple stimulation technique findings in vascular Parkinsonism and Parkinson's disease.
abstract: OBJECTIVE
  One of the predominant clinical features that differentiates vascular Parkinsonism (VP) from Parkinson's disease (PD) is the pyramidal sign. The triple stimulation technique (TST) is one of the most sensitive methods for comparing upper motor neuron involvement in patients with VP and PD. This study aimed to evaluate the usefulness of the TST as a diagnostic tool for VP.
  
  
  METHODS
  Thirteen VP patients, 18 PD patients and 10 age-matched healthy controls were enrolled in this study. We obtained basic participant demographic information and transcranial magnetic stimulation (TMS) parameters, including the TST amplitude ratio, from all participants. We compared the TMS parameters among the VP, PD and control groups.
  
  
  RESULTS
  The TST amplitude ratio was significantly lower in the VP group than in the PD and control groups (71.59 ± 11.86 vs. 96.42 ± 5.11 and 97.70 ± 3.82, respectively; p<0.01). The TST amplitude ratio was positively correlated with scores obtained on the United Parkinson's Disease Rating Scale-III, which reflects motor function.
  
  
  CONCLUSIONS
  The TST is an effective and easy technique that offers improved diagnostic sensitivity in patients with VP by assessing upper motor neuron involvement. The TST may also represent a useful monitoring tool for evaluating disease progression.
  
  
  CONCLUSIONS
  This study is the first to assess pyramidal involvement in patients with VP using the collision technique.
authors.affiliation: Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
authors.forename: Wooyoung
authors.initials: W
authors.lastname: Jang
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Republic of Korea. Electronic address: loca99@paik.ac.kr.
authors.forename: Jinse
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Neurology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Youn
authors.affiliation: Department of Neurology, Chungnam National University Hospital, College of Medicine, Daejun, Republic of Korea.
authors.forename: Eungseok
authors.initials: E
authors.lastname: Oh
authors.affiliation: Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea. Electronic address: jkd@gnah.co.kr.
authors.forename: Kwang Deog
authors.initials: KD
authors.lastname: Jo
authors.affiliation: Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
authors.forename: Moon Kyu
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee-Tae
authors.initials: HT
authors.lastname: Kim
mesh_terms: D000368:Aged; D004568:Electrodiagnosis / Q000379:methods*; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000209:etiology / Q000503:physiopathology; D009046:Motor Neurons; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Collision technique; Electrodiagnosis; Movement disorder; Neurophysiology; Parkinsonism