Hello! I read carefully your question and understand your concern. Your MRI finding have revealed chronic changes of the small vessels in the brain, leading to small repeated brain strokes. It is related to uncontrolled hypertension and diabetes. From the other hand this MRI findings can exclude Parkinson disease, but can not exclude Parkinson syndrome, which means that you have the clinical features of Parkinson, but they are related to damage to the basal ganglia caused by small vessel disease. Parkinson s Syndrome is diagnosed based on the physical examination. Further tests to consider would be DAT scan, which could examine better the damage to the basal ganglia. Levo-Dopa trial can be performed to examine your response to this drug. If it is positive, Parkinson s syndrome would be likely and treatment with dopa agonist drugs or levo-dopa should be considered. Meanwhile, I recommend you to closely monitor your blood pressure and fasting glucose, and take aspirin and a statin to prevent further progression of small vessel disease, leading to further aggravation of your situation. Hope you will find this answer helpful! Kind regards, Dr. Aida