1
|
Artusi CA, Geroin C, Nonnekes J, Aquino C, Garg D, Dale ML, Schlosser D, Lai Y, Al‐Wardat M, Salari M, Wolke R, Labou VT, Imbalzano G, Camozzi S, Merello M, Bloem BR, Capato T, Djaldetti R, Doherty K, Fasano A, Tibar H, Lopiano L, Margraf NG, Moreau C, Ugawa Y, Bhidayasiri R, Tinazzi M. Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review. Mov Disord Clin Pract 2023; 10:1585-1596. [PMID: 38026508 PMCID: PMC10654876 DOI: 10.1002/mdc3.13879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/09/2023] [Accepted: 08/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Postural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson's disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies. Objectives We conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic. Methods We applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps. Results Ninety-two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms. Conclusions The recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point toward many different (possibly non-mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.
Collapse
Affiliation(s)
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Jorik Nonnekes
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and BehaviourDepartment of RehabilitationNijmegenThe Netherlands
| | - Camila Aquino
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, and Department of Community Health SciencesUniversity of CalgaryCalgaryABCanada
| | - Divyani Garg
- Department of Neurology, Lady Hardinge Medical College, New Delhi, India. Department of NeurologyVardhman Mahavir Medical College and Safdarjung HospitalNew DelhiIndia
| | - Marian L. Dale
- Oregon Health & Science UniversityDepartment of NeurologyPortlandORUSA
| | - Darbe Schlosser
- Graduate Student in the Motor Learning Program at Teachers CollegeColumbia UniversityNew YorkNYUSA
| | - Yijie Lai
- Department of Neurosurgery, Center for Functional NeurosurgeryRuijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Mohammad Al‐Wardat
- Department of Rehabilitation Sciences, Faculty of Applied Medical SciencesJordan University of Science and TechnologyIrbidJordan
| | - Mehri Salari
- Department of NeurologyShahid Beheshti University of Medical SciencesTehranIran
| | - Robin Wolke
- Department of NeurologyUKSH, Christian‐Albrechts‐UniversityKielGermany
| | | | - Gabriele Imbalzano
- Department of Neuroscience Rita Levi MontalciniUniversity of TurinTorinoItaly
| | - Serena Camozzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Marcelo Merello
- Movement Disorders ServiceFLENI, CONICETBuenos AiresArgentina
| | - Bastiaan R. Bloem
- Department of NeurologyRadboud University Medical Centre, Donders Institute for Brain, Cognition and BehaviourNijmegenThe Netherlands
| | - Tamine Capato
- Department of NeurologyRadboud University Medical Centre, Donders Institute for Brain, Cognition and BehaviourNijmegenThe Netherlands
- University of São PauloDepartment of Neurology, Movement Disorders CenterSão PauloBrazil
| | - Ruth Djaldetti
- Department of Neurology, Rabin Medical Center, Petah Tikva; Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Karen Doherty
- Department of NeurologyRoyal Victoria HospitalBelfastUnited Kingdom
- Centre for Medical EducationQueens University BelfastBelfastUnited Kingdom
| | - Alfonso Fasano
- Division of NeurologyUniversity of TorontoTorontoONCanada
- Krembil Brain InstituteTorontoONCanada
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria ShulmanMovement Disorders Clinic, Toronto Western Hospital, UHNTorontoONCanada
| | - Houyam Tibar
- Service de Neurologie B et de Neurogénétique Hôpital des Spécialités OTO‐Neuro‐OphtalmologiqueIbn Sina University Hospital, Medical School of Rabat, Mohamed 5 University of RabatRabatMorocco
| | - Leonardo Lopiano
- Department of Neuroscience Rita Levi MontalciniUniversity of TurinTorinoItaly
| | - Nils G. Margraf
- Department of NeurologyUKSH, Christian‐Albrechts‐UniversityKielGermany
| | - Caroline Moreau
- Expert Center for Parkinson's Disease, Neurological Department, Inserm UMR 1172Lille University HospitalLilleFrance
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross SocietyBangkokThailand
- The Academy of ScienceThe Royal Society of ThailandBangkokThailand
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | | |
Collapse
|
2
|
Cao S, Cui Y, Jin J, Li F, Liu X, Feng T. Prevalence of axial postural abnormalities and their subtypes in Parkinson's disease: a systematic review and meta-analysis. J Neurol 2023; 270:139-151. [PMID: 36098837 DOI: 10.1007/s00415-022-11354-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Axial postural abnormalities, mainly involving the spinal deformities, are disabling symptoms of Parkinson's disease (PD). However, the prevalence of axial postural abnormalities in PD and their clinical correlates remain unclear. The present study aimed to conduct a systematic review and meta-analysis of the prevalence of overall and subtypes of axial postural abnormalities in PD. METHODS PubMed, Embase, Web of Science and Cochrane databases were searched up to 31st March, 2022. We identified studies that reported the prevalence of axial postural abnormalities in PD. The pooled estimate of prevalence was calculated using a random effect model. Subgroup analysis and meta-regression were performed. RESULTS There were 19 studies met the inclusion criteria. The overall prevalence of axial postural abnormalities in PD was 22.1% (95% CI 19.7-24.5%). The prevalence of each subtype of axial postural abnormalities was 19.6% for scoliosis (95% CI 10.6-28.7%), 10.2% for camptocormia (95% CI 7.7-12.7%), 8% for Pisa syndrome (95% CI 4.7-11.4%), and 7.9% for antecollis (95% CI 3.9-11.9%). Subgroup analysis showed that the measuring method of axial postural abnormalities exerted significant effects on prevalence estimates. Axial postural abnormalities in PD were associated with older age, longer disease duration, higher H-Y stage, greater levodopa equivalent daily dose, more severe motor symptoms, motor fluctuations, and akinetic-rigid subtype. CONCLUSIONS Axial postural abnormalities, which include scoliosis, camptocormia, Pisa syndrome, and antecollis, are not uncommon in patients with PD. Future research on axial postural abnormalities should be based on uniform diagnostic criteria and measuring methods.
Collapse
Affiliation(s)
- Shuangshuang Cao
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Yidu Central Hospital of Weifang, Shandong, China
| | - Yusha Cui
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jianing Jin
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Fangfei Li
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xin Liu
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Tao Feng
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
| |
Collapse
|
3
|
Su Z, Liu S, Chen G, Gan J, Bao X, Zhu H, Wang X, Wu H, Ji Y. Pisa syndrome in dementia with Lewy bodies: A Chinese multicenter study. Parkinsonism Relat Disord 2022; 103:50-55. [PMID: 36041278 DOI: 10.1016/j.parkreldis.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Pisa syndrome (PS) is rarely reported in Dementia with Lewy bodies (DLB). The aim of this article is to investigate the prevalence rate of PS and the correlation with clinical features evaluated in patients with DLB. METHODS A total of 209 DLB patients were consecutively recruited and underwent standardized clinical evaluation in our multicenter study. The associations between PS and clinical factors were evaluated. RESULTS The prevalence rate of PS in patients with DLB was 15.3%, which was higher in the moderate and severe stages than mild cognitive impairment and mild stages (81.2% vs. 18.8%). Patients with PS had a longer duration of disease (P = 0.020) and parkinsonism (P = 0.003), higher scores of NPI (P = 0.028), ADL (P = 0.002) and UPDRS part III (P < 0.001), lower scores of clock drawing test (P = 0.009), visuospatial/executive abilities (P = 0.018), attention (P = 0.020), language and praxis (P = 0.020), registration (P = 0.012), greater H&Y stage (P < 0.001), and higher proportion of cholinesterase inhibitors used (P = 0.044) than those without PS. Longer disease duration (OR = 1.166, P = 0.023), presence of parkinsonism (OR = 7.971, P = 0.007), moderate and severe dementia (OR = 3.215, P = 0.021) were associated with the presence of PS. Patients had a longer duration of PS (P = 0.014) and lower mean age of onset (P = 0.040) in the group with severe lateral trunk flexion. CONCLUSION The development of PS may be associated with longer disease duration, the presence of parkinsonism and severe stages of dementia in DLB. Cholinesterase inhibitors may have a correlation with PS. The severity of lateral flexion is related to the duration of PS and mean age of onset.
Collapse
Affiliation(s)
- Zhou Su
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China; Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Shuai Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Gang Chen
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Jinghuan Gan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xinran Bao
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Hongcan Zhu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaodan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Hao Wu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Yong Ji
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China.
| |
Collapse
|
4
|
Pongmala C, Artusi CA, Zibetti M, Pitakpatapee Y, Wangthumrong T, Sangpeamsook T, Srikajon J, Srivanitchapoom P, Youn J, Cho JW, Kim M, Zamil Shinawi HM, Obaid MT, Baumann A, Margraf NG, Pona-Ferreira F, Leitão M, Lobo T, Ferreira JJ, Fabbri M, Lopiano L. Postural abnormalities in Asian and Caucasian Parkinson's disease patients: A multicenter study. Parkinsonism Relat Disord 2022; 97:91-98. [PMID: 35378428 DOI: 10.1016/j.parkreldis.2022.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Postural abnormalities (PA) are disabling features of Parkinson's disease (PD). Indirect analyses suggested a higher prevalence of PA among Asian patients compared to Caucasian ones, but no direct comparisons have been performed so far. METHODS An international, multicenter, cross-sectional study was performed in 6 European and Asian movement disorders centers with the aim to clarify differences and similarities of prevalence and characteristics of PA in Asian vs. Caucasian PD patients. Axial PA, encompassing antecollis (AC), camptocormia (CC), and Pisa syndrome (PS), and appendicular PA (appPA) were systematically searched and analysed in consecutive patients. RESULTS 88 (27%) of 326 PD patients had PA (29.1% in Asians and 24.3% in Caucasians, p: 0.331). Prevalence of axial PA was 23.6% in Asians and 24.3% in Caucasians (p = 0.886), in spite of a longer disease duration among Caucasians, but a longer PA duration among Asians. No differences in prevalence between AC, CC, and PS were found between the two ethnicities. The prevalence of appPA was higher in Asians (p = 0.036), but the regression analysis did not confirm a significant difference related to ethnicity. Considering the whole population, male gender (OR, 4.036; 95% CI, 1.926-8.456; p < 0.005), a longer disease duration (OR, 2.61; 95% CI, 1.024-6.653; p = 0.044), and a higher axial score (OR, 1.242; 95% CI, 1.122-1.375; p < 0.0005) were the factors associated with axial PA. CONCLUSION The prevalence of axial PA in PD patients is not influenced by ethnicity. However, Asian PD patients tend to develop PA earlier in the disease course, particularly AC.
Collapse
Affiliation(s)
- Chatkaew Pongmala
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy
| | - Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy.
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy
| | - Yuvadee Pitakpatapee
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Takarn Wangthumrong
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanita Sangpeamsook
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jindapa Srikajon
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prachaya Srivanitchapoom
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jinyoung Youn
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Jin Whan Cho
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Minkyeong Kim
- Department of Neurology, Gyeongsang National University Hospital, Jinju, South Korea
| | | | - Mona Talib Obaid
- National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Alexander Baumann
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Nils G Margraf
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | | | | | - Teresa Lobo
- CNS-Campus Neurológico, Torres Vedras, Portugal
| | - Joaquim J Ferreira
- CNS-Campus Neurológico, Torres Vedras, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Instituto Medicina Molecular João Lobo Antunes, Lisbon, Portugal
| | - Margherita Fabbri
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center; Toulouse University Hospital; INSERM; University of Toulouse 3; Toulouse, France
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy
| |
Collapse
|
5
|
Huh YE, Seo DW, Kim K, Chung WH, Kim S, Cho JW. Factors Contributing to the Severity and Laterality of Pisa Syndrome in Parkinson's Disease. Front Aging Neurosci 2022; 13:716990. [PMID: 35046790 PMCID: PMC8761952 DOI: 10.3389/fnagi.2021.716990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022] Open
Abstract
Objective: Pisa syndrome (PS) is a disabling postural deformity in Parkinson’s disease (PD). We aimed to elucidate clinical factors determining the severity and laterality of PS in PD. Methods: In 54 PD patients with PS, we measured the clinical factors that are previously known to contribute to the occurrence of PS as follows: asymmetry of motor symptoms for the evaluation of asymmetric basal ganglia dysfunction, the degree and direction of subjective visual vertical (SVV) tilt for the misperception of body verticality, the canal paresis for unilateral peripheral vestibulopathy, and the tonic electromyographic (EMG) hyperactivity of paraspinal muscles for dystonia. Multivariable linear and logistic regression analyses were conducted to identify the clinical factors associated with the degree of truncal tilt, for the quantification of the severity of PS, and PS tilting to the less affected side, respectively. Results: The multivariable linear regression analyses revealed that the larger degree of SVV tilt (β = 0.29, SE = 0.10, p = 0.005), right-sided SVV tilt (β = 2.32, SE = 0.82, p = 0.007), and higher Hoehn and Yahr (HY) stage (β = 4.01, SE = 1.29, p = 0.003) significantly increased the severity of PS. In the multivariable logistic regression analyses, greater asymmetry of motor symptoms [odds ratio (OR) = 2.01, 95% CI = 1.34–3.49] was significantly associated with PS tilting to the less affected side, while right-sided SVV tilt (OR = 0.02, 95% CI = 0.001–0.21), unilateral canal paresis (OR = 0.06, 95% CI = 0.003–0.79), and higher HY stage (OR = 0.04, 95% CI = 0.002–0.46) were associated with PS tilting to the more affected side. Conclusion: Misperception of verticality, asymmetric basal ganglia dysfunction, unilateral peripheral vestibulopathy, and motor disability are the clinical factors associated with the severity and laterality of PS in patients with PD.
Collapse
Affiliation(s)
- Young Eun Huh
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Dae-Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kunhyun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Ho Chung
- Department of Otolaryngology, Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seonwoo Kim
- Statistics and Data Center, Samsung Medical Center, Research Institute for Future Medicine, Seoul, South Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
6
|
He J, Cui Z, Li S, Chen H, Su W. Effect of Bilateral Subthalamic Nucleus Deep Brain Stimulation on Pisa Syndrome in Parkinson's Disease. Front Neurol 2021; 12:739298. [PMID: 34744979 PMCID: PMC8566818 DOI: 10.3389/fneur.2021.739298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022] Open
Abstract
Objective: To observe the efficacy of bilateral subthalamic nucleus deep brain stimulation on Pisa syndrome in patients with Parkinson's disease. Methods: A total of 52 patients with Parkinson's disease who underwent deep brain stimulation in Beijing Hospital from July 1, 2016 to July 1, 2020 were reviewed. The clinical data were collected for the patients who met the diagnostic criteria of Pisa syndrome on “Medication-Off” state pre-operatively. Results: Two patients met the diagnostic criteria of Pisa syndrome before operation, with a Pisa angle of 10 and 14°, respectively. The lateral trunk flexion of the two patients improved after operation. In stimulation-on/medication-off state, the Pisa angle decreased from 10 to 2° and from 14 to 6°, respectively. Conclusion: Bilateral subthalamic nucleus deep brain stimulation might have beneficial effects on lateral trunk flexion in PD patients, but the predictors of curative effect are not clear.
Collapse
Affiliation(s)
- Jing He
- Neurology Department, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Zhuang Cui
- Neurosurgery Department, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Shuhua Li
- Neurology Department, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Haibo Chen
- Neurology Department, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Wen Su
- Neurology Department, National Center of Gerontology, Beijing Hospital, Beijing, China
| |
Collapse
|