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Pongmala C, Fabbri M, 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, Lopiano L, Artusi CA. Gait and axial postural abnormalities correlations in Parkinson's disease: A multicenter quantitative study. Parkinsonism Relat Disord 2022; 105:19-23. [PMID: 36332288 DOI: 10.1016/j.parkreldis.2022.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/16/2022] [Accepted: 10/23/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Gait and axial postural abnormalities (PA) are common and disabling symptoms of Parkinson's disease (PD). The interplay between them has been poorly explored. METHODS A standardized protocol encompassing videos and photos for posture and gait analysis of PD patients with a clinically defined PA (MDS-UPDRS-III item 3.13 > 0) was used in 6 movement disorder centers. A comprehensive evaluation was performed to clarify the association between gait performance and the presence and severity of PA. RESULTS 225 PD patients were enrolled: 57 had severe PA, 149 mild PA, and 19 did not meet criteria for PA, according to a recent consensus agreement on PA definition. PD patients with severe PA were significantly older (p:0.001), with longer disease duration (p:0.007), worse MDS-UPDRS-II and -III scores and axial sub-scores (p < 0.0005), higher LEDD (p:0.002) and HY stage (p < 0.0005), and a significantly lower velocity (p < 0.001) and cadence (p:0.021), if compared to mild PA patients. The multiple regression analysis evaluating gait parameters and degrees of trunk/neck flexion showed that higher degrees of lumbar anterior trunk flexion were correlated with lower step length (OR -0.244; p:0.014) and lower velocity (OR -0.005; p:0.028). CONCLUSIONS Our results highlight the possible impact of severe anterior trunk flection on PD patients' gait, with a specific detrimental effect on gait velocity and step length. Personalized rehabilitation strategies should be elaborated based on the different features of PA, aiming to target a combined treatment of postural and specifically related gait pattern alterations.
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Affiliation(s)
- Chatkaew Pongmala
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy; Department of Radiology, University of Michigan, Ann Arbor, USA
| | - 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
| | - 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, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jin Whan Cho
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Minkyeong Kim
- Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of 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
| | - Leonardo Lopiano
- 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.
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Pitakpatapee Y, Srikajon J, Sangpeamsook T, Saengphatrachai W, Srivanitchapoom P. A Rare Cause of a Treatable Abnormal Movement, Not to Miss. Mov Disord Clin Pract 2022; 9:S13-S16. [PMID: 36118509 PMCID: PMC9465002 DOI: 10.1002/mdc3.13541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/21/2022] [Accepted: 03/12/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yuvadee Pitakpatapee
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jindapa Srikajon
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Tanita Sangpeamsook
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Weerawat Saengphatrachai
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Prachaya Srivanitchapoom
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Pitakpatapee Y, Soontrapa P, Suengtaworn A, Srikajon J, Sangpeamsook T, Komoltri C, Srivanitchapoom P. Effect of combined facial exercise with botulinum toxin A on health-related quality of life in Thai adults with hemifacial spasm: a randomised controlled pilot cross-over trial. J Neurol Neurosurg Psychiatry 2021; 92:337-339. [PMID: 32928937 DOI: 10.1136/jnnp-2020-323604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/25/2020] [Accepted: 08/19/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Yuvadee Pitakpatapee
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pannathat Soontrapa
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Arpakorn Suengtaworn
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jindapa Srikajon
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanita Sangpeamsook
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chulalak Komoltri
- Research Group and Research Network Division, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prachaya Srivanitchapoom
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Srikajon J, Srivanitchapoom P, Pitakpatapee Y. Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS): The classical clinical manifestations, fundoscopic examination, and brain MRI findings. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wangthumrong T, Pongmala C, Pitakpatapee Y, Srikajon J, Vichutavate M, Srivanitchapoom P. Prevalence and characteristics of postural deformities in Thai patients with Parkinson's Disease. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Srikajon J, Siritho S, Ngamsombat C, Prayoonwiwat N, Chirapapaisan N. Differences in clinical features between optic neuritis in neuromyelitis optica spectrum disorders and in multiple sclerosis. Mult Scler J Exp Transl Clin 2018; 4:2055217318791196. [PMID: 30116549 PMCID: PMC6088491 DOI: 10.1177/2055217318791196] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 01/10/2023] Open
Abstract
Background Optic neuritis (ON) is one of the common manifestations both in neuromyelitis-optica spectrum disorders (NMOSD) and in multiple sclerosis (MS). Objectives The objective of this paper is to compare clinical presentations, laboratories and imaging findings in ON associated with MS and NMOSD. Methods A retrospective chart review was performed in patients presenting with ON in 59 NMOSD patients with 72 eyes’ involvement and 163 ON attacks, and 20 MS patients with 23 eyes’ involvement and 36 ON attacks. Results ON-NMOSD patients had recurrent ON more often and tended to have simultaneous bilateral ON involvement at their first ON attack. Individuals with ON-NMOSD revealed worse visual acuity at first ON attacks and also had poorer long-term visual outcome than those with ON-MS, with nearly half of ON-NMOSD patients still having LogMAR visual acuity ≥1 at their last follow-up (p = 0.035). Significant thinner average retinal nerve fiber layer thickness was found in the ON-NMOSD group. We found no significant differences in segmentation location of the optic nerve lesions and the length of involvement between the two groups. Conclusions It was difficult to completely differentiate ON-NMOSD from ON-MS. ON-NMOSD patients, however, tended to have simultaneous bilateral ON involvement and poorer long-term visual outcome than individuals with ON-MS.
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Affiliation(s)
- Jindapa Srikajon
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Thailand
| | - Sasitorn Siritho
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Thailand.,Bumrungrad International Hospital, Thailand
| | - Chanon Ngamsombat
- Radiology Department, Siriraj Hospital, Mahidol University, Thailand
| | - Naraporn Prayoonwiwat
- Department of Neurology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Niphon Chirapapaisan
- Department of Ophthalmology, Faculty of Medicine SirirajHospital, Mahidol University, Bangkok, Thailand
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Pitakpatapee Y, Srikajon J, Rattanathamsakul N, Suengtaworn A, Srivanitchapoom P. Facio-oculo-palatal myoclonus complicated by recurrent brainstem infarction. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Srikajon J, Siritho S, Prayoonwiwat N. Distinguishing clinical features between multiple sclerosis (MS)-related optic neuritis (ON) and neuromyelitis optica disorders (NMOSD)-related ON. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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