Subthalamic nucleus stimulation improves Parkinson's disease-associated camptocormia in parallel to its preoperative levodopa responsiveness

Yamada, Kazumichi; Shinojima, Naoki; Hamasaki, Tadashi; Kuratsu, Jun Ichi

doi:10.1136/jnnp-2015-310926

Cited by 23 publications

(43 citation statements)

References 29 publications

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“…These three studies report comparisons of pre‐ and postsurgical means, but individual patient data are not available . Of the remaining 35 articles, there were three additional retrospective cohort studies, 12 case series with sample sizes of up to 25 patients, and 20 case reports …”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐one studies evaluated the effects of DBS on postural deformities in PD patients. One study reported postural abnormalities after withdrawal of dopaminergic medications . The other 30 studies retrospectively analyzed postural deformities during the best medication and stimulation conditions.…”

Section: Resultsmentioning

confidence: 99%

“…Camptocormia (trunk anteflexion, bent spine syndrome) was defined using a thoracolumbar or bending angle threshold of either ≥30 or ≥ 45 degrees . One case report used the shoulder‐hip‐knee angle .…”

Section: Resultsmentioning

confidence: 99%

“…Ventral thoracolumbar angle ≥30 degrees and ventral thoracic angle ≥45 degrees were used to define lower and upper subtypes of camptocormia, respectively . These subtypes were also investigated in another study . Scoliosis was defined as a Cobb angle >15 degrees in one article .…”

Section: Resultsmentioning

confidence: 99%

“…These three studies report comparisons of pre-and postsurgical means, but individual patient data are not available. [6][7][8] Of the remaining 35 articles, there were three additional retrospective cohort studies, [9][10][11] 12 case series with sample sizes of up to 25 patients, [12][13][14][15][16][17][18][19][20][21][22][23] and 20 case reports. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Thirty-one studies evaluated the effects of DBS on postural deformities in PD patients.…”

Section: High Risk Of Bias: Retrospective Design Variable Populationmentioning

confidence: 99%

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Effects of Deep Brain Stimulation on Postural Trunk Deformities: A Systematic Review

Lizárraga

Fasano

2019

Movement Disord Clin Pract

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Background Deep brain stimulation (DBS) effects on postural deformities are still poorly explored. Methods Systematic review in accord with the Preferred Reporting Items for Systematic review and Meta‐Analysis guidelines (PRISMA). Results All 38 studies that met predefined eligibility criteria had high risk of bias attributed to retrospective analysis of heterogeneous populations with variable and incompletely reported demographic and clinical characteristics, definitions, outcomes, DBS indications, targets, and settings. Five patient groups were identified in the 35 studies with individual data available: (1) parkinsonian camptocormia (n = 96): 89 patients underwent subthalamic (STN) and 7 globus pallidus pars interna (GPi) DBS. Camptocormia was the indication in 3 patients. After DBS, camptocormia improved in 57 of 96 patients (4.3–100% improvement) and remained stable or worsened in 39 of 96 patients (2–100% worsening). (2) dystonic camptocormia (n = 16): All underwent GPi‐DBS. They were younger and with shorter disease duration, but longer deformity duration, compared with parkinsonian camptocormia. After GPi‐DBS, camptocormia improved in all patients (50–100% improvement). (3) Parkinsonian Pisa syndrome (n = 14): 11 patients underwent STN‐DBS for motor fluctuations whereas Pisa syndrome was the indication for pedunculopontine and GPi‐DBS in 2 patients. After DBS, Pisa improved in 10 of 14 patients (33.3–66.7% improvement). (4) Dystonic opisthotonus: 2 young patients remarkably responded to GPi‐DBS. (5) Parkinsonian anterocollis: There were variable responses in 3 patients after STN‐DBS for motor fluctuations. Conclusions Low‐quality level of evidence suggests that dystonic camptocormia and opisthotonus improve after GPi‐DBS. Parkinsonian camptocormia, Pisa syndrome, and anterocollis have variable responses, and their dystonic features should be further explored.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: High Risk Of Bias: Retrospective Design Variable Populationmentioning

confidence: 99%

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Effects of Deep Brain Stimulation on Postural Trunk Deformities: A Systematic Review

Lizárraga

Fasano

2019

Movement Disord Clin Pract

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Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review

Artusi,

Geroin,

Nonnekes

et al. 2023

Movement Disord Clin Pract

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BackgroundPostural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson 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.ObjectivesWe 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.MethodsWe applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps.ResultsNinety‐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.ConclusionsThe 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 towards many different (possibly non‐mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.This article is protected by copyright. All rights reserved.

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The prevalence of chronic low back pain and lumbar deformities in patients with Parkinson’s disease: implications on spinal surgery

et al. 2018

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Subthalamic nucleus stimulation improves Parkinson's disease-associated camptocormia in parallel to its preoperative levodopa responsiveness

Abstract: STN stimulation improves PD-associated camptocormia in parallel with preoperative levodopa responsiveness. Long symptom duration interferes with levodopa responsiveness.

Cited by 23 publications

References 29 publications

Effects of Deep Brain Stimulation on Postural Trunk Deformities: A Systematic Review

Effects of Deep Brain Stimulation on Postural Trunk Deformities: A Systematic Review

Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review

The prevalence of chronic low back pain and lumbar deformities in patients with Parkinson’s disease: implications on spinal surgery

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