Treatment of camptocormia with continuous subcutaneous infusions of apomorphine: 1-year prospective pilot study

Menšíková, Kateřina; Kaiserová, Michaela; Vaštík, Miroslav; Kurčová, Sandra; Kaňovský, Petr

doi:10.1007/s00702-014-1297-9

Cited by 12 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mensikova et al 46 conducted a pilot trial of CSAI (dose range: 40–70 mg/day) in five patients with PD who had camptocormia unresponsive to regular oral dopaminergic medications (ON/OFF phenomenon). All five patients on CSAI showed clinical improvement in camptocormia by week four, and this effect remained stable for a mean of 1.8 years.…”

Section: Resultsmentioning

confidence: 99%

Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review

Kukkle

Garg

Merello

2023

Movement Disord Clin Pract

View full text Add to dashboard Cite

BackgroundContinuous subcutaneous apomorphine infusion (CSAI) is one of the advanced therapies for Parkinson's disease (PD).MethodsA systematic review of all published articles in English on CSAI for PD till January 30, 2022 was conducted.ResultsA total of 82 articles met the search criteria. Publications included retrospective or prospective open‐label observational studies, with a limited number of randomized control trials (RCT). Publications were highly heterogeneous and focused on different aspects of CSAI and included clinical audits, effects on cognition/behavior, axial symptoms, nocturnal issues, adverse events/reasons for discontinuation and comparison with other continuous dopaminergic therapies. CSAI was used in patients who presented severe motor fluctuations not resolved by oral therapy, poor candidates for deep brain stimulation (DBS) due to cognitive/behavioral issues or in those with DBS weaning effect. Recent studies have also shown that CSAI was useful for nocturnal usage in advanced PD, in addition to daytime utilization. Adverse effects were common and include skin lesions, sedation and nausea. Pump management difficulties and patient decisions were common reasons for therapy dropout, predominantly during the initial stages of the CSAI.ConclusionThere is consistent agreement on the benefits of CSAI in reducing OFF periods and improving ON periods without troublesome dyskinesia and specific motor and non‐motor symptoms. Although there is a paucity of RCTs, current data from almost 30 years of use suggests CSAI to be beneficial in advanced cases of PD.

show abstract

Section: Resultsmentioning

confidence: 99%

Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review

Kukkle

Garg

Merello

2023

Movement Disord Clin Pract

View full text Add to dashboard Cite

show abstract

“…The main study limitations were pitfalls in study design, small sample size, different diagnostic criteria to define axial postural abnormalities, and use of one or more different measurement methods: standard goniometric measurement with a wall goniometer, smartphone, protractor, inclinometer or photographs was used in 22 studies, 40,47,48,50,51,57,58,60–66,72,73,77,78,81,82,98,101 software‐based measurement with NeuroPostureApp, Kinovea, MB Ruler® software, or Image J was used in 12, 37–39,41,44–46,49,51,52,56,97,99 Cobb angle, X‐ray in nine, 42,43,55,71,79,81,83–85 a spinal mouse electronic measuring device in one study 91 ; 26 studies reported no instrument, tool or bony reference points for evaluating axial postural abnormalities 53,54,59,67–70,74–76,80,86–90,92–96,100,102–105 . The quality appraisal was good in 29% (n = 20), fair in 43% (n = 30), and poor in 28% (n = 19) studies.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies on the pathophysiology of axial postural abnormalities in parkinsonism involved cohorts of PD patients (n = 63 studies) 37–99 or a cohort of patients with MSA (n = 1 study) 100 and mixed populations including PD, MSA, PSP, DLB (n = 5 studies) 101–105 . The total number of patients was 2181 for PD, 29 for MSA, and 34 for other mixed sample populations.…”

Section: Resultsmentioning

confidence: 99%

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

Artusi,

Geroin,

Nonnekes

et al. 2023

Movement Disord Clin Pract

View full text Add to dashboard Cite

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.

show abstract

“…46 Optimizar la terapia de la enfermedad de Parkinson puede mejorar el SEI, como se describió con la infusión continua de apomorfina a cinco pacientes con un seguimiento de tres años. 47 Algunos pacientes con distonía de la musculatura abdominal podrían beneficiarse parcialmente de la inyección de toxina botulínica en los músculos rectos abdominales, oblicuo externo y psoas ilíaco. 7,48,49 Se ha demostrado que la neuroestimulación bilateral del núcleo subtalámico mejora los principales síntomas del Parkinson.…”

Section: Tratamiento Del Sei En Pacientes Con Enfermedad De Parkinsonunclassified

Síndrome de la espalda inclinada. Presentación de cuatro casos y revisión de la bibliografía. [Bent spine syndrome. Presentation of four cases and literature review]

Covaro

Vilà-Canet²,

Ciccolo

et al. 2019

Rev. Asoc. Arg. Ort. y Traumatol

View full text Add to dashboard Cite

El síndrome de la espalda inclinada o camptocormia es una causa de desequilibrio sagital del tronco no estructurada de difícil manejo médico y quirúrgico. Puede ser secundario a enfermedades del sistema nervioso central o periférico, o de origen primario muscular, como la atrofia aislada de la musculatura paravertebral espinal. El diagnóstico se basa en la evaluación clínica, los estudios por imágenes, el electromiograma y la biopsia muscular. El síndrome de la espalda inclinada, cualquiera fuera su causa, tiene un pronóstico pobre, los síntomas suelen progresar hasta afectar la bipedestación de manera irreversible. Presentamos un análisis retrospectivo de cuatro casos de síndrome de la espalda inclinada tratados en nuestro centro y una revisión de la bibliografía. AbstractIntroduction: The bent spine syndrome (BSS) or camptocornia is a cause of unstructured sagittal imbalance of difficult medical and surgical management.Objective: To describe the causes of BSS and how to approach its treatment.Materials and Methods: Retrospective analysis of 4 cases of BSS treated at our center and review of the literature.Results: The 4 cases were women between 60 and 82 years of age, 3 due to an isolated atrophy of the paravertebral spinal erectorae musculature and 1 case due to an inflammatory myopathy.Conclusions: The prognosis of any BSS is poor, so the symptoms usually progress to irreversible difficulty to maintain upright posture.

show abstract

Treatment of camptocormia with continuous subcutaneous infusions of apomorphine: 1-year prospective pilot study

Cited by 12 publications

References 22 publications

Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review

Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review

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

Síndrome de la espalda inclinada. Presentación de cuatro casos y revisión de la bibliografía. [Bent spine syndrome. Presentation of four cases and literature review]

Contact Info

Product

Resources

About