Michele Tinazzi1, Marialuisa Gandolfi2,3, Roberto Ceravolo4, Marianna Capecci5, Elisa Andrenelli5, Maria Gabriella Ceravolo5, Laura Bonanni6, Marco Onofrj6, Michela Vitale6, Mauro Catalan7, Paola Polverino7, Claudio Bertolotti7, Sonia Mazzucchi4, Sara Giannoni4, Nicola Smania2,3, Stefano Tamburin1, Laura Vacca8, Fabrizio Stocchi8, Fabiana G Radicati8, Carlo Alberto Artusi9, Maurizio Zibetti9, Leonardo Lopiano9, Alfonso Fasano10,11, Christian Geroin1. 1. Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy. 2. Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy. 3. Neurorehabilitation Unit Azienda Ospedaliera Universitaria Integrata Verona Italy. 4. Department of Clinical and Experimental Medicine University of Pisa Pisa Italy. 5. Department of Experimental and Clinical Medicine Neurorehabilitation Clinic, "Politecnica delle Marche" University Ancona Italy. 6. Department of Neuroscience, Imaging and Clinical Sciences University G. d'Annunzio of Chieti-Pescara Chieti-Pescara Italy. 7. Clinical Neurology Unit, Department of Medical, Surgical and Health Services University of Trieste Trieste Italy. 8. University and Institute for Research and Medical Care, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Roma Italy. 9. Department of Neuroscience "Rita Levi Montalcini," University of Torino Torino Italy. 10. Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital University Health Network, Division of Neurology, University of Toronto Toronto Ontario Canada. 11. Krembil Brain Institute Toronto Ontario Canada.
Abstract
INTRODUCTION: The overall frequency of postural abnormalities (PA) in Parkinson's disease (PD) is unknown. We evaluated the overall prevalence of PA and assessed the association with demographic and clinical variables. METHODS: For this multicenter, cross-sectional study, consecutive PD outpatients attending 7 tertiary Italian centers were enrolled. Patients were evaluated and compared for the presence of isolated PA such as camptocormia, Pisa syndrome, and anterocollis and for combined forms (ie, camptocormia + Pisa syndrome) together with demographic and clinical variables. RESULTS: Of the total 811 PD patients enrolled, 174 (21.5%; 95% confidence interval [CI], 18.6%-24.3%) presented PA, 144 of which had isolated PA and 30 had combined PA. The prevalence of camptocormia was 11.2% (95% CI, 9%-13.3%), Pisa syndrome 8% (95% CI, 6.2%-9.9%), and anterocollis 6.5% (95% CI, 4.9%-8.3%). Patients with PA were more often male and older with longer disease duration, more advanced disease stage, more severe PD symptoms, a bradykinetic/rigid phenotype, and poorer quality of life. They were initially treated with levodopa, and more likely to be treated with a combination of levodopa and dopamine agonist, took a higher daily levodopa equivalent daily dose, and had more comorbidities. Falls and back pain were more frequent in PD patients with PA than in those without PA. Multiple logistic regression models confirmed an association between PA and male gender, older age, Hoehn and Yahr stage, and total Unified Parkinson's Disease Rating Scale score. CONCLUSIONS: PA are frequent and disabling complications in PD, especially in the advanced disease stages.
INTRODUCTION: The overall frequency of postural abnormalities (PA) in Parkinson's disease (PD) is unknown. We evaluated the overall prevalence of PA and assessed the association with demographic and clinical variables. METHODS: For this multicenter, cross-sectional study, consecutive PD outpatients attending 7 tertiary Italian centers were enrolled. Patients were evaluated and compared for the presence of isolated PA such as camptocormia, Pisa syndrome, and anterocollis and for combined forms (ie, camptocormia + Pisa syndrome) together with demographic and clinical variables. RESULTS: Of the total 811 PD patients enrolled, 174 (21.5%; 95% confidence interval [CI], 18.6%-24.3%) presented PA, 144 of which had isolated PA and 30 had combined PA. The prevalence of camptocormia was 11.2% (95% CI, 9%-13.3%), Pisa syndrome 8% (95% CI, 6.2%-9.9%), and anterocollis 6.5% (95% CI, 4.9%-8.3%). Patients with PA were more often male and older with longer disease duration, more advanced disease stage, more severe PD symptoms, a bradykinetic/rigid phenotype, and poorer quality of life. They were initially treated with levodopa, and more likely to be treated with a combination of levodopa and dopamine agonist, took a higher daily levodopa equivalent daily dose, and had more comorbidities. Falls and back pain were more frequent in PD patients with PA than in those without PA. Multiple logistic regression models confirmed an association between PA and male gender, older age, Hoehn and Yahr stage, and total Unified Parkinson's Disease Rating Scale score. CONCLUSIONS: PA are frequent and disabling complications in PD, especially in the advanced disease stages.
Authors: F Bloch; J L Houeto; S Tezenas du Montcel; F Bonneville; F Etchepare; M L Welter; S Rivaud-Pechoux; V Hahn-Barma; T Maisonobe; C Behar; J Y Lazennec; E Kurys; I Arnulf; A M Bonnet; Y Agid Journal: J Neurol Neurosurg Psychiatry Date: 2006-06-05 Impact factor: 10.154
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Authors: D Tiple; G Fabbrini; C Colosimo; D Ottaviani; F Camerota; G Defazio; A Berardelli Journal: J Neurol Neurosurg Psychiatry Date: 2008-10-17 Impact factor: 10.154
Authors: Christian Geroin; Carlo Alberto Artusi; Marialuisa Gandolfi; Elisabetta Zanolin; Roberto Ceravolo; Marianna Capecci; Elisa Andrenelli; Maria Gabriella Ceravolo; Laura Bonanni; Marco Onofrj; Roberta Telese; Giulia Bellavita; Mauro Catalan; Paolo Manganotti; Sonia Mazzucchi; Sara Giannoni; Laura Vacca; Fabrizio Stocchi; Miriam Casali; Cristian Falup-Pecurariu; Maurizio Zibetti; Alfonso Fasano; Leonardo Lopiano; Michele Tinazzi Journal: Front Neurol Date: 2020-03-31 Impact factor: 4.003