Effect of subthalamic deep brain stimulation on posture in Parkinson's disease: A blind computerized analysis

Roediger, Jan; Artusi, Carlo Alberto; Romagnolo, Alberto; Boyne, Pierce; Zibetti, Maurizio; Lopiano, Leonardo; Espay, Alberto J.; Fasano, Alfonso; Merola, Aristide

doi:10.1016/j.parkreldis.2019.01.003

Cited by 30 publications

(54 citation statements)

References 26 publications

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“…Thus, a total of 38 articles were selected for data extraction (Fig. ) . Full data are available from the authors upon request.…”

Section: Resultsmentioning

confidence: 99%

“…Three of these studies are retrospective cohorts with relatively large samples of 74 to 158 PD patients. 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%

“…Pisa syndrome (trunk lateroflexion) was more consistently defined as lateral thoracolumbar angle ≥10 degrees . Anterocollis (neck anteflexion, camptocephalia, and dropped head syndrome) was defined using a threshold angle of 45 degrees . In another study, x‐rays were used to define anterocollis as a C7 sagittal vertical axis > 5 cm .…”

Section: Resultsmentioning

confidence: 99%

“…There was no reported definition for opisthotonus (trunk retroflexion, ectatocormia) . Methods to determine postural angles were also variable and included patient pictures, video frames, x‐rays, CT studies, and/or computer software specifically designed for this purpose in one recent study …”

Section: Resultsmentioning

confidence: 99%

“…Anterocollis outcomes were based on clinical observation only . A recent study evaluated changes in global postural angles after subthalamic DBS (STN‐DBS), regardless of the presence or absence of postural abnormalities . When reported, postsurgical follow‐up times were also variable: 3 to 67 months for camptocormia, 12 to 48 months for Pisa syndrome, 4 to 24 months for opisthotonus, and 6 to 9 months for anterocollis.…”

Section: Resultsmentioning

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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“…Thus, a total of 38 articles were selected for data extraction (Fig. ) . Full data are available from the authors upon request.…”

Section: Resultsmentioning

confidence: 99%