Muscle echo intensity of abdominal wall in Parkinson’s disease and healthy controls: a cross sectional study

Bissolotti, Luciano; Ruggeri, Janis; Rota, Matteo; Calza, Stefano; Cipolla, Costantino

doi:10.1007/s10072-020-04440-3

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…Trunk position in PD has been measured or assumed from muscle echo intensity of the abdominal wall [ 18 ], from review of video recordings [ 4 , 19 ], subjectively using the 0–4 MDS Unified Parkinson’s Disease Rating Scale [ 20 – 22 ], or through observation [ 23 ]. Here, we use objective ultrasound motion detection to study and quantify alterations of body position in patients with PD and consider the longer-term effectiveness of DBS in the STN.…”

Section: Introductionmentioning

confidence: 99%

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

et al. 2021

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Parkinson’s disease (PD) can produce postural abnormalities of the standing body position such as kyphosis. We investigated the effects of PD, deep brain stimulation (DBS) in the subthalamic nucleus (STN), vision and adaptation on body position in a well-defined group of patients with PD in quiet standing and during balance perturbations. Ten patients with PD and 25 young and 17 old control participants were recruited. Body position was measured with 3D motion tracking of the ankle, knee, hip, shoulder and head. By taking the ankle as reference, we mapped the position of the joints during quiet standing and balance perturbations through repeated calf muscle vibration. We did this to explore the effect of PD, DBS in the STN, and vision on the motor learning process of adaptation in response to the repeated stimulus. We found that patients with PD adopt a different body position with DBS ON vs. DBS OFF, to young and old controls, and with eyes open vs. eyes closed. There was an altered body position in PD with greater flexion of the head, shoulder and knee (p≤0.042) and a posterior position of the hip with DBS OFF (p≤0.014). With DBS ON, body position was brought more in line with the position taken by control participants but there was still evidence of greater flexion at the head, shoulder and knee. The amplitude of movement during the vibration period decreased in controls at all measured sites with eyes open and closed (except at the head in old controls with eyes open) showing adaptation which contrasted the weaker adaptive responses in patients with PD. Our findings suggest that alterations of posture and greater forward leaning with repeated calf vibration, are independent from reduced movement amplitude changes. DBS in the STN can significantly improve body position in PD although the effects are not completely reversed. Patients with PD maintain adaptive capabilities by leaning further forward and reducing movement amplitude despite their kyphotic posture.

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Section: Introductionmentioning

confidence: 99%

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

et al. 2021

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“…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%

“…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][61][62][63][64][65][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][38][39]41,[44][45][46]49,51,52,56,97,99 Cobb angle, X-ray in nine, 42,43,55,71,79,81,[83][84][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,...…”

Section: Pathophysiology: Main Findingsmentioning

confidence: 99%

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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“…However, these studies used qualitative scores for analyzing echogenicity, not a quantitative measurement of a fraction of black or gray value. It is worth noting that the Heckmatt score has been established in the field of muscle ultrasound for the assessment of echogenicity changes [ 16 ]. However, for nerve ultrasound to date, there is no standard evaluation method for echogenicity.…”

Section: Discussionmentioning

confidence: 99%

Nerve Echogenicity in Polyneuropathies of Various Etiologies—Results of a Retrospective Semi-Automatic Analysis of High-Resolution Ultrasound Images

et al. 2022

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Echogenicity of peripheral nerves in high-resolution ultrasound (HRUS) provides insight into the structural damage of peripheral nerves in various polyneuropathies. The aim of this study was to compare nerve echogenicity in different primarily axonal or demyelinating polyneuropathies to examine the significance of this parameter. Performing semi-automated echogenicity analysis and applying Image J, we retrospectively used HRUS images of 19 patients with critical illness polyneuropathy (CIP), and 27 patients with chemotherapy-induced polyneuropathy (CIN) and compared them to 20 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). The fraction of black representing echogenicity was measured after converting the images into black and white. The nerves of patients with progressive CIDP significantly differed from the hyperechogenic nerves of patients with other polyneuropathies at the following sites: the median nerve at the forearm (p < 0.001), the median nerve at the upper arm (p < 0.004), and the ulnar nerve at the upper arm (p < 0.001). The other polyneuropathies showed no notable differences. Altogether, the comparison of echogenicity between different polyneuropathies supports the assumption that there are differences depending on the genesis of the structural nerve damage. However, these differences are slight, and cannot be used to show clear differences between each polyneuropathy form.

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Muscle echo intensity of abdominal wall in Parkinson’s disease and healthy controls: a cross sectional study

Cited by 7 publications

References 32 publications

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

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

Nerve Echogenicity in Polyneuropathies of Various Etiologies—Results of a Retrospective Semi-Automatic Analysis of High-Resolution Ultrasound Images

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