Relationship between Postural Deformities and Frontal Function in Parkinson’s Disease

Ninomiya, Satoko; Morita, Akihiko; Teramoto, Hiroko; Akimoto, Takayoshi; Shiota, Hiroshi; Kamei, Satoshi

doi:10.1155/2015/462143

Cited by 6 publications

(9 citation statements)

References 35 publications

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“…Firstly, the PD-noPS group contained fewer patients than the PD-PS group because patients in the two groups were matched for disease severity, which increased with the presence of PS 14 . Secondly, although global cognitive function did not differ between patient groups, we did not perform detailed assessments of executive or visuospatial dysfunction, which may also have a role in the development of PS 36 , 37 . Thirdly, healthy controls or patients with PS due to other diseases were not included in our study.…”

Section: Discussionmentioning

confidence: 98%

Pisa Syndrome in Parkinson’s Disease: Pathogenic Roles of Verticality Perception Deficits

Huh

Kim

Chung

et al. 2018

Sci Rep

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We elucidated whether verticality misperception is associated with the generation of Pisa syndrome (PS) in patients with Parkinson’s disease (PD). To examine the heterogenous influence of verticality perception, we also identified the characteristics distinguishing between PD patients with PS who tilted toward the deviation of perceived verticality and those who did not. Subjective visual vertical (SVV) testing was performed in 54 PD patients with PS and 36 without PS to measure verticality perception. Other potential risk factors for PS were evaluated by assessing the asymmetry of motor symptoms, EMG activities of paraspinal muscles, bithermal caloric tests, back pain history, and Berg Balance Scale. Abnormal SVV (odds ratio (OR) 18.40, p = 0.006), postural imbalance (OR 0.71, p = 0.046), and unilateral EMG hyperactivity of paraspinal muscles (OR 39.62, p = 0.027) were independent contributors to PS. In subgroup analysis, EMG hyperactivity of paraspinal muscles contralateral to the leaning side and postural imbalance were associated with PD patients with PS who tilted toward the SVV deviation, whereas back pain was more frequent in those who did not. Verticality misperception is a potent risk factor for PS in PD and contributes differentially to PS depending on the congruence between its direction and PS direction, indicating distinct pathogenic roles.

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Section: Discussionmentioning

confidence: 98%

Pisa Syndrome in Parkinson’s Disease: Pathogenic Roles of Verticality Perception Deficits

Huh

Kim

Chung

et al. 2018

Sci Rep

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“…Patients with camptocormia are usually older, have a long disease duration, and a higher degree of severity [3] , and experience problems with sleep, hallucination, and moods [7,11] , and present with frontal executive dysfunction [20] and lower mini-mental status examination (MMSE) scores [7] . The MMSE score in the study population was >28, but the executive function was not examined.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Mild Camptocormia with Selegiline in Patients with Parkinson's Disease

Yoritaka

Mori

2016

Eur Neurol

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Background: Camptocormia in Parkinson's disease (PD) is unresponsive to various therapies and induced difficulties in their day-to-day life. Objective: This study, an open trial, was aimed at assessing the efficacy of selegiline in the treatment of mild camptocormia in PD patients. Methods: Participants were administered 5 mg of selegiline for the first 8 weeks and 7.5 mg for the second 8 weeks. Results: As primary endpoints, the degree of thoracolumbar anteflexion decreased from 23.2° (mean) (11.8° (SD)) at baseline to 18.3° (7.1°) at 16 weeks, and the area of postural sway measured using a Gravicorder increased. However, the differences were not significant. Thoracolumbar anteflexion improved in 60% of the participants. Conclusions: In this study, 60% of the participants showed an improvement in anteflexion of the thoracolumbar spine with selegiline, but the change in the degree of anteflexion was 5°, which was not statistically significant. Participants with significant improvement in thoracolumbar anteflexion had an increased postural sway. This change was induced by a decrease in truncal muscle tonus or change in the center of gravity. This study combined the study of anteflexion and stability, and provides information on the treatment of short-term or mild camptocormia.

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“…Appropriate perception of one’s own posture is reportedly difficult in PD patients who have developed postural deformity [ 4 , 5 ]. Recently there have been reported the issue that the onset of postural deformities in PD patients might be related to frontal lobe dysfunction as Behavioral Assessment of the Dysexecutive Syndrome score was significantly lower in PD patients with severe postural deformities than without it [ 6 ]. On the basis of these reports, factors other than extrapyramidal disorder are conjectured to be involved in the mechanism of onset for postural deformities.…”

Section: Introductionmentioning

confidence: 99%

Forward flexion of trunk in Parkinson's disease patients is affected by subjective vertical position

et al. 2017

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PurposeNo method has been established to evaluate the dissociation between subjective and objective vertical positions with respect to the self-awareness of postural deformity in patients with Parkinson’s disease (PD). The purpose of this study was to demonstrate, from the relationship between an assessment of the dissociation of subjective and objective vertical positions of PD patients and an assessment based on established PD clinical evaluation scales, that the dissociation regarding vertical position is a factor in the severity of the forward flexion of trunk (FFT).MethodsSubjects were 39 PD patients and 15 age-matched healthy individuals (control group). Posture was evaluated with measurement of FFT angle during static standing and the subjective vertical position (SV) of the patient. For evaluation of motor function, the Modified Hoehn & Yahr scale, Unified Parkinson’s Disease Rating Scale (UPDRS), 3-m Timed Up and Go Test (TUG), and Functional Reach Test (FRT) were used.ResultsIn PD patients, FFT angle in the 3rd tertile of patients was 13.8±9.7°, significantly greater than those in the control group and the 1st and 2nd tertiles of PD patients (control group vs 3rd tertile, p = 0.008; 1st tertile vs 3rd tertile, p<0.001; 2nd vs 3rd tertile, p = 0.008). In multiple regression analysis for factors in the FFT angle, significant factors were SV, disease duration, and the standard deviation of each SV angle measurement.ConclusionThe dissociation between SV and objective vertical position affects the FFT of PD patients, suggesting an involvement of non-basal ganglia pathologies.

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Relationship between Postural Deformities and Frontal Function in Parkinson’s Disease

Cited by 6 publications

References 35 publications

Pisa Syndrome in Parkinson’s Disease: Pathogenic Roles of Verticality Perception Deficits

Pisa Syndrome in Parkinson’s Disease: Pathogenic Roles of Verticality Perception Deficits

Treatment of Mild Camptocormia with Selegiline in Patients with Parkinson's Disease

Forward flexion of trunk in Parkinson's disease patients is affected by subjective vertical position

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