Parkinson’s disease with camptocormia
Frédéric Bloch,J. L. Houeto,S. Tezenas du Montcel,Fabrice Bonneville,Fabien Etchepare,M.-L. Welter,Sophie Rivaud-Péchoux,Valérie Hahn-Barma,Thierry Maisonobe,C. Béhar,J. Y. Lazennec,Ewa Kurys,Isabelle Arnulf,Anne-Marie Bonnet,Yves Agid +14 more
TLDR
Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm, and it is suggested that the salient features of parkinsonism observed in patients with camps are likely to represent a specific form of Parkinson’s disease.Abstract:
Background: Camptocormia is defined as an abnormal flexion of the trunk that appears when standing or walking and disappears in the supine position. The origin of the disorder is unknown, but it is usually attributed either to a primary or a secondary paravertebral muscle myopathy or a motor neurone disorder. Camptocormia is also observed in a minority of patients with parkinsonism. Objective: To characterise the clinical and electrophysiological features of camptocormia and parkinsonian symptoms in patients with Parkinson’s disease and camptocormia compared with patients with Parkinson’s disease without camptocormia. Methods: Patients with parkinsonism and camptocormia (excluding patients with multiple system atrophy) prospectively underwent a multidisciplinary clinical (neurological, neuropsychological, psychological, rheumatological) and neurophysiological (electromyogram, ocular movement recording) examination and were compared with age-matched patients with Parkinson’s disease without camptocormia. Results: The camptocormia developed after 8.5 (SD 5.3) years of parkinsonism, responded poorly to levodopa treatment (20%) and displayed features consistent with axial dystonia. Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm. Conclusion: We suggest that (1) the salient features of parkinsonism observed in patients with camptocormia are likely to represent a specific form of Parkinson’s disease and camptocormia is an axial dystonia and (2) both camptocormia and parkinsonism in these patients might result from additional, non-dopaminergic neuronal dysfunction in the basal ganglia.read more
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Parkinson’s disease: clinical features and diagnosis
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TL;DR: Improved understanding of the mechanisms underlying postural deformities in PD might ultimately lead to more effective management strategies for these disabling and drug-refractory complications.
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TL;DR: This MDS‐commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess features in Parkinson's disease.
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Samuel D. Kim,Samuel D. Kim,Natalie E. Allen,Colleen G. Canning,Victor S.C. Fung,Victor S.C. Fung +5 more
TL;DR: This paper showed that physical therapy, especially highly challenging balance exercises, can improve postural stability and reduce the risk of falls, although the long-term effects of physical therapy interventions on postural instability need to be explored given the progressive nature of PD.
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