Parkinson’s disease with camptocormia
01 Nov 2006-Journal of Neurology, Neurosurgery, and Psychiatry (J Neurol Neurosurg Psychiatry)-Vol. 77, Iss: 11, pp 1223-1228
TL;DR: 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.
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TL;DR: Camptocormia is organic in the vast majority of the cases due to neurological disease, or rarely drugs, trauma, orthopedic abnormalities or idiopathic, or due to some rare conditions.
Abstract: Purpose. To identify and highlight the variable causes of camptocormia.Method. Literature review.Results. Camptocormia (bent spine syndrome) is an acquired postural disease characterised by forward flexion of the thoraco-lumbar spine. Camptocormia leads to lumbar kyphosis and increases during walking or standing and completely disappears in supine position. Camptocormia is multicausal due to central or peripheral nervous system disease, idiopathic or due to some rare conditions. Camptocormia is most frequently associated with Parkinson's disease. Other causes include dystonia, multisystem atrophy, Alzheimer's disease, myopathy, motor neuron disease, myasthenia or chronic inflammatory demyelinating polyneuropathy. Rare causes include adverse reactions of drugs, disc herniation, arthritis, spinal trauma, paraneoplastic disorder, or psychiatric disease (more rarely than previously thought). Camptocormia is diagnosed upon clinical investigations, imaging of the cerebrum or spine, electromyography or muscle bi...
12 citations
Cites background from "Parkinson’s disease with camptocorm..."
...Since it is frequently associated with Parkinson’s disease [1] or dystonias [3], it may be classified as axial dystonia or selective form of Parkinson’s disease....
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...Camptocormia, also known as bent spine syndrome or kyphose hysterique and first described in World War I soldiers traumatised by shell shocks by the French neurologists Souques and Rosanoff-Saloff in 1915, is an acquired postural disease with forwardflexed posture, leading to lumbar kyphosis observed and increased when the patient stands up or walks [1,2]....
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...In the latter case camptocormia may be attributed to additional, non-dopaminergic neuronal dysfunction in the basal ganglia or the brainstem [1]....
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...In quite a number of cases camptocormia is associated with lower back pain [1] and there may be concomitant weakness of the gluteal muscles and hip or knee flexion [1]....
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...PNS disorders associated with camptocormia include myopathic disorders such as myotonic dystrophy type 1 and type 2, axial myopathy, dysferlinopathy [5], nemaline myopathy, hypothyroid myopathy, inflammatory myopathy, dermatomyositis, polymyositis, inclusion body myositis [1] or myasthenia gravis....
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TL;DR: The CSA of paraspinal muscles and erector spinae width can be good predictive markers for improving camptocormia in patients with PD after deep brain stimulation.
Abstract: Background Camptocormia, a disturbance of posture, is a well-described clinical feature of PD and other parkinsonian syndromes. Previous reports have shown that DBS of the subthalamic nucleus (STN) or globus pallidus internus is effective in treating camptocormia. However, the efficacy of DBS for camptocormia varies. Objective To determine a clinical marker for selecting an appropriate therapy for camptocormia, a disabling manifestation of Parkinson's disease (PD) that has a variable response to systemic and local therapies. Methods We obtained pre-operative lumbar magnetic resonance imaging of 14 consecutive PD patients with camptocormia who underwent subthalamic nucleus deep brain stimulation (STN-DBS) in this retrospective-designed study. Lumbar MRI was performed three to six months prior to the operation. We measured the cross-sectional area (CSA) and width of each participant's paraspinal muscles. Results Four (28.6%) patients were effective (EF), five (35.7%) were partially effective (PE), and five (35.7%) were non-effective (NE) to STN-DBS. The lumbar paraspinal CSA and width were significantly larger in the EF group than in the PE and NE groups. Conclusions The CSA of paraspinal muscles and erector spinae width can be good predictive markers for improving camptocormia in patients with PD after deep brain stimulation.
12 citations
TL;DR: Tagus to walldistance, C7 to wall distance, and inclinometric kyphosis measure are reliable and valid nonradiologic measures of forward flexed posture in individuals with Parkinson disease.
12 citations
TL;DR: Given the overlap between Parkinson's disease and essential tremor, genetic variants in α‐synuclein (SNCA) are examined as risk determinants for essential tre tremor.
Abstract: Background:
Given the overlap between Parkinson's disease and essential tremor, we examined genetic variants in α-synuclein (SNCA) as risk determinants for essential tremor.
Methods:
Samples from 661 essential tremor subjects and 1316 control subjects from 4 participating North American sites were included in this study. Parkinson's disease samples (n = 427) were compared against controls. Twenty variants were selected for association analysis within the SNCA locus. Individual logistic regression analyses against essential tremor diagnosis were run for each variant and then combined using meta-analysis.
Results:
Our results do not show a significant association between variants in the SNCA locus and risk of essential tremor, whereas the established association of SNCA variants with Parkinson's disease risk was observed.
Conclusions:
Whereas genetic factors are likely to play a large role in essential tremor pathogenesis, our results do not support a role for common SNCA genetic variants in risk for essential tremor. © 2011 Movement Disorder Society
12 citations
TL;DR: Male patients and those with sexual dysfunction or disorientation are likely to present with camptocormia in the future, and this study suggests that this condition may emerge as PD progresses.
12 citations
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76,181 citations
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TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
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70,887 citations
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TL;DR: The Mini-International Neuropsychiatric Interview is designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings.
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TL;DR: Controversy over the effectiveness of therapeutic measures for parkinsonism is due partially to this wide variability and to the paucity of clinical information about the natural history of the syndrome.
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