Objective: We hypothesized that the trunk muscles might have an impact on Pisa syndrome, so we performed a sonographic investigation of the trunk muscles of PD patients with Pisa syndrome.

Background: Pisa syndrome is a medical condition characterized by lateral flexion of the spine, which is noticeable in the seated or standing positions, but which disappears in the supine position. Pisa syndrome is often recognized in patients with Parkinson’s disease (PD), and its pathophysiology is unclear.

Methods: The participants comprised patients with PD (3 males and 10 females; mean age 73.3 years; Hoehn & Yahr stageII3, III7, IV3; lateral flexion right 7, left 6) who had been treated with antiparkinson drugs at our hospital. Patients with spinal disease and other neurological diseases were excluded. We compared the thickness of the trunk muscles of the bending side with that of the unbending side using sonographic images of the transversus abdominis (TrA), internal oblique (IO), external oblique (EO), rectus abdominis (RA), and lumbar multifidus (LM) muscles. We also compared the thickness of the trunk muscles of PD with Pisa syndrome with that of control group of PD patients without trunk bending.

Results: The results showed that there was a significant difference between the EO thickness of the bending side (mean±SD: 3.71 ± 0.51 mm) and that of the unbending side (5.31 ± 0.51 mm) (p = 0.032). EO thickness of the bending side was significantly thinner than EO thickness of control group.

Conclusions: Our results revealed an asymmetry of the EO thickness in PD patients with Pisa syndrome; this asymmetry may be a cause of the postural abnormalities.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sonographic-investigation-of-pisa-syndrome-in-parkinsons-disease/