Objective: To evaluate the overall prevalence of postural abnormalities (PA) in patients with Parkinson’s disease (PD) and to assess their association with demographic and clinical variables.

Background: In PD the overall frequency of PA is unknown. Previous studies have investigated the prevalence of each isolated PA reporting variable results [1,2,3].

Method: We performed a multicenter cross-sectional study enrolling consecutive PD outpatients attending 7 tertiary Italian centers. Patients underwent evaluations and were compared according to the presence of isolated PA including camptocormia (CC), Pisa syndrome (PS) and anterocollis (AC) and of combined forms (i.e CC+PS, CC+AC, etc.) for several demographic and clinical variables.

Results: Among 811 PD patients enrolled, PA were detected in 174 patients (21.5%, 95% CI 18.6%-24.3%). Isolated PA were 144 whilst the combined were 30. The prevalence of CC was 11.2% (95% CI 9%-13.3%), of PS was 8% (CI 6.2%-9.9%) and of AC was 6.5% (CI 4.9%-8.3%). PA patients were more frequent male, older, with longer disease duration, had a more advanced disease stage, more severe PD symptoms, bradykinetic/rigid phenotype, and poorer quality of life. They were initially treated with L-dopa, took higher daily L-dopa equivalent daily dose, and had more comorbidities. Falls and back pain were more frequent in PD with PA than in PD without PA. Multiple logistic regression models confirmed a association of PA with male gender, Hoehn & Yahr stage, and total score of UPDRS. Combined PA were associated with a more advanced PD stage and severity of symptoms than isolated PA.

Conclusion: PA are frequent and disabling complications in PD. Early detection and treatment of PA may prevent the development of fixed and irreversible deformities.

References: [1] Doherty KM, van de Warrenburg BP, Peralta MC, et al. Postural deformities in Parkinson’s disease. Lancet Neurol 2011;10:538-549; [2] Srivanitchapoom P, Hallett M. Camptocormia in Parkinson’s disease: definition, epidemiology, pathogenesis and treatment modalities. J Neurol Neurosurg Psychiatry 2016; 87:75-85; [3] Tinazzi M, Fasano A, Geroin C, et al. Italian Pisa Syndrome Study Group. Pisa syndrome in Parkinson disease: An observational multicenter Italian study. Neurology 2015;85:1769-79.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/postural-abnormalities-in-parkinsons-disease-an-epidemiological-and-clinical-multicenter-study/