June 2011
Doherty KM, van de Warrenburg BP, Peralta MC,
Silveira-Moriyama L, Azulay JP, Gershanik OS, Bloem BR
Postural deformities are frequent and disabling complications of
Parkinson's disease (PD) and atypical parkinsonism. These deformities
include camptocormia, antecollis, Pisa syndrome, and scoliosis.
Recognition of specific postural syndromes might have differential
diagnostic value in patients presenting with parkinsonism.
The evidence
to date suggests that postural deformities have a multifactorial
pathophysiology. Contributing factors include muscular rigidity; axial
dystonia; weakness caused by myopathy; body scheme defects due to
centrally impaired proprioception; and structural changes in the spine.
The relative contribution of these different factors varies between
patients and across specific syndromes.
Improved understanding of the
mechanisms underlying postural deformities in PD might ultimately lead
us to more effective management strategies for these disabling and
drug-refractory complications.
