Castrioto Anna, Piscicelli Céline, Pérennou Dominic, Krack Paul, Debû Bettina
Grenoble University Hospital, Psychiatry and Neurology Dept., Grenoble, France; Grenoble Institute of Neuroscience, INSERM-UJF-CEA U836, Grenoble, France.
Mov Disord. 2014 Aug;29(9):1100-7. doi: 10.1002/mds.25925. Epub 2014 Jun 7.
Postural abnormalities such as postural deviations affect nearly all patients with advanced Parkinson's disease and represent an important source of disability. Although their existence has long been known, their management remains a challenge as they respond poorly to medication, brain surgery, or physiotherapy. Improving management strategies will require better understanding of the mechanisms underlying such postural deformities. In this review on the pathophysiology of Pisa syndrome, we examine the data supporting the central and peripheral hypotheses that attempt to explain these lateral trunk deviations. Although the pathophysiology is very probably multifactorial, the bulk of the data supports central, rather than peripheral, hypotheses. The central hypotheses that are best supported by both animal studies and clinical data include asymmetry of basal ganglia output and abnormalities in the central integration of sensory information. Further studies are needed to elucidate the pathophysiology underlying Pisa syndrome.
姿势异常，如姿势偏差，几乎影响所有晚期帕金森病患者，是残疾的一个重要来源。尽管其存在早已为人所知，但由于它们对药物治疗、脑部手术或物理治疗反应不佳，其管理仍然是一项挑战。改善管理策略需要更好地理解这些姿势畸形背后的机制。在这篇关于比萨综合征病理生理学的综述中，我们研究了支持试图解释这些躯干侧偏的中枢和外周假说的数据。尽管病理生理学很可能是多因素的，但大量数据支持中枢而非外周假说。动物研究和临床数据最支持的中枢假说包括基底神经节输出不对称和感觉信息中枢整合异常。需要进一步研究以阐明比萨综合征背后的病理生理学。
