Tinazzi Michele, Geroin Christian, Gandolfi Marialuisa, Smania Nicola, Tamburin Stefano, Morgante Francesca, Fasano Alfonso
Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Mov Disord. 2016 Dec;31(12):1785-1795. doi: 10.1002/mds.26829. Epub 2016 Oct 25.
Pisa syndrome was first described in 1972 in patients treated with neuroleptics. Since 2003, when it was first reported in patients with Parkinson's disease (PD), Pisa syndrome has progressively drawn the attention of clinicians and researchers. Although emerging evidence has partially clarified its prevalence and pathophysiology, the current debate revolves around diagnostic criteria and assessment and the effectiveness of pharmacological, surgical, and rehabilitative approaches. Contrary to initial thought, Pisa syndrome is common among PD patients, with an estimated prevalence of 8.8% according to a large survey. Furthermore, it is associated with the following specific patient features: more severe motor phenotype, ongoing combined pharmacological treatment with levodopa and dopamine agonists, gait disorders, and such comorbidities as osteoporosis and arthrosis. The present literature on treatment outcomes is scant, and the uneven effectiveness of specific treatments has produced conflicting results. This might be because of the limited knowledge of Pisa syndrome pathophysiology and its variable clinical presentation, which further complicates designing randomized clinical trials on this condition. However, because some forms of Pisa syndrome are potentially reversible, there is growing consensus on the importance of its early recognition and the importance of pharmacological adjustment and rehabilitation. © 2016 International Parkinson and Movement Disorder Society.
Pisa综合征于1972年首次在接受抗精神病药物治疗的患者中被描述。自2003年首次在帕金森病（PD）患者中报道以来，Pisa综合征逐渐引起了临床医生和研究人员的关注。尽管新出现的证据部分阐明了其患病率和病理生理学，但目前的争论集中在诊断标准、评估以及药物、手术和康复方法的有效性上。与最初的想法相反，Pisa综合征在PD患者中很常见，根据一项大型调查，估计患病率为8.8%。此外，它与以下特定患者特征相关：更严重的运动表型、正在使用左旋多巴和多巴胺激动剂联合进行药物治疗、步态障碍以及骨质疏松症和关节炎等合并症。目前关于治疗结果的文献很少，特定治疗方法效果参差不齐产生了相互矛盾的结果。这可能是因为对Pisa综合征病理生理学的了解有限及其临床表现多变，这使得针对这种情况设计随机临床试验更加复杂。然而，由于某些形式的Pisa综合征可能是可逆的，对于早期识别以及药物调整和康复的重要性，人们的共识越来越高。© 2016国际帕金森病和运动障碍协会。
