Tinazzi Michele, Gandolfi Marialuisa, Ceravolo Roberto, Capecci Marianna, Andrenelli Elisa, Ceravolo Maria Gabriella, Bonanni Laura, Onofrj Marco, Vitale Michela, Catalan Mauro, Polverino Paola, Bertolotti Claudio, Mazzucchi Sonia, Giannoni Sara, Smania Nicola, Tamburin Stefano, Vacca Laura, Stocchi Fabrizio, Radicati Fabiana G, Artusi Carlo Alberto, Zibetti Maurizio, Lopiano Leonardo, Fasano Alfonso, Geroin Christian
Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy.
Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy.
Mov Disord Clin Pract. 2019 Jun 29;6(7):576-585. doi: 10.1002/mdc3.12810. eCollection 2019 Sep.
The overall frequency of postural abnormalities (PA) in Parkinson's disease (PD) is unknown. We evaluated the overall prevalence of PA and assessed the association with demographic and clinical variables.
For this multicenter, cross-sectional study, consecutive PD outpatients attending 7 tertiary Italian centers were enrolled. Patients were evaluated and compared for the presence of isolated PA such as camptocormia, Pisa syndrome, and anterocollis and for combined forms (ie, camptocormia + Pisa syndrome) together with demographic and clinical variables.
Of the total 811 PD patients enrolled, 174 (21.5%; 95% confidence interval [CI], 18.6%-24.3%) presented PA, 144 of which had isolated PA and 30 had combined PA. The prevalence of camptocormia was 11.2% (95% CI, 9%-13.3%), Pisa syndrome 8% (95% CI, 6.2%-9.9%), and anterocollis 6.5% (95% CI, 4.9%-8.3%). Patients with PA were more often male and older with longer disease duration, more advanced disease stage, more severe PD symptoms, a bradykinetic/rigid phenotype, and poorer quality of life. They were initially treated with l, and more likely to be treated with a combination of l and dopamine agonist, took a higher daily l equivalent daily dose, and had more comorbidities. Falls and back pain were more frequent in PD patients with PA than in those without PA. Multiple logistic regression models confirmed an association between PA and male gender, older age, Hoehn and Yahr stage, and total Unified Parkinson's Disease Rating Scale score.
PA are frequent and disabling complications in PD, especially in the advanced disease stages.
帕金森病（PD）中姿势异常（PA）的总体发生率尚不清楚。我们评估了PA的总体患病率，并评估了其与人口统计学和临床变量的关联。
在这项多中心横断面研究中，纳入了意大利7个三级医疗中心的连续PD门诊患者。对患者进行评估并比较孤立性PA（如弯腰驼背、比萨综合征和前斜颈）以及联合形式（即弯腰驼背 + 比萨综合征）的存在情况，同时比较人口统计学和临床变量。
在总共纳入的811例PD患者中，174例（21.5%；95%置信区间[CI]，18.6%-24.3%）出现PA，其中144例为孤立性PA，30例为联合性PA。弯腰驼背的患病率为11.2%（95%CI，9%-13.3%），比萨综合征为8%（95%CI，6.2%-9.9%），前斜颈为6.5%（95%CI，4.9%-8.3%）。有PA的患者男性更多、年龄更大、病程更长、疾病分期更晚、PD症状更严重、为运动迟缓/僵硬型表型且生活质量更差。他们最初接受左旋多巴治疗，更有可能接受左旋多巴和多巴胺激动剂联合治疗，每日左旋多巴等效日剂量更高，且合并症更多。有PA的PD患者比无PA的患者跌倒和背痛更频繁。多元逻辑回归模型证实PA与男性性别、年龄较大、Hoehn和Yahr分期以及帕金森病统一评分量表总分之间存在关联。
PA是PD中常见且致残的并发症，尤其是在疾病晚期。
