Trenkwalder C, Paulus W, Krafczyk S, Hawken M, Oertel W H, Brandt T
Department of Neurology, Ludwig-Maximilians-University of Munich, Germany.
Acta Neurol Scand. 1995 Jun;91(6):444-52.
Patients with an akinetic Parkinson syndrome of the lower extremities and a poor response to L-DOPA have been described as "lower body Parkinsonism" (LBP). These patients are characterized by frequent fallings and poor balance.
We have studied body sway with static (force platform) and dynamic (Equitest) posturography in 11 LBP patients, 6 of them revealing deep white matter lesions on MRI and 10 patients with advanced Parkinson's disease (PD) and compared performance with 30 age-matched controls.
When standing on a fixed support the postural performance of both patient groups lay within the normal range. The balance of LBP patients worsened in the static testing in the conditions "eyes open on foam" (p < 0.05) and "eyes closed on foam" (p < 0.0006, of 11 patients falling), whereas the balance of PD patients deteriorated only with "eyes closed on foam" (p < 0.05). Dynamic posturography confirmed these results in 6 different sensory conditions, clearly distinguishing the more unstable LBP patients from PD patients during "standing, eyes closed, foot support sway referenced" (p < 0.005).
We conclude, that postural adjustments in LBP patients are more disturbed than those in PD patients and posturography can be an additional tool for the differential diagnosis of Parkinson syndromes with gait disorders.
下肢运动不能性帕金森综合征且对左旋多巴反应不佳的患者被描述为“下体帕金森症”（LBP）。这些患者的特征是频繁跌倒和平衡能力差。
我们使用静态（力平台）和动态（Equitest）姿势描记法研究了11例LBP患者的身体摆动情况，其中6例在MRI上显示深部白质病变，10例为晚期帕金森病（PD）患者，并将其表现与30名年龄匹配的对照组进行了比较。
当站在固定支撑物上时，两组患者的姿势表现均在正常范围内。LBP患者在“睁眼站在泡沫上”（p < 0.05）和“闭眼站在泡沫上”（11例患者中有跌倒情况，p < 0.0006）的静态测试中平衡能力恶化，而PD患者仅在“闭眼站在泡沫上”时平衡能力下降（p < 0.05）。动态姿势描记法在6种不同的感觉条件下证实了这些结果，在“站立，闭眼，足部支撑摆动参考”时清楚地将更不稳定的LBP患者与PD患者区分开来（p < 0.005）。
我们得出结论，LBP患者的姿势调整比PD患者更受干扰，姿势描记法可以作为鉴别伴有步态障碍的帕金森综合征的一种辅助工具。
